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Rotz SJ, Bhatt NS, Hamilton BK, Duncan C, Aljurf M, Atsuta Y, Beebe K, Buchbinder D, Burkhard P, Carpenter PA, Chaudhri N, Elemuary M, Elsawy M, Guilcher GM, Hamad N, Karduss A, Peric Z, Purtill D, Rizzo D, Rodrigues M, Ostriz MBR, Salooja N, Schoemans H, Seber A, Sharma A, Srivastava A, Stewart SK, Baker KS, Majhail NS, Phelan R. International Recommendations for Screening and Preventative Practices for Long-Term Survivors of Transplantation and Cellular Therapy: A 2023 Update. Transplant Cell Ther 2024; 30:349-385. [PMID: 38413247 DOI: 10.1016/j.jtct.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 02/29/2024]
Abstract
As hematopoietic cell transplantation (HCT) and cellular therapy expand to new indications and international access improves, the number of HCTs performed annually continues to rise. Parallel improvements in HCT techniques and supportive care entails more patients surviving long term, creating further emphasis on survivorship needs. Survivors are at risk for developing late complications secondary to pretransplantation, peritransplantation, and post-transplantation exposures and other underlying risk factors. Guidelines for screening and preventive practices for HCT survivors were originally published in 2006 and then updated in 2012. An international group of experts was convened to review the contemporary literature and update the recommendations while considering the changing practices of HCT and cellular therapy. This review provides updated pediatric and adult survivorship guidelines for HCT and cellular therapy. The contributory role of chronic graft-versus-host disease (cGVHD) to the development of late effects is discussed, but cGVHD management is not covered in detail. These guidelines emphasize the special needs of patients with distinct underlying HCT indications or comorbidities (eg, hemoglobinopathies, older adults) but do not replace more detailed group-, disease-, or condition-specific guidelines. Although these recommendations should be applicable to the vast majority of HCT recipients, resource constraints may limit their implementation in some settings.
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Affiliation(s)
- Seth J Rotz
- Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Pediatric Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
| | - Neel S Bhatt
- Fred Hutchinson Cancer Center, Seattle, Washington
| | - Betty K Hamilton
- Blood and Marrow Transplant Program, Department of Hematology and Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Christine Duncan
- Dana Farber/Boston Children's Cancer and Blood Disorders Center, Harvard University, Boston, Massachusetts
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Yoshiko Atsuta
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
| | - Kristen Beebe
- Phoenix Children's Hospital and Mayo Clinic Arizona, Phoenix, Arizona
| | - David Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, California
| | | | | | - Naeem Chaudhri
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed Elemuary
- Hematology and BMT, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mahmoud Elsawy
- Division of Hematology, Dalhousie University, QEII Health Sciences Center, Halifax, Nova Scotia, Canada
| | - Gregory Mt Guilcher
- Section of Pediatric Oncology/Transplant and Cellular Therapy, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital Sydney, St Vincent's Clinical School Sydney, University of New South Wales, School of Medicine Sydney, University of Notre Dame Australia, Australia
| | - Amado Karduss
- Bone Marrow Transplant Program, Clinica las Americas, Medellin, Colombia
| | - Zinaida Peric
- BMT Unit, Department of Hematology, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Duncan Purtill
- Fiona Stanley Hospital, Murdoch, PathWest Laboratory Medicine WA, Australia
| | - Douglas Rizzo
- Medical College of Wisconsin, Milwaukee, Wisconsin; Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Maria Belén Rosales Ostriz
- Division of hematology and bone marrow transplantation, Instituto de trasplante y alta complejidad (ITAC), Buenos Aires, Argentina
| | - Nina Salooja
- Centre for Haematology, Imperial College London, London, United Kingdom
| | - Helene Schoemans
- Department of Hematology, University Hospitals Leuven, Department of Public Health and Primary Care, ACCENT VV, KU Leuven, University of Leuven, Leuven, Belgium
| | | | - Akshay Sharma
- Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Alok Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | | | | | - Navneet S Majhail
- Sarah Cannon Transplant and Cellular Therapy Network, Nashville, Tennessee
| | - Rachel Phelan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
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Incesu RB, Barletta F, Tappero S, Piccinelli ML, Garcia CC, Morra S, Scheipner L, Tian Z, Saad F, Shariat SF, Ahyai S, Longo N, Chun FKH, de Cobelli O, Terrone C, Briganti A, Tilki D, Graefen M, Karakiewicz PI. Survival differences in non-seminoma testis cancer patients according to race/ethnicity. Cancer Epidemiol 2024; 89:102538. [PMID: 38377946 DOI: 10.1016/j.canep.2024.102538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/13/2024] [Accepted: 01/21/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Historic evidence suggests that non-Caucasian race/ethnicity predisposes to higher testis cancer-specific mortality (CSM) in non-seminoma. However, it is unknown, whether higher CSM in non-Caucasians applies to Hispanics or Asians or African-Americans, or all of the above groups. In contemporary patients, we tested whether CSM is higher in these select non-Caucasian groups than in Caucasians, in overall and in stage-specific comparisons: stage I vs. stage II vs. stage III. METHODS The Surveillance, Epidemiology, and End Results (SEER) database (2004 -2019) was used. Kaplan-Meier plots and multivariable Cox regression models tested the effect of race/ethnicity on CSM after stratification for stage (I vs. II vs. III) and adjustment for prognosis groups in stage III. RESULTS In all 13,515 non-seminoma patients, CSM in non-Caucasians was invariably higher than in Caucasians. In stage-specific analyses, race/ethnicity represented an independent predictor of CSM in Hispanics in stage I (HR 1.8, p = 0.004), stage II (HR 2.2, p = 0.007) and stage III (HR 1.4, p < 0.001); in African-Americans in stage I (HR 3.2; p = 0.007) and stage III (HR 1.5; p = 0.042); and in Asians in only stage III (HR 1.6, p = 0.01). CONCLUSIONS In general, CSM is higher in non-Caucasian non-seminoma patients. However, the CSM increase differs according to non-Caucasian race/ethnicity groups. Specifically, higher CSM applies to all stages of non-seminoma in Hispanics, to stages I and III in African-Americans and only to stage III in Asians. These differences are important for individual patient management, as well as for design of prospective trials.
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Affiliation(s)
- Reha-Baris Incesu
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
| | - Francesco Barletta
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Stefano Tappero
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Martino, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Mattia Luca Piccinelli
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy
| | - Cristina Cano Garcia
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Simone Morra
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Lukas Scheipner
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy
| | - Carlo Terrone
- Department of Urology, IRCCS Policlinico San Martino, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Abrahim O, Premkumar A, Kubi B, Wolfe SB, Paneitz DC, Singh R, Thomas J, Michel E, Osho AA. Does Failure to Rescue Drive Race/Ethnicity-based Disparities in Survival After Heart Transplantation? Ann Surg 2024; 279:361-365. [PMID: 37144385 DOI: 10.1097/sla.0000000000005890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE The objective was to assess whether race/ethnicity is an independent predictor of failure to rescue (FTR) after orthotopic heart transplantation (OHT). SUMMARY BACKGROUND DATA Outcomes following OHT vary by patient level factors; for example, non-White patients have worse outcomes than White patients after OHT. Failure to rescue is an important factor associated with cardiac surgery outcomes, but its relationship to demographic factors is unknown. METHODS Using the United Network for Organ Sharing database, we included all adult patients who underwent primary isolated OHT between 1/1/2006 snd 6/30/2021. FTR was defined as the inability to prevent mortality after at least one of the UNOS-designated postoperative complications. Donor, recipient, and transplant characteristics, including complications and FTR, were compared across race/ethnicity. Logistic regression models were created to identify factors associated with complications and FTR. Kaplan Meier and adjusted Cox proportional hazards models evaluated the association between race/ethnicity and posttransplant survival. RESULTS There were 33,244 adult, isolated heart transplant recipients included: the distribution of race/ethnicity was 66% (n=21,937) White, 21.2% (7,062) Black, 8.3% (2,768) Hispanic, and 3.3% (1,096) Asian. The frequency of complications and FTR differed significantly by race/ethnicity. After adjustment, Hispanic recipients were more likely to experience FTR than White recipients (OR 1.327, 95% CI[1.075-1.639], P =0.02). Black recipients had lower 5-year survival compared with other races/ethnicities (HR 1.276, 95% CI[1.207-1.348], P <0.0001). CONCLUSIONS In the US, Black recipients have an increased risk of mortality after OHT compared with White recipients, without associated differences in FTR. In contrast, Hispanic recipients have an increased likelihood of FTR, but no significant mortality difference compared with White recipients. These findings highlight the need for tailored approaches to addressing race/ethnicity-based health inequities in the practice of heart transplantation.
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Affiliation(s)
- Orit Abrahim
- Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
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Pinto NP, Scholefield BR, Topjian AA. Pediatric cardiac arrest: A review of recovery and survivorship. Resuscitation 2024; 194:110075. [PMID: 38097105 DOI: 10.1016/j.resuscitation.2023.110075] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Neethi P Pinto
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
| | | | - Alexis A Topjian
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
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Sawyer KN. Priorities for cardiac arrest survivorship science. Resuscitation 2024; 194:110065. [PMID: 38061575 DOI: 10.1016/j.resuscitation.2023.110065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023]
Affiliation(s)
- Kelly N Sawyer
- University of Pittsburgh School of Medicine, Department of Emergency Medicine, Iroquois Building, Suite 400A, 3600 Forbes Avenue, Pittsburgh, PA 15261, USA.
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6
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Ren L, Ren Y, Yang Y, Wang W, Xu T, Wang Y, Xu J, Maihemaiti A, Lan T, Li P, Zhou C, Wang P, Liu P. Clinical profiles in multiple myeloma patients with extreme survivals: a study from a National Medical Center in China. Hematology 2023; 28:2277503. [PMID: 38018564 DOI: 10.1080/16078454.2023.2277503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/25/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES The clinical outcomes of multiple myeloma (MM) patients are highly variable in the real-world setting. Some MM patients may have clinical endings that do not abide by the book. We aim to describe features of MM patients with extreme survivals in real-world practice. METHODS This retrospective study enrolled 941 patients consecutively visited a national medical center, China, between July 1995 and December 2021. Among patients, we identified two groups of MM patients with extreme survivals, 56 were in the long-term remission (LR) group with progression-free survival (PFS) ≥ 60 months, and 82 were in the rapid progression (RP) group with PFS ≤ 6 months. RESULTS CRAB features, of which hypercalcemia, renal insufficiency, and anemia were more common in the RP group, except for bone disease, with a comparable incidence at diagnosis in both groups (88.8 vs 85.7%, P = 0.52). High-risk cytogenetics was detected in 45.7% of patients in the RP group. Of note, 14.3% of MM patients in the LR group harbored del (17p). According to the Revised International Staging System (R-ISS), 9% of patients belonged to stage I in the RP group, and 19% of patients in the LR group were found in stage III. There were 8 (15.7%) patients in the LR group only achieved partial response (PR) as the best response. Median time to best response (TBR) for LR and RP group patients was 4.6 and 1.4 months, respectively. CONCLUSIONS The disparities in the survivals of MM patients indicated that some unexpected factors have influenced the outcomes in the real-world setting.
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Affiliation(s)
- Liang Ren
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yuhong Ren
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yang Yang
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Wenjing Wang
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Tianhong Xu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yawen Wang
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jiadai Xu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Aziguli Maihemaiti
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Tianwei Lan
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Panpan Li
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Chi Zhou
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Pu Wang
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Peng Liu
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
- Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
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Copur MS. Life After Colorectal Cancer: Survivorship the Road Less Traveled. Clin Colorectal Cancer 2023; 22:345-346. [PMID: 37925305 DOI: 10.1016/j.clcc.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/01/2023] [Indexed: 11/06/2023]
Affiliation(s)
- Mehmet Sitki Copur
- Mary Lanning Healthcare, Morrison Cancer Center, Hastings, NE; University of Nebraska Medical Center, Adjunct Faculty, Omaha, NE.
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Kunt N, Araz M, Yildirim MS, Findik S, Kocak MZ, Eryilmaz MK, Artac M. The Effect of RAS/BRAF Mutation Status on Prognosis and Relapse Pattern in Early Stage Colon Cancers. J Gastrointest Cancer 2023; 54:1316-1321. [PMID: 37191843 DOI: 10.1007/s12029-023-00943-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE It is known that the RAS and BRAF mutations are predictive for targeted therapies in treating metastatic colon cancer and negatively affect the prognosis of the disease. However, there are limited studies in early-stage colon cancer about the relationship of this mutational condition with the prognosis and relapse pattern of the disease. In this study, we evaluated the effects of mutational status on the clinical pattern of recurrence and survival in early-stage colon cancer in addition to classical risk factors. METHODS Patients with early-stage colon cancer at the first time of diagnosis and developing recurrence or metastasis on following up were included in this study. Patients were divided into two groups according to the at the time of relapse RAS/BRAF mutation status: mutant or non-mutant/wild types. Then, mutation analysis was performed again from the early-stage tissue of the patients if available. The relationship between early-stage mutation status and progression-free survival (PFS), overall survival (OS), and relapse pattern was analyzed. RESULTS The number of patients with mutant and non-mutations in the early stage was 39 and 40, respectively. Mutant and non-mutant patients with stage 3 disease were similar (69% and 70%, respectively). OS (47.27 months vs. 67.53 months; p = 0.02) and PFS (25.12 vs. 38.13 months; p = 0.049) were statistically significantly lower in mutant patients, respectively. Most patients had distant metastases on both sides at recurrence (61.5% vs. 62.5%, respectively). There was no significant difference between mutant and non-mutant patients regarding distant metastasis and local recurrence rates (p = 0.657). A discordance of 11.4% between early-stage and late-stage tissue mutation status. CONCLUSION The presence of mutation in early-stage colon cancer is associated with shorter OS and PFS. The mutational status did not have a significant effect on the recurrence pattern. Because of the discordance of early-stage and late-stage mutational status, it is recommended to perform mutation analysis from tissue at relapse.
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Affiliation(s)
- Nazli Kunt
- Department of Internal Medicine, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey.
| | - Murat Araz
- Department of Oncology, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey
| | - Mahmut Selman Yildirim
- Department of Medical Genetics, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey
| | - Siddika Findik
- Department of Pathology, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey
| | - Mehmet Zahid Kocak
- Department of Oncology, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey
| | - Melek Karakurt Eryilmaz
- Department of Oncology, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey
| | - Mehmet Artac
- Department of Oncology, Faculty of Medicine, Necmettin Erbakan University Meram, Saraykoy Akyokus Street 42080, Konya, Turkey
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Ilie G, MacDonald C, Richman H, Rendon R, Mason R, Nuyens A, Bailly G, Bell D, Patil N, Bowes D, Champion E, Wilke D, Massoeurs L, Hassan N, Rutledge RDH. Assessing the Efficacy of a 28-Day Comprehensive Online Prostate Cancer Patient Empowerment Program (PC-PEP) in Facilitating Engagement of Prostate Cancer Patients in Their Survivorship Care: A Qualitative Study. Curr Oncol 2023; 30:8633-8652. [PMID: 37754541 PMCID: PMC10528560 DOI: 10.3390/curroncol30090626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/28/2023] Open
Abstract
A 28-day Prostate Cancer-Patient Empowerment Program (PC-PEP) developed through patient engagement was successful at promoting mental and physical health. Thirty prostate cancer patients from Halifax, Canada participated in the 28-day PC-PEP intervention in early 2019. PC-PEP encompassed daily patient education and empowerment videos, prescribed physical activities (including pelvic floor exercises), a mostly plant-based diet, stress reduction techniques, intimacy education, social connection, and support. Quantitative exit surveys and semi-structured interviews (conducted in focus groups of ten) were used to assess perceived factors that facilitated or impeded adherence to the program. The program received high praise from the patients and was deemed extremely useful by the participating men, who rated it 9 out of 10. Patients expressed that the multifaceted, online, home-based nature of the program helped them adhere to it better than they would have had to a single or less comprehensive intervention. Feedback from the participants indicated that the program, when viewed as a whole, was perceived as greater than the sum of its individual parts. Furthermore, the program addressed various issues, including emotional vulnerability and distress, physical fitness, urinary incontinence, challenges in expressing emotions, perceived lack of control over healthcare decisions, emotional fragility, and hesitancy to discuss prostate cancer-related matters in social settings. Patients highly (9.6/10) endorsed integrating the program into the standard care regimen from the very beginning of diagnosis. However, challenges such as work commitments were noted. Patients' high endorsement of PC-PEP suggests that its implementation into the standard of care from day one of diagnosis may be warranted.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.M.); (H.R.); (A.N.); (L.M.); (N.H.)
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Cody MacDonald
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.M.); (H.R.); (A.N.); (L.M.); (N.H.)
| | - Hal Richman
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.M.); (H.R.); (A.N.); (L.M.); (N.H.)
| | - Ricardo Rendon
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ross Mason
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Alexandra Nuyens
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.M.); (H.R.); (A.N.); (L.M.); (N.H.)
| | - Greg Bailly
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Bell
- Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Nikhilesh Patil
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Bowes
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | | | - Derek Wilke
- Department of Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Lia Massoeurs
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.M.); (H.R.); (A.N.); (L.M.); (N.H.)
| | - Nada Hassan
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada; (C.M.); (H.R.); (A.N.); (L.M.); (N.H.)
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10
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Morrison-Jones V, West M. Post-Operative Care of the Cancer Patient: Emphasis on Functional Recovery, Rapid Rescue, and Survivorship. Curr Oncol 2023; 30:8575-8585. [PMID: 37754537 PMCID: PMC10527900 DOI: 10.3390/curroncol30090622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/16/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023] Open
Abstract
A cancer diagnosis and its subsequent treatments are life-changing events, impacting the patient and their family. Treatment options available for cancer care are developing at pace, with more patients now able to achieve a cancer cure. This is achieved through the development of novel cancer treatments, surgery, and modern imaging, but also as a result of better understanding treatment/surgical trauma, rescue after complications, perioperative care, and innovative interventions like pre-habilitation, enhanced recovery, and enhanced post-operative care. With more patients living with and beyond cancer, the role of survivorship and quality of life after cancer treatment is gaining importance. The impact cancer treatments can have on patients vary, and the "scars" treatments leave are not always visible. To adequately support patients through their cancer journeys, we need to look past the short-term interactions they have with medical professionals and encourage them to consider their lives after cancer, which often is not a reflection of life before a cancer diagnosis.
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Affiliation(s)
- Victoria Morrison-Jones
- Hepato-Biliary Surgery Unit, University Hospitals Southampton, Tremona Road, Southampton SO16 6YD, UK;
| | - Malcolm West
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Complex Cancer and Exenterative Service, University Hospitals Southampton, Tremona Road, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, Perioperative and Critical Care Theme, University Hospitals Southampton, Tremona Road, Southampton SO16 6YD, UK
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11
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Franco EL, Harper DM. Acting on past lessons and learning new ones. eLife 2023; 12:e91607. [PMID: 37671700 PMCID: PMC10482427 DOI: 10.7554/elife.91607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
eLife has published a special issue containing articles that examine how cancer prevention, control, care and survivorship were impacted by the COVID-19 pandemic.
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12
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Herbst N, Javidfar J. The Burden of Survivorship After Venoarterial Extracorporeal Membrane Oxygenation: A Black Box. Crit Care Med 2023; 51:1278-1280. [PMID: 37589522 DOI: 10.1097/ccm.0000000000005948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- Nicole Herbst
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA
| | - Jeffrey Javidfar
- Division of Cardiothoracic Surgery, Department of Surgery, Emory School of Medicine, Atlanta, GA
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13
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Zhu J, Oh JH, Simhal AK, Elkin R, Norton L, Deasy JO, Tannenbaum A. Geometric graph neural networks on multi-omics data to predict cancer survival outcomes. Comput Biol Med 2023; 163:107117. [PMID: 37329617 PMCID: PMC10638676 DOI: 10.1016/j.compbiomed.2023.107117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/19/2023]
Abstract
The advance of sequencing technologies has enabled a thorough molecular characterization of the genome in human cancers. To improve patient prognosis predictions and subsequent treatment strategies, it is imperative to develop advanced computational methods to analyze large-scale, high-dimensional genomic data. However, traditional machine learning methods face a challenge in handling the high-dimensional, low-sample size problem that is shown in most genomic data sets. To address this, our group has developed geometric network analysis techniques on multi-omics data in connection with prior biological knowledge derived from protein-protein interactions (PPIs) or pathways. Geometric features obtained from the genomic network, such as Ollivier-Ricci curvature and the invariant measure of the associated Markov chain, have been shown to be predictive of survival outcomes in various cancers. In this study, we propose a novel supervised deep learning method called geometric graph neural network (GGNN) that incorporates such geometric features into deep learning for enhanced predictive power and interpretability. More specifically, we utilize a state-of-the-art graph neural network with sparse connections between the hidden layers based on known biology of the PPI network and pathway information. Geometric features along with multi-omics data are then incorporated into the corresponding layers. The proposed approach utilizes a local-global principle in such a manner that highly predictive features are selected at the front layers and fed directly to the last layer for multivariable Cox proportional-hazards regression modeling. The method was applied to multi-omics data from the CoMMpass study of multiple myeloma and ten major cancers in The Cancer Genome Atlas (TCGA). In most experiments, our method showed superior predictive performance compared to other alternative methods.
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Affiliation(s)
- Jiening Zhu
- Department of Applied Mathematics & Statistics, Stony Brook University, NY, USA.
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, NY, USA.
| | - Anish K Simhal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, NY, USA.
| | - Rena Elkin
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, NY, USA.
| | - Larry Norton
- Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, USA.
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, NY, USA.
| | - Allen Tannenbaum
- Department of Applied Mathematics & Statistics, Stony Brook University, NY, USA; Department of Computer Science, Stony Brook University, NY, USA.
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14
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Bergerot CD, Wang AWT, Serpentini S, Borgese C, Kim Y. Healthcare providers' perceptions about the unmet needs of their patients with cancer across healthcare systems: results of the International Psycho-Oncology Society survivorship survey. Support Care Cancer 2023; 31:538. [PMID: 37632538 DOI: 10.1007/s00520-023-07998-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/15/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE Systematic understanding of patients' unmet needs is essential for providing effective supportive care. This study sought to compare the unmet needs of patients with cancer identified by health care providers (HCPs) among four major healthcare systems. METHODS HCPs (n = 247) participated in the International Psycho-Oncology Society (IPOS) Survivorship Online Survey, evaluating their patients' unmet needs. The country of HCPs was grouped into four major healthcare systems: Beveridge model, Bismarck model, National Health Insurance model, and out-of-pocket model. RESULTS Most HCPs were from countries with the Bismarck model. Substantial levels (> 50%) of unmet needs in all domains are reported across the four healthcare systems. Pediatric patients/survivors living in countries under out-of-pocket healthcare model were evaluated to have less unmet needs for managing decline in physical or cognitive functioning and insomnia/sleep difficulty/fatigue, than those in countries under Beveridge, Bismarck, and National Health Insurance models. Moreover, middle-aged patients/survivors under Beveridge and National Health Insurance models were likely to have greater unmet needs for dealing with cancer-related financial concerns than those under Bismarck model. CONCLUSION This study provides valuable insights into the unmet needs of patients with cancer in different healthcare systems, highlighting the significance of targeted interventions to address the unique needs of patients across diverse healthcare systems. Further investigation is warranted to identify the system factors associated with patients' unmet needs, enabling the development of effective healthcare policies and interventions to comprehensively address the multifaceted needs of patients with cancer.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Supportive Care, Oncoclinicas, SMH/N Quadra 02, Ed de Clínicas, 12º Andar, Brasilia, DF, Brazil.
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15
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Beltran-Bless AA, Clemons M. How Frequently Should Patients with Breast Cancer Have Routine Follow-Up Visits? NEJM Evid 2023; 2:EVIDtt2300062. [PMID: 38320146 DOI: 10.1056/evidtt2300062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Prospective Data Regarding the Optimal Frequency and ModalityProspective data regarding the optimal frequency and modality of follow up after definitive therapy for localized breast cancer is lacking, especially as it relates to time to recurrence detection. This article reviews the evidence and proposes a randomized trial to evaluate on-demand versus guideline-based survivorship care.
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Affiliation(s)
- Ana-Alicia Beltran-Bless
- Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa
- Ottawa Cancer Centre, Ottawa
| | - Mark Clemons
- Division of Medical Oncology and Department of Medicine, University of Ottawa, Ottawa
- Ottawa Cancer Centre, Ottawa
- Ottawa Hospital Research Institute, Ottawa
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16
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Li K, Leng X, He W, Du K, Li C, Liu K, Wang C, Liu G, Li Z, Jiang L, Li K, Zhou Q, Li J, Luo X, Nie X, Lu S, Li H, Fang Q, Xiao W, Han Y, Peng L. Resected lymph nodes and survival of patients with esophageal squamous cell carcinoma: an observational study. Int J Surg 2023; 109:2001-2009. [PMID: 37222685 PMCID: PMC10389544 DOI: 10.1097/js9.0000000000000436] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/01/2022] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND The incidence and mortality of esophageal cancer are high. Therefore, the authors aimed to investigate how the number of dissected lymph nodes (LNs) during esophagectomy for esophageal squamous cell carcinoma impacts overall survival (OS), particularly that of patients with positive LNs. MATERIALS AND METHODS Data from 2010 to 2017 were obtained from the Sichuan Cancer Hospital and Institute Esophageal Cancer Case Management Database. Participants were divided into two groups: patients with negative lymph nodes (N0) and patients with positive lymph nodes (N+). The median number of resected LNs during surgery was 24; therefore, patients with 15-23 and those with 24 or more resected LNs were assigned to subgroups A and B, respectively. RESULTS After a median follow-up of 60.33 months, 1624 patients who underwent esophagectomy were evaluated; 60.53 and 39.47% had a pathological diagnosis of N+ or N0, respectively. The median OS was 33.9 months for the N+ group; however, the N0 group did not achieve the median OS. The mean OS was 84.9 months. In the N+ group, the median OS times of subgroups A and B were 31.2 and 37.1 months, respectively. The OS rates at 1, 3, and 5 years were 82, 43, and 34%, respectively, for subgroup A of the N+ group; they were 86, 51, and 38%, respectively, for subgroup B of the N+ group. Subgroups A and B of the N0 group exhibited no statistically significant differences. CONCLUSION Increasing the number of LNs harvested during surgery to 24 or more could improve the OS of patients with positive LNs but not that of patients with negative LNs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lin Peng
- Division of Thoracic Surgery, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Afliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, Sichuan, People's Republic of China
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17
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Dee EC, Ho FDV, Yee K, Lin VK. Survivorship Care for People With Cancer in the Indo-Pacific: The Imperative to Harness Political Determinants, International Exchange, and Technological Innovation. JCO Glob Oncol 2023; 9:e2300052. [PMID: 37290023 PMCID: PMC10497291 DOI: 10.1200/go.23.00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/07/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
- Edward Christopher Dee
- Edward Christopher Dee, MD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Frances Dominique V. Ho, BSc, College of Medicine, University of the Philippines, Manila, Philippines; Kaisin Yee, BSc, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA, SingHealth Duke-NUS Global Health Institute, Singapore, Singapore; and Vivian K. Lin, DrPH, MPH, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Frances Dominique V. Ho
- Edward Christopher Dee, MD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Frances Dominique V. Ho, BSc, College of Medicine, University of the Philippines, Manila, Philippines; Kaisin Yee, BSc, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA, SingHealth Duke-NUS Global Health Institute, Singapore, Singapore; and Vivian K. Lin, DrPH, MPH, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Kaisin Yee
- Edward Christopher Dee, MD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Frances Dominique V. Ho, BSc, College of Medicine, University of the Philippines, Manila, Philippines; Kaisin Yee, BSc, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA, SingHealth Duke-NUS Global Health Institute, Singapore, Singapore; and Vivian K. Lin, DrPH, MPH, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Vivian K. Lin
- Edward Christopher Dee, MD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Frances Dominique V. Ho, BSc, College of Medicine, University of the Philippines, Manila, Philippines; Kaisin Yee, BSc, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA, SingHealth Duke-NUS Global Health Institute, Singapore, Singapore; and Vivian K. Lin, DrPH, MPH, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
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18
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Kurosawa S. [An enjoyable 23-year career as a hematologist in metropolitan emergency hospitals, a researcher of post-transplant survivorship, and a community hematologist-oncologist]. Rinsho Ketsueki 2023; 64:803-809. [PMID: 37673634 DOI: 10.11406/rinketsu.64.803] [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] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
I would like to express my sincere gratitude to be given such an honorable opportunity. I am more than happy to share my personal experience as one example of the diversity of women in hematology. After graduating from Tohoku University, I began my residency training at Japanese Red Cross Musashino Hospital and Tokyo Metropolitan Bokutoh Hospital, which are extremely busy designated hospitals in Tokyo. Both had highly active emergency care centers, and I believe that the rigorous training I received there not only honed my basic patient care skills, but also increased my physical and mental strength. Since I referred many patients to National Cancer Center Hospital, I found it amusing that Dr. Fukuda recruited me based on the recommendation of those patients. I was so fortunate to have many opportunities to contribute as a primary investigator in meaningful nationwide clinical studies. At present, I appreciate my country life as a community hematologist-oncologist. I also did not expect that I would have continuing opportunities to collaborate with researchers nationwide thanks to rapid progress in remote communications, and nothing would make me happier than to continue participating in projects on cancer survivorship.
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19
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Yuan Z, Li Y, Shi M, Yang F, Gao J, Yao J, Zhang MQ. SOTIP is a versatile method for microenvironment modeling with spatial omics data. Nat Commun 2022; 13:7330. [PMID: 36443314 PMCID: PMC9705407 DOI: 10.1038/s41467-022-34867-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
The rapidly developing spatial omics generated datasets with diverse scales and modalities. However, most existing methods focus on modeling dynamics of single cells while ignore microenvironments (MEs). Here we present SOTIP (Spatial Omics mulTIPle-task analysis), a versatile method incorporating MEs and their interrelationships into a unified graph. Based on this graph, spatial heterogeneity quantification, spatial domain identification, differential microenvironment analysis, and other downstream tasks can be performed. We validate each module's accuracy, robustness, scalability and interpretability on various spatial omics datasets. In two independent mouse cerebral cortex spatial transcriptomics datasets, we reveal a gradient spatial heterogeneity pattern strongly correlated with the cortical depth. In human triple-negative breast cancer spatial proteomics datasets, we identify molecular polarizations and MEs associated with different patient survivals. Overall, by modeling biologically explainable MEs, SOTIP outperforms state-of-art methods and provides some perspectives for spatial omics data exploration and interpretation.
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Affiliation(s)
- Zhiyuan Yuan
- Institute of Science and Technology for Brain-Inspired Intelligence; MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200433, China.
- Tencent AI Lab, Shenzhen, China.
- MOE Key Laboratory of Bioinformatics; Bioinformatics Division and Center for Synthetic & Systems Biology, BNRist; Department of Automation, Tsinghua University, Beijing, 100084, China.
| | - Yisi Li
- MOE Key Laboratory of Bioinformatics; Bioinformatics Division and Center for Synthetic & Systems Biology, BNRist; Department of Automation, Tsinghua University, Beijing, 100084, China
| | - Minglei Shi
- MOE Key Laboratory of Bioinformatics; Bioinformatics Division and Center for Synthetic & Systems Biology, School of Medicine, Tsinghua University, Beijing, 100084, China
| | | | - Juntao Gao
- MOE Key Laboratory of Bioinformatics; Bioinformatics Division and Center for Synthetic & Systems Biology, BNRist; Department of Automation, Tsinghua University, Beijing, 100084, China
| | | | - Michael Q Zhang
- MOE Key Laboratory of Bioinformatics; Bioinformatics Division and Center for Synthetic & Systems Biology, BNRist; Department of Automation, Tsinghua University, Beijing, 100084, China.
- MOE Key Laboratory of Bioinformatics; Bioinformatics Division and Center for Synthetic & Systems Biology, School of Medicine, Tsinghua University, Beijing, 100084, China.
- Department of Biological Sciences, Center for Systems Biology, The University of Texas, Richardson, TX, 75080-3021, USA.
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20
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Xiang W, Wu C, Wu H, Fang S, Liu N, Yu H. Survival Comparisons between Breast Conservation Surgery and Mastectomy Followed by Postoperative Radiotherapy in Stage I-III Breast Cancer Patients: Analysis of the Surveillance, Epidemiology, and End Results (Seer) Program Database. Curr Oncol 2022; 29:5731-5747. [PMID: 36005190 PMCID: PMC9406949 DOI: 10.3390/curroncol29080452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/06/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aims to evaluate the overall and breast cancer-specific survival (BCSS) after breast-conserving surgery (BCS) plus radiotherapy (RT) compared with mastectomy plus RT in resectable breast cancer. Moreover, the aim is to also identify the subgroups who benefit from BCS plus RT and establish a predictive nomogram for stage II patients. Methods: Stage I−III breast cancer patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 1990 and 2016. Patients with available clinical information were split into two groups: BCS plus RT and mastectomy plus RT. Kaplan−Meier survival analysis, univariate and multivariate regression analysis, and propensity score matching were used in the study. Hazard ratio (HR) was calculated based on stratified Cox univariate regression analyses. A prognostic nomogram by multivariable Cox regression model was developed for stage II patients, and consistency index (C-index) and calibration curve were used to evaluate the accuracy of the nomogram in the training and validation set. Results: A total of 24,590 eligible patients were enrolled. The difference in overall survival (OS) and BCSS remained significant in stage II patients both before and after PSM (after PSM: OS: HR = 0.8536, p = 0.0115; BCSS: HR = 0.7803, p = 0.0013). In stage II patients, the survival advantage effect of BCS plus RT on OS and BCSS was observed in the following subgroups: any age, smaller tumor size (<1 cm), stage IIA (T2N0, T0−1N1), ER (+), and any PR status. Secondly, the C-indexes for BCSS prediction was 0.714 (95% CI 0.694−0.734). The calibration curves showed perfect agreement in both the training and validation sets. Conclusions: BCS plus RT significantly improved the survival rates for patients of stage IIA (T2N0, T0−1N1), ER (+). For stage II patients, the nomogram was a good predictor of 5-, 10-, and 15-year BCSS. Our study may help guide treatment decisions and prolong the survival of stage II breast cancer patients.
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Affiliation(s)
- Wenbin Xiang
- Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, China
| | - Chaoyan Wu
- Department of Integrated Traditional Chinese Medicine and Western Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Huachao Wu
- Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, China
| | - Sha Fang
- Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, China
| | - Nuomin Liu
- Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, China
| | - Haijun Yu
- Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
- Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, China
- Correspondence: ; Tel.: +86-027-6781-3154
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21
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Workie SG, Zewale TA, Wassie GT, Belew MA, Abeje ED. Survival and predictors of mortality among chronic kidney disease patients on hemodialysis in Amhara region, Ethiopia, 2021. BMC Nephrol 2022; 23:193. [PMID: 35606716 PMCID: PMC9125902 DOI: 10.1186/s12882-022-02825-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/17/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite the high economic and mortality burden of chronic kidney disease, studies on survival and predictors of mortality among patients on hemodialysis in Ethiopia especially in the Amhara region are scarce considering their importance to identify some modifiable risk factors for early mortality to improve the patient's prognosis. So, this study was done to fill the identified gaps. The study aimed to assess survival and predictors of mortality among end-stage renal disease patients on hemodialysis in Amhara regional state, Ethiopia, 2020/2021. METHOD Institution-based retrospective record review was conducted in Felege Hiwot, Gonder, and Gambi hospitals from March 5 to April 5, 2021. A total of 436 medical records were selected using a simple random sampling technique. A life table was used to estimate probabilities of survival at different time intervals. Multivariable cox regression was used to identify risk factors for mortality. RESULT Out of the 436 patients 153 (35.1%) had died. The median survival time was 345 days with a mortality rate of 1.89 per 1000 person-days (95%CI (1.62, 2.22)). Patients live in rural residences (AHR = 1.48, 95%CI (1.04, 2.12)), patients whose cause of CKD was hypertension (AHR = 1.49, 95%CI (1.01, 2.23)) and human immune virus (AHR = 2.22, 95%CI (1.41, 3.51)), and patients who use a central venous catheter (AHR = 3.15, 95%CI (2.08, 4.77)) had increased risk of death while staying 4 h on hemodialysis (AHR = 0.43, 95%CI (0.23, 0.80)) decreases the risk of death among chronic kidney disease patients on hemodialysis. CONCLUSIONS The overall survival rate and median survival time of chronic kidney disease patients on hemodialysis were low in the Amhara region as compared with other developing Sub-Saharan African counties.
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Affiliation(s)
- Sewnet Getaye Workie
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Debre Berhan University, PO box 445, Debre Berhan, Ethiopia
| | - Taye Abuhay Zewale
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, PO box 79, Bahir Dar, Ethiopia
| | - Gizachew Tadesse Wassie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, PO box 79, Bahir Dar, Ethiopia
| | - Makda Abate Belew
- Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Science, Debre Berhan University, PO box 445, Debre Berhan, Ethiopia
| | - Eleni Dagnaw Abeje
- Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Science, Debre Berhan University, PO box 445, Debre Berhan, Ethiopia
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22
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Li Y, Zhang Y, Jia X, Jiang P, Mao Z, Liang T, Du Y, Zhang J, Zhang G, Niu G, Guo H. Effect of Immune-Related Adverse Events and Pneumonitis on Prognosis in Advanced Non-Small Cell Lung Cancer: A Comprehensive Systematic Review and Meta-analysis. Clin Lung Cancer 2021; 22:e889-e900. [PMID: 34183265 DOI: 10.1016/j.cllc.2021.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The correlation between immune-related adverse events (irAEs) and prognosis remains controversial in advanced non-small cell lung cancer (NSCLC). The aim of this study was to systematically evaluate the effect of irAEs, especially checkpoint inhibitor pneumonitis (CIP), on the survival and treatment response in advanced NSCLC. METHODS The primary outcomes were overall survival (OS) and objective response rate (ORR). Databases were searched for relevant studies, and meta-analysis was conducted with RevMan. RESULTS A total of 51 studies involving 12,600 participants were included. The development of irAEs had an advantageous effect on OS and ORR in advanced NSCLC (OS: hazard ratio [HR], 0.56 [95% confidence interval [CI] 0.46 to 0.67]; ORR: odds ratio [OR], 3.13 [2.41 to 4.06]). The occurrence of endocrine and skin irAEs had advantageous effects on both OS and ORR (endocrine OS, HR, 0.47 [-0.37 to 0.59]; endocrine ORR: OR, 1.90 [1.27 to 2.84]; skin OS: HR, 0.48 [0.38 to 0.61]; skin ORR: OR, 4.30 [2.68 to 6.91]). Severe-grade irAEs resulted in shorter OS than low-grade irAEs (HR, 1.49 [1.06, 2.09]), and multiple irAEs resulted in better ORR compared with 1 irAE (OR, 2.04 [1.41 to 2.94]). The occurrence of CIP had no significant effect on OS (HR, 1.14 [0.70 to 1.86]), but it was associated with better ORR (OR, 2.12 [1.06 to 4.25]). Severe-grade CIP had no effect on OS or ORR, but CIP leading to treatment discontinuation resulted in shorter OS (HR, 2.35 [1.17 to 4.72]). CONCLUSION The development of irAEs had advantageous effects on survival and response in advanced NSCLC. CIP had no effect on survival, but it predicted better response.
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Affiliation(s)
- Yanlin Li
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yajuan Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaohui Jia
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Panpan Jiang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ziyang Mao
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ting Liang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yonghao Du
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jia Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Guangjian Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Gang Niu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hui Guo
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, Shaanxi, China; Bioinspired Engineering and Biomechanics Center, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, Shaanxi, China
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Moura JMB, Henriques da Silva R, Soares Ferreira Júnior W, Cristina da Silva T, Albuquerque UP. Memory for medicinal plants remains in ancient and modern environments suggesting an evolved adaptedness. PLoS One 2021; 16:e0258986. [PMID: 34695160 PMCID: PMC8544875 DOI: 10.1371/journal.pone.0258986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022] Open
Abstract
Adaptive memory is the propensity of human memory to easily store and retrieve important information to deal with challenges related to the Pleistocene. Recent evidence shows that humans have had a multiregional evolution across the African continent, including the rainforests and deciduous forests; however, there is little evidence regarding the implications of these origins and the relevant and recurring challenges of these environments on survival processing advantage in memory. In this study, we conducted an experiment with volunteers to analyze whether adaptive memory operates in the retrieval of important information to solve challenges of using medicinal plants to treat diseases in the ancestral environments of the savanna, rainforests, and deciduous forests compared to the modern environments of desert, tundra, coniferous forest, and urban areas. We used simulated survival environments and asked volunteers (30 per simulated scenario) to imagine themselves sick in one of these environments, and needing to find medicinal plants to treat their disease. The volunteers rated the relevance of 32 words to solve this challenge, followed by a surprise memory test. Our results showed no ancestral priority in recalling relevant information, as both ancestral and modern environments showed a similar recall of relevant information. This suggests that the evolved cognitive apparatus allows human beings to survive and can create survival strategies to face challenges imposed in various environments. We believe that this is only possible if the human mind operates through a flexible cognitive mechanism. This flexibility can reflect, for example, the different environments that the first hominids inhabited and the different dangerous situations that they faced.
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Affiliation(s)
- Joelson Moreno Brito Moura
- Departamento de Biologia, Universidade Federal Rural de Pernambuco, Recife, Pernambuco, Brazil
- Departamento de Botânica, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Risoneide Henriques da Silva
- Departamento de Biologia, Universidade Federal Rural de Pernambuco, Recife, Pernambuco, Brazil
- Departamento de Botânica, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Caminati A, Madotto F, Conti S, Cesana G, Mantovani L, Harari S. The natural history of idiopathic pulmonary fibrosis in a large European population: the role of age, sex and comorbidities. Intern Emerg Med 2021; 16:1793-1802. [PMID: 33586036 DOI: 10.1007/s11739-021-02651-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 11/21/2020] [Accepted: 01/21/2021] [Indexed: 02/08/2023]
Abstract
Placebo arms of clinical trials provide an opportunity to investigate the natural history of idiopathic pulmonary fibrosis (IPF) but these patients are not representative of the real life IPF population. Objective of this article is to evaluate patients' characteristics of incident IPF cases and their impact on mortality and hospitalizations risk. We conducted a retrospective cohort study using data from administrative databases from 2000 to 2010. Based on different algorithms reported in literature, incident IPF cases were identified. We applied Cox proportional hazards models to assess relationship between patients' characteristics, mortality and hospitalization. According to three case definitions, we identified 2338, 460 and 1704 incident IPF cases. Mean age at diagnosis was about 72 years, the proportion of male varied between 59 and 62% and patients with at least one chronic disease were between 70 and 74%. Age, male sex and comorbidities were associated to worse outcomes. Congestive heart failure (CHF), diabetes and cancer were conditions associated to mortality, while those associated to hospitalization were CHF and chronic obstructive pulmonary disease. Our data source provided one of the largest samples of unselected patients with a long follow-up period. Using different algorithms proposed and validated in literature, we observed that mortality and hospitalization rate are high in patients with IPF and age, sex and comorbidities significantly affect clinical outcomes. Females show a significant survival advantage over males, even after adjusting for age and comorbidities. Patients with pre-existing diseases, especially those with pulmonary and cardiovascular diseases are at higher risk.
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Affiliation(s)
- Antonella Caminati
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare. Ospedale San Giuseppe, MultiMedica IRCCS, Via San Vittore 12, 20123, Milan, MI, Italy.
| | - Fabiana Madotto
- Value-based Healthcare Unit, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20099, Milan, Italy
- Research Centre on Public Health, Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Monza e Brianza, Italy
| | - Sara Conti
- Research Centre on Public Health, Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Monza e Brianza, Italy
| | - Giancarlo Cesana
- Research Centre on Public Health, Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Monza e Brianza, Italy
| | - Lorenzo Mantovani
- Value-based Healthcare Unit, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20099, Milan, Italy
- Research Centre on Public Health, Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Monza e Brianza, Italy
| | - Sergio Harari
- U.O. di Pneumologia e Terapia Semi-Intensiva Respiratoria, Servizio di Fisiopatologia Respiratoria ed Emodinamica Polmonare. Ospedale San Giuseppe, MultiMedica IRCCS, Via San Vittore 12, 20123, Milan, MI, Italy
- Clinica Medica, Ospedale San Giuseppe MultiMedica IRCCS, Via San Vittore 12, 20123, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Milan, Italy
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Daoud F, Rachdi I, Somai M, Zaouak A, Hammami H, Ouederni M, Maamouri R, Zoubeidi H, Tougorti M, Ksouri J, Dhaou BB, Aydi Z, Fenniche S, Cheour M, Boussema F. Epidemiological, clinical, and therapeutic characteristics of Behçet's disease: a monocentric study in Tunisia. Pan Afr Med J 2021; 40:13. [PMID: 34733381 PMCID: PMC8531968 DOI: 10.11604/pamj.2021.40.13.19146] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/23/2020] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION to describe the epidemiological, clinical, therapeutic and evolving characteristics of Behçet´s disease and identify prognostic factors. METHODS we have realized a retrospective, single-center study, conducted over a period of 26 years and including 130 patients presenting Behçet´s disease and hospitalized in an Internal Medicine Department. RESULTS the mean age of the Behçet´s disease at onset was 30.3 ±8.8 years and that at diagnosis was 34.6 ±9.4 years. The sex ratio (male/female) was 2.5. The mean delay of diagnosis was 53.5 months. Oral aphthosis was constant. The frequency of the manifestations was: genital aphtosis 71.5%, pseudofolliculitis 84.6%, erythema nodosum 11.5%, positive pathergy test 50%, ocular disease 36.9%, venous thrombosis 30%, arterial disease 4.6%, joint damage 30.8%, neurological disease 19.2% and digestive disease 0.8%. The male gender was significantly associated with ocular involvement (p =0.02), venous disease (p =0.01) and occurrence of relapses (p =0.01). The mean follow up was 68.5 ± 77.3 months. The poor survival prognostic factors were male gender, ocular involvement, venous disease, cardiovascular disease, a duration of follow up ≤12 months and a diagnostic delay ≤ 24 months. Conclusion: improving the prognosis of Behçet´s disease requires a shortening of the time to diagnosis, multidisciplinary collaboration, intensive treatment of functional threats, regular monitoring, and patient adherence.
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Affiliation(s)
- Fatma Daoud
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Imène Rachdi
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Mehdi Somai
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Anissa Zaouak
- Department of Dermatology, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Houda Hammami
- Department of Dermatology, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Meriem Ouederni
- Ophthalmology Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Rym Maamouri
- Ophthalmology Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Hana Zoubeidi
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Molka Tougorti
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Jihène Ksouri
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Besma Ben Dhaou
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Zohra Aydi
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Samy Fenniche
- Department of Dermatology, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Monia Cheour
- Ophthalmology Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Fatma Boussema
- Internal Medicine Department, Habib Thameur Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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Sun JM, Shen L, Shah MA, Enzinger P, Adenis A, Doi T, Kojima T, Metges JP, Li Z, Kim SB, Cho BC, Mansoor W, Li SH, Sunpaweravong P, Maqueda MA, Goekkurt E, Hara H, Antunes L, Fountzilas C, Tsuji A, Oliden VC, Liu Q, Shah S, Bhagia P, Kato K. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet 2021; 398:759-771. [PMID: 34454674 DOI: 10.1016/s0140-6736(21)01234-4] [Citation(s) in RCA: 534] [Impact Index Per Article: 178.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND First-line therapy for advanced oesophageal cancer is currently limited to fluoropyrimidine plus platinum-based chemotherapy. We aimed to evaluate the antitumour activity of pembrolizumab plus chemotherapy versus chemotherapy alone as first-line treatment in advanced oesophageal cancer and Siewert type 1 gastro-oesophageal junction cancer. METHODS We did a randomised, placebo-controlled, double-blind, phase 3 study across 168 medical centres in 26 countries. Patients aged 18 years or older with previously untreated, histologically or cytologically confirmed, locally advanced, unresectable or metastatic oesophageal cancer or Siewert type 1 gastro-oesophageal junction cancer (regardless of PD-L1 status), measurable disease per Response Evaluation Criteria in Solid Tumors version 1.1, and Eastern Cooperative Oncology Group performance status of 0-1, were randomly assigned (1:1) to intravenous pembrolizumab 200 mg or placebo, plus 5-fluorouracil and cisplatin (chemotherapy), once every 3 weeks for up to 35 cycles. Randomisation was stratified by geographical region, histology, and performance status. Patients, investigators, and site staff were masked to group assignment and PD-L1 biomarker status. Primary endpoints were overall survival in patients with oesophageal squamous cell carcinoma and PD-L1 combined positive score (CPS) of 10 or more, and overall survival and progression-free survival in patients with oesophageal squamous cell carcinoma, PD-L1 CPS of 10 or more, and in all randomised patients. This trial is registered with ClinicalTrials.gov, NCT03189719, and is closed to recruitment. FINDINGS Between July 25, 2017, and June 3, 2019, 1020 patients were screened and 749 were enrolled and randomly assigned to pembrolizumab plus chemotherapy (n=373 [50%]) or placebo plus chemotherapy (n=376 [50%]). At the first interim analysis (median follow-up of 22·6 months), pembrolizumab plus chemotherapy was superior to placebo plus chemotherapy for overall survival in patients with oesophageal squamous cell carcinoma and PD-L1 CPS of 10 or more (median 13·9 months vs 8·8 months; hazard ratio 0·57 [95% CI 0·43-0·75]; p<0·0001), oesophageal squamous cell carcinoma (12·6 months vs 9·8 months; 0·72 [0·60-0·88]; p=0·0006), PD-L1 CPS of 10 or more (13·5 months vs 9·4 months; 0·62 [0·49-0·78]; p<0·0001), and in all randomised patients (12·4 months vs 9·8 months; 0·73 [0·62-0·86]; p<0·0001). Pembrolizumab plus chemotherapy was superior to placebo plus chemotherapy for progression-free survival in patients with oesophageal squamous cell carcinoma (6·3 months vs 5·8 months; 0·65 [0·54-0·78]; p<0·0001), PD-L1 CPS of 10 or more (7·5 months vs 5·5 months; 0·51 [0·41-0·65]; p<0·0001), and in all randomised patients (6·3 months vs 5·8 months; 0·65 [0·55-0·76]; p<0·0001). Treatment-related adverse events of grade 3 or higher occurred in 266 (72%) patients in the pembrolizumab plus chemotherapy group versus 250 (68%) in the placebo plus chemotherapy group. INTERPRETATION Compared with placebo plus chemotherapy, pembrolizumab plus chemotherapy improved overall survival in patients with previously untreated, advanced oesophageal squamous cell carcinoma and PD-L1 CPS of 10 or more, and overall survival and progression-free survival in patients with oesophageal squamous cell carcinoma, PD-L1 CPS of 10 or more, and in all randomised patients regardless of histology, and had a manageable safety profile in the total as-treated population. FUNDING Merck Sharp & Dohme.
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Affiliation(s)
- Jong-Mu Sun
- Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
| | - Lin Shen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Manish A Shah
- Weill Cornell Medical College, New York City, NY, USA
| | | | - Antoine Adenis
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm, Université Montpellier, ICM, Montpellier, France
| | - Toshihiko Doi
- National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Jean-Philippe Metges
- CHU Brest-Institut de Cancerologie et d'Hematologie ARPEGO Network, Brest, France
| | - Zhigang Li
- Section of Oesophageal Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Sung-Bae Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Byoung Chul Cho
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Shau-Hsuan Li
- Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | | | | | - Eray Goekkurt
- Hematology Oncology Practice Eppendorf and University Cancer Center Hamburg, Hamburg, Germany
| | | | - Luis Antunes
- University Hospital of Santa Maria, Federal University of Santa Maria, and Viver Research Center, Santa Maria, Brazil
| | | | | | | | - Qi Liu
- Merck, Kenilworth, NJ, USA
| | | | | | - Ken Kato
- National Cancer Center Hospital, Tokyo, Japan
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Shui Y, Li M, Su J, Chen M, Gu X, Guo W. Prognostic and clinicopathological significance of systemic immune-inflammation index in pancreatic cancer: a meta-analysis of 2,365 patients. Aging (Albany NY) 2021; 13:20585-20597. [PMID: 34435973 PMCID: PMC8436945 DOI: 10.18632/aging.203449] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/02/2021] [Indexed: 12/31/2022]
Abstract
The prognostic value of the systemic immune-inflammation index (SII) in patients with pancreatic cancer is conflicting according to previous investigations. Therefore, we performed a meta-analysis to explore the association between SII and pancreatic cancer prognosis. Electronic databases were searched for studies exploring the association of SII with prognostic outcomes in pancreatic cancer. The endpoints were overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and clinicopathological parameters. The prognostic value of SII was estimated by hazard ratio (HR) or odds ratio (OR) with a 95% confidence interval (CI). Nine studies containing 11 cohorts with 2,365 subjects in total were included in this meta-analysis. Elevated SII was associated with poor OS (HR=1.50, 95% CI=1.15-1.96, p=0.002), RFS/PFS/DFS (HR=1.52, 95% CI=1.01-2.28, p=0.045), and CSS (HR=2.60, 95% CI=1.65-4.09, p < 0.001) in patients with pancreatic cancer. Additionally, there was no significant association between SII and other parameters in pancreatic cancer such as sex, tumor location, lymph node metastasis, tumor-node-metastasis stage, vascular invasion, and grade. This meta-analysis suggested that elevated SII was a significant prognostic marker for short-term and long-term survival outcomes in patients with pancreatic cancer.
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Affiliation(s)
- Yifang Shui
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
- Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, Henan, China
- Open and Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, Henan, China
- Zhengzhou Key Laboratory of Hepatobiliary and Pancreatic Diseases and Organ Transplantation, Zhengzhou 450052, Henan, China
- Department of Breast Disease Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Mengquan Li
- Department of Breast Disease Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Jing Su
- Department of Breast Disease Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Mingxun Chen
- Department of Hepatobiliary and Pancreatic Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, Henan, China
| | - Xiaobin Gu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Wenzhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
- Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, Henan, China
- Open and Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, Henan, China
- Zhengzhou Key Laboratory of Hepatobiliary and Pancreatic Diseases and Organ Transplantation, Zhengzhou 450052, Henan, China
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Duineveld LAM, Vos JAM, Wieldraaijer T, Donkervoort SC, Wind J, van Weert HCPM, van Asselt KM. Recruitment challenges to the I CARE study: a randomised trial on general practitioner-led colon cancer survivorship care. BMJ Open 2021; 11:e048985. [PMID: 34429313 PMCID: PMC8386209 DOI: 10.1136/bmjopen-2021-048985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES The I CARE study (Improving Care After colon canceR treatment in the Netherlands) aims to compare surgeon-led to general practitioner (GP)-led colon cancer survivorship care. Recruitment to the trial took longer than expected. In this descriptive study, recruitment is critically reviewed. SETTING Patients were recruited from eight Dutch medical centres. PARTICIPANTS Patients treated with curative intent for stages I-III colon cancer. Target patient sample size was calculated at 300. INTERVENTIONS Patients were randomised to surgeon-led (usual) versus GP-led care, with or without access to an eHealth application (Oncokompas). OUTCOME MEASURES Baseline characteristics of (non-)participants, reasons for non-participation and strategies to improve recruitment were reviewed. RESULTS Out of 1238 eligible patients, 353 patients were included. Of these, 50 patients dropped out shortly after randomisation and before start of the intervention, resulting in a participation rate of 25%. Participants were on average slightly younger (68.1 years vs 69.3 years) and more often male (67% vs 50%) in comparison to non-participants. A total of 806 patients declined participation for reasons most often relating to research (57%), including the wish to remain in specialist care (31%) and too much effort to participate (12%). Some patients mentioned health (9%) and confrontation with the disease (5%) as a reason. In 43 cases, GPs declined participation, often related to the study objective, need for financial compensation and time restraints. The generally low participation rate led to concerns about reaching the target sample size. Methods to overcome recruitment challenges included changes to the original recruitment procedure and the addition of new study centres. CONCLUSIONS Challenges were faced in the recruitment to a randomised trial on GP-led colon cancer survivorship care. Research on the transition of care requires sufficient time, funding and support base among patients and healthcare professionals. These findings will help inform researchers and policy-makers on the development of future practices. TRIAL REGISTRATION NUMBER NTR4860.
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Affiliation(s)
- Laura A M Duineveld
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Julien A M Vos
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Thijs Wieldraaijer
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sandra C Donkervoort
- Department of Surgery, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - Jan Wind
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk C P M van Weert
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Kristel M van Asselt
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
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Du YT, Li YW, Zhao BJ, Guo XY, Feng Y, Zuo MZ, Fu C, Zhou WJ, Li HJ, Liu YF, Cheng T, Mu DL, Zeng Y, Liu PF, Li Y, An HY, Zhu SN, Li XY, Li HJ, Wu YF, Wang DX, Sessler DI. Long-term Survival after Combined Epidural-General Anesthesia or General Anesthesia Alone: Follow-up of a Randomized Trial. Anesthesiology 2021; 135:233-245. [PMID: 34195784 DOI: 10.1097/aln.0000000000003835] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Experimental and observational research suggests that combined epidural-general anesthesia may improve long-term survival after cancer surgery by reducing anesthetic and opioid consumption and by blunting surgery-related inflammation. This study therefore tested the primary hypothesis that combined epidural-general anesthesia improves long-term survival in elderly patients. METHODS This article presents a long-term follow-up of patients enrolled in a previous trial conducted at five hospitals. Patients aged 60 to 90 yr and scheduled for major noncardiac thoracic and abdominal surgeries were randomly assigned to either combined epidural-general anesthesia with postoperative epidural analgesia or general anesthesia alone with postoperative intravenous analgesia. The primary outcome was overall postoperative survival. Secondary outcomes included cancer-specific, recurrence-free, and event-free survival. RESULTS Among 1,802 patients who were enrolled and randomized in the underlying trial, 1,712 were included in the long-term analysis; 92% had surgery for cancer. The median follow-up duration was 66 months (interquartile range, 61 to 80). Among patients assigned to combined epidural-general anesthesia, 355 of 853 (42%) died compared with 326 of 859 (38%) deaths in patients assigned to general anesthesia alone: adjusted hazard ratio, 1.07; 95% CI, 0.92 to 1.24; P = 0.408. Cancer-specific survival was similar with combined epidural-general anesthesia (327 of 853 [38%]) and general anesthesia alone (292 of 859 [34%]): adjusted hazard ratio, 1.09; 95% CI, 0.93 to 1.28; P = 0.290. Recurrence-free survival was 401 of 853 [47%] for patients who had combined epidural-general anesthesia versus 389 of 859 [45%] with general anesthesia alone: adjusted hazard ratio, 0.97; 95% CI, 0.84 to 1.12; P = 0.692. Event-free survival was 466 of 853 [55%] in patients who had combined epidural-general anesthesia versus 450 of 859 [52%] for general anesthesia alone: adjusted hazard ratio, 0.99; 95% CI, 0.86 to 1.12; P = 0.815. CONCLUSIONS In elderly patients having major thoracic and abdominal surgery, combined epidural-general anesthesia with epidural analgesia did not improve overall or cancer-specific long-term mortality. Nor did epidural analgesia improve recurrence-free survival. Either approach can therefore reasonably be selected based on patient and clinician preference. EDITOR’S PERSPECTIVE
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Abstract
Living with relatives can be highly beneficial, enhancing reproduction and survival. High relatedness can, however, increase susceptibility to pathogens. Here, we examine whether the benefits of living with relatives offset the harm caused by pathogens, and if this depends on whether species typically live with kin. Using comparative meta-analysis of plants, animals, and a bacterium (nspecies = 56), we show that high within-group relatedness increases mortality when pathogens are present. In contrast, mortality decreased with relatedness when pathogens were rare, particularly in species that live with kin. Furthermore, across groups variation in mortality was lower when relatedness was high, but abundances of pathogens were more variable. The effects of within-group relatedness were only evident when pathogens were experimentally manipulated, suggesting that the harm caused by pathogens is masked by the benefits of living with relatives in nature. These results highlight the importance of kin selection for understanding disease spread in natural populations.
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Sikora SS, Bharathy KGS, Krishnan P, Babu P. Twelve-Year Survival After Resection of Hepatocellular Carcinoma with Right Atrial Tumor Thrombus. J Gastrointest Cancer 2021; 52:1169-1174. [PMID: 34196937 DOI: 10.1007/s12029-021-00659-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION A large hepatocellular carcinoma (HCC) with macrovascular invasion is generally considered to have poor prognosis due to unfavorable tumor biology andsuch patients are relegated to palliative options. This report describes long term survival after surgery in a patient with HCC and tumor thrombus in the rightatrium. METHODS Case records of the patient, details of follow up visits and surveillance computed tomography scans performed were reviewed. A brief discussion of thesurgical strategy adopted along with outcome of similar cases in literature is presented. RESULTS A 60 year old man presented with a HCC in segments 4, 5 with extension of tumor into the middle, left hepatic veins, inferior vena cava and right atrium.Patient underwent extraction of the tumor thrombus from the right atrium under cardiopulmonary bypass along with extended left hepatectomy. He receivedthree cycles of adjuvant chemotherapy with Gemcitabine, Oxaliplatin and Interferon. There was a parietal wall recurrence after 1 year and 10 months whichwas excised. Since then he remains well and is on regular follow up for more than 12 years from his index surgery with no evidence of disease, making himthe longest known survivor with such an advanced presentation. CONCLUSION This is an unusual instance where aggressive resection for HCC with right atrial tumor thrombus has resulted in an exceptionally long survival.
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Affiliation(s)
- Sadiq S Sikora
- Department of Surgical Gastroenterology & Liver Transplantation, Sakra World Hospital, Bangalore, India.
| | - Kishore G S Bharathy
- Department of Surgical Gastroenterology & Liver Transplantation, Sakra World Hospital, Bangalore, India
| | - Prasad Krishnan
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA
| | - Prasad Babu
- Department of Surgical Gastroenterology, Yashoda Hospital, Secunderabad, India
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Solanki SL, Kaur J, Gupta AM, Patkar S, Joshi R, Ambulkar RP, Patil A, Goel M. Cancer related nutritional and inflammatory markers as predictive parameters of immediate postoperative complications and long-term survival after hepatectomies. Surg Oncol 2021; 37:101526. [PMID: 33582497 DOI: 10.1016/j.suronc.2021.101526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/27/2020] [Accepted: 01/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The overall survival (OS), disease-free survival (DFS) and complications after liver resections is unsatisfactory. Cancer-related malnutrition and inflammation have an effect on survival but not studied/not clear on postoperative complications. METHODS We retrospectively analyzed prospectively maintained database of 309 patients. The outcome variables included complications in terms of Clavien-Dindo (CD) Score, OS and DFS; We studied effect of preoperative albumin globulin ratio (AGR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and aspartate transaminase to platelet ratio index (APRI) and dynamic change from pre-operative to postoperative value (Delta-AGR, Delta-NLR, Delta-PLR and Delta-APRI) on complications, OS and DFS. RESULTS Total 98 patients (31.71%) had postoperative complications. Fifty patients had CD 1 & 2 and 35 (11.33%) had CD 3 & 4, and 13 (4.12%) had mortality (CD 5). Low AGR, high NLR, high PLR and high Delta-AGR and high Delta-APRI predicted increased major complications. Preoperative high NLR predicted worse OS and low AGR predicted worse OS and DFS. Delta-APRI showed trends towards worse OS and DFS. CONCLUSION These serum inflammatory markers can predict immediate postoperative complications. Preoperative AGR and preoperative NLR can predict survival after liver resections. High Delta-AGR, which is a new entity, is predicting more postoperative complications and needs further detailed studies.
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Affiliation(s)
- Sohan Lal Solanki
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
| | - Jasmeen Kaur
- Department of Anesthesiology and Perioperative Medicine, Augusta University Medical Center, Augusta, GA, USA
| | - Amit M Gupta
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Riddhi Joshi
- Department of Anaesthesia, Dubbo Base Hospital, Dubbo, NSW, Australia
| | - Reshma P Ambulkar
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Akshay Patil
- Clinical Research Secretariat, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Mahesh Goel
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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Majoe M, Libbrecht R, Foitzik S, Nehring V. Queen loss increases worker survival in leaf-cutting ants under paraquat-induced oxidative stress. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190735. [PMID: 33678018 PMCID: PMC7938173 DOI: 10.1098/rstb.2019.0735] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Accepted: 10/19/2020] [Indexed: 01/18/2023] Open
Abstract
Longevity is traded off with fecundity in most solitary species, but the two traits are positively linked in social insects. In ants, the most fecund individuals (queens and kings) live longer than the non-reproductive individuals, the workers. In many species, workers may become fertile following queen loss, and recent evidence suggests that worker fecundity extends worker lifespan. We postulated that this effect is in part owing to improved resilience to oxidative stress, and tested this hypothesis in three Myrmicine ants: Temnothorax rugatulus, and the leaf-cutting ants Atta colombica and Acromyrmex echinatior. We removed the queen from colonies to induce worker reproduction and subjected workers to oxidative stress. Oxidative stress drastically reduced survival, but this effect was less pronounced in leaf-cutting ant workers from queenless nests. We also found that, irrespective of oxidative stress, outside workers died earlier than inside workers did, likely because they were older. Since At. colombica workers cannot produce fertile offspring, our results indicate that direct reproduction is not necessary to extend the lives of queenless workers. Our findings suggest that workers are less resilient to oxidative stress in the presence of the queen, and raise questions on the proximate and ultimate mechanisms underlying socially mediated variation in worker lifespan. This article is part of the theme issue 'Ageing and sociality: why, when and how does sociality change ageing patterns?'
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Affiliation(s)
- Megha Majoe
- Institute of Organismic and Molecular Evolution, Johannes Gutenberg University Mainz, Hanns Dieter Hüsch Weg 15, 55128 Mainz, Germany
- Institute for Biology I (Zoology), University of Freiburg, Hauptstrasse 1, D-79104 Freiburg, Germany
| | - Romain Libbrecht
- Institute of Organismic and Molecular Evolution, Johannes Gutenberg University Mainz, Hanns Dieter Hüsch Weg 15, 55128 Mainz, Germany
| | - Susanne Foitzik
- Institute of Organismic and Molecular Evolution, Johannes Gutenberg University Mainz, Hanns Dieter Hüsch Weg 15, 55128 Mainz, Germany
| | - Volker Nehring
- Institute for Biology I (Zoology), University of Freiburg, Hauptstrasse 1, D-79104 Freiburg, Germany
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Li YX, Wang NN, Zhou YX, Lin CG, Wu JS, Chen XQ, Chen GJ, Du ZJ. Planococcus maritimus ML1206 Isolated from Wild Oysters Enhances the Survival of Caenorhabditis elegans against Vibrio anguillarum. Mar Drugs 2021; 19:md19030150. [PMID: 33809116 PMCID: PMC7999227 DOI: 10.3390/md19030150] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022] Open
Abstract
With the widespread occurrence of aquaculture diseases and the broad application of antibiotics, drug-resistant pathogens have increasingly affected aquatic animals’ health. Marine probiotics, which live under high pressure in a saltwater environment, show high potential as a substitute for antibiotics in the field of aquatic disease control. In this study, twenty strains of non-hemolytic bacteria were isolated from the intestine of wild oysters and perch, and a model of Caenorhabditis elegans infected by Vibrio anguillarum was established. Based on the model, ML1206, which showed a 99% similarity of 16S rRNA sequence to Planococcus maritimus, was selected as a potential marine probiotic, with strong antibacterial capabilities and great acid and bile salt tolerance, to protect Caenorhabditis elegans from being damaged by Vibrio anguillarum. Combined with plate counting and transmission electron microscopy, it was found that strain ML1206 could significantly inhibit Vibrio anguillarum colonization in the intestinal tract of Caenorhabditis elegans. Acute oral toxicity tests in mice showed that ML1206 was safe and non-toxic. The real-time qPCR results showed a higher expression level of genes related to the antibacterial peptide (ilys-3) and detoxification (ugt-22, cyp-35A3, and cyp-14A3) in the group of Caenorhabditis elegans protected by ML1206 compared to the control group. It is speculated that ML1206, as a potential probiotic, may inhibit the infection caused by Vibrio anguillarum through stimulating Caenorhabditis elegans to secrete antibacterial effectors and detoxification proteins. This paper provides a new direction for screening marine probiotics and an experimental basis to support the potential application of ML1206 as a marine probiotic in aquaculture.
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Affiliation(s)
- Ying-Xiu Li
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
| | - Nan-Nan Wang
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
| | - Yan-Xia Zhou
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
| | - Chun-Guo Lin
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
| | - Jing-Shan Wu
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
| | - Xin-Qi Chen
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
| | - Guan-Jun Chen
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
- State Key Laboratory of Microbial Technology, Shandong University, Jinan 250100, China
- Correspondence: (G.J.C.); (Z.-J.D.)
| | - Zong-Jun Du
- Marine College, Shandong University, Weihai 264209, China; (Y.-X.L.); (N.-N.W.); (Y.-X.Z.); (C.-G.L.); (J.-S.W.); (X.-Q.C.)
- State Key Laboratory of Microbial Technology, Shandong University, Jinan 250100, China
- Correspondence: (G.J.C.); (Z.-J.D.)
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Wasinski F, Chaves FM, Pedroso JA, Mansano NS, Camporez JP, Gusmão DO, List EO, Kopchick JJ, Frazão R, Szawka RE, Donato J. Growth hormone receptor in dopaminergic neurones regulates stress-induced prolactin release in male mice. J Neuroendocrinol 2021; 33:e12957. [PMID: 33769619 PMCID: PMC9670090 DOI: 10.1111/jne.12957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022]
Abstract
Arcuate nucleus (ARH) dopaminergic neurones regulate several biological functions, including prolactin secretion and metabolism. These cells are responsive to growth hormone (GH), although it is still unknown whether GH action on ARH dopaminergic neurones is required to regulate different physiological aspects. Mice carrying specific deletion of GH receptor (GHR) in tyrosine hydroxylase (TH)- or dopamine transporter (DAT)-expressing cells were produced. We investigated possible changes in energy balance, glucose homeostasis, fertility, pup survival and restraint stress-induced prolactin release. GHR deletion in DAT- or TH-expressing cells did not cause changes in food intake, energy expenditure, ambulatory activity, nutrient oxidation, glucose tolerance, insulin sensitivity and counter-regulatory response to hypoglycaemia in male and female mice. In addition, GHR deletion in dopaminergic cells caused no gross effects on reproduction and pup survival. However, restraint stress-induced prolactin release was significantly impaired in DAT- and TH-specific GHR knockout male mice, as well as in pegvisomant-treated wild-type males, whereas an intact response was observed in females. Patch clamp recordings were performed in ARH DAT neurones and, in contrast to prolactin, GH did not cause acute changes in the electrical activity of DAT neurones. Furthermore, TH phosphorylation at Ser40 in ARH neurones and median eminence axonal terminals was not altered in DAT-specific GHR knockout male mice during restraint stress. In conclusion, GH action in dopaminergic neurones is required for stress-induced prolactin release in male mice, suggesting the existence of sex differences in the capacity of GHR signalling to affect prolactin secretion. The mechanism behind this regulation still needs to be identified.
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Affiliation(s)
- Frederick Wasinski
- Universidade de Sao Paulo, Instituto de Ciencias Biomedicas, Departamento de Fisiologia e Biofísica, Sao Paulo, Brazil
| | - Fernanda M. Chaves
- Universidade de Sao Paulo, Instituto de Ciencias Biomedicas, Departamento de Fisiologia e Biofísica, Sao Paulo, Brazil
| | - João A.B. Pedroso
- Universidade de Sao Paulo, Instituto de Ciencias Biomedicas, Departamento de Fisiologia e Biofísica, Sao Paulo, Brazil
| | - Naira S. Mansano
- Universidade de Sao Paulo, Instituto de Ciencias Biomedicas, Departamento de Anatomia, Sao Paulo, Brazil
| | - João Paulo Camporez
- Universidade de Sao Paulo, Faculdade de Medicina de Ribeirao Preto, Departamento de Fisiologia, Ribeirao Preto, Brazil
| | - Daniela O. Gusmão
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Edward O. List
- Edison Biotechnology Institute and Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - John J. Kopchick
- Edison Biotechnology Institute and Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Renata Frazão
- Universidade de Sao Paulo, Instituto de Ciencias Biomedicas, Departamento de Anatomia, Sao Paulo, Brazil
| | - Raphael E. Szawka
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jose Donato
- Universidade de Sao Paulo, Instituto de Ciencias Biomedicas, Departamento de Fisiologia e Biofísica, Sao Paulo, Brazil
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Lheureux S, Cristea MC, Bruce JP, Garg S, Cabanero M, Mantia-Smaldone G, Olawaiye AB, Ellard SL, Weberpals JI, Wahner Hendrickson AE, Fleming GF, Welch S, Dhani NC, Stockley T, Rath P, Karakasis K, Jones GN, Jenkins S, Rodriguez-Canales J, Tracy M, Tan Q, Bowering V, Udagani S, Wang L, Kunos CA, Chen E, Pugh TJ, Oza AM. Adavosertib plus gemcitabine for platinum-resistant or platinum-refractory recurrent ovarian cancer: a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet 2021; 397:281-292. [PMID: 33485453 PMCID: PMC10792546 DOI: 10.1016/s0140-6736(20)32554-x] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The Wee1 (WEE1hu) inhibitor adavosertib and gemcitabine have shown preclinical synergy and promising activity in early phase clinical trials. We aimed to determine the efficacy of this combination in patients with ovarian cancer. METHODS In this double-blind, randomised, placebo-controlled, phase 2 trial, women with measurable recurrent platinum-resistant or platinum-refractory high-grade serous ovarian cancer were recruited from 11 academic centres in the USA and Canada. Women were eligible if they were aged 18 years or older, had an Eastern Cooperative Oncology Group performance status of 0-2, a life expectancy of more than 3 months, and normal organ and marrow function. Women with ovarian cancer of non-high-grade serous histology were eligible for enrolment in a non-randomised exploratory cohort. Eligible participants with high-grade serous ovarian cancer were randomly assigned (2:1), using block randomisation (block size of three and six) and no stratification, to receive intravenous gemcitabine (1000 mg/m2 on days 1, 8, and 15) with either oral adavosertib (175 mg) or identical placebo once daily on days 1, 2, 8, 9, 15, and 16, in 28-day cycles until disease progression or unacceptable toxicity. Patients and the team caring for each patient were masked to treatment assignment. The primary endpoint was progression-free survival. The safety and efficacy analysis population comprised all patients who received at least one dose of treatment. The trial is registered with ClinicalTrials.gov, NCT02151292, and is closed to accrual. FINDINGS Between Sept 22, 2014, and May 30, 2018, 124 women were enrolled, of whom 99 had high-grade serous ovarian cancer and were randomly assigned to adavosertib plus gemcitabine (65 [66%]) or placebo plus gemcitabine (34 [34%]). 25 women with non-high-grade serous ovarian cancer were enrolled in the exploratory cohort. After randomisation, five patients with high-grade serous ovarian cancer were found to be ineligible (four in the experimental group and one in the control group) and did not receive treatment. Median age for all treated patients (n=119) was 62 years (IQR 54-67). Progression-free survival was longer with adavosertib plus gemcitabine (median 4·6 months [95% CI 3·6-6·4] with adavosertib plus gemcitabine vs 3·0 months [1·8-3·8] with placebo plus gemcitabine; hazard ratio 0·55 [95% CI 0·35-0·90]; log-rank p=0·015). The most frequent grade 3 or worse adverse events were haematological (neutropenia in 38 [62%] of 61 participants in the adavosertib plus gemcitabine group vs ten [30%] of 33 in the placebo plus gemcitabine group; thrombocytopenia in 19 [31%] of 61 in the adavosertib plus gemcitabine group vs two [6%] of 33 in the placebo plus gemcitabine group). There were no treatment-related deaths; two patients (one in each group in the high-grade serous ovarian cancer cohort) died while on study medication (from sepsis in the experimental group and from disease progression in the control group). INTERPRETATION The observed clinical efficacy of a Wee1 inhibitor combined with gemcitabine supports ongoing assessment of DNA damage response drugs in high-grade serous ovarian cancer, a TP53-mutated tumour type with high replication stress. This therapeutic approach might be applicable to other tumour types with high replication stress; larger confirmatory studies are required. FUNDING US National Cancer Institute Cancer Therapy Evaluation Program, Ontario Institute for Cancer Research, US Department of Defense, Princess Margaret Cancer Foundation, and AstraZeneca.
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Affiliation(s)
| | | | | | - Swati Garg
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | | | | | | | | | | | | | | | | | | | - Prisni Rath
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | - Gemma N Jones
- Translational Medicine, Oncology R&D, AstraZeneca, Cambridge, UK
| | - Suzanne Jenkins
- Translational Medicine, Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - Michael Tracy
- Translational Medicine, Oncology R&D, AstraZeneca, Cambridge, UK
| | - Qian Tan
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | | | - Lisa Wang
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | - Eric Chen
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Trevor J Pugh
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Amit M Oza
- Princess Margaret Cancer Centre, Toronto, ON, Canada.
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Sanogo ZL, Yaro AS, Dao A, Diallo M, Yossi O, Samaké D, Krajacich BJ, Faiman R, Lehmann T. The Effects of High-Altitude Windborne Migration on Survival, Oviposition, and Blood-Feeding of the African Malaria Mosquito, Anopheles gambiae s.l. (Diptera: Culicidae). J Med Entomol 2021; 58:343-349. [PMID: 32667040 PMCID: PMC7801746 DOI: 10.1093/jme/tjaa137] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Indexed: 06/11/2023]
Abstract
Recent results of high-altitude windborne mosquito migration raised questions about the viability of these mosquitoes despite ample evidence that many insect species, including other dipterans, have been known to migrate regularly over tens or hundreds of kilometers on high-altitude winds and retain their viability. To address these concerns, we subjected wild Anopheles gambiae s.l. Giles mosquitoes to a high-altitude survival assay, followed by oviposition (egg laying) and blood feeding assays. Despite carrying out the survival assay under exceptionally harsh conditions that probably provide the lowest survival potential following high altitude flight, a high proportion of the mosquitoes survived for 6- and even 11-h assay durations at 120- to 250-m altitudes. Minimal differences in egg laying success were noted between mosquitoes exposed to high altitude survival assay and those kept near the ground. Similarly, minimal differences were found in the female's ability to take an additional bloodmeal after oviposition between these groups. We conclude that similar to other high-altitude migrating insects, mosquitoes are able to withstand extended high-altitude flight and subsequently reproduce and transmit pathogens by blood feeding on new hosts.
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Affiliation(s)
- Zana L Sanogo
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
| | - Alpha S Yaro
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
| | - Adama Dao
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
| | - Moussa Diallo
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
| | - Ousman Yossi
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
| | - Djibril Samaké
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
| | | | - Roy Faiman
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD
| | - Tovi Lehmann
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-Stomatology, Bamako, Mali
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Timsina LR, Zarzaur B, Haggstrom DA, Jenkins PC, Lustberg M, Obeng-Gyasi S. Dissemination of cancer survivorship care plans: who is being left out? Support Care Cancer 2021; 29:4295-4302. [PMID: 33415363 DOI: 10.1007/s00520-020-05915-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The Institute of Medicine (IOM) and the American College of Surgeons Commission on Cancer (CoC) recommend a clear and effectively explained comprehensive survivorship care plan (SCP) be given to all cancer survivors. The objective of this study is to understand the relationship between social determinants of health (SDOH) and self-reported receipt of SCP by cancer survivors in the USA. METHODS We analyzed an adult population of cancer survivors in the 2016 Behavioral Risk Factor Surveillance System's (BRFSS) Survivorship modules. Weighted multivariable logistic regression was used to analyze the association of SDOH and reported receipt of SCP. RESULTS There were 7061 cancer patients eligible for an SCP. The probability of reporting receipt of SCP decreased with lower educational achievement (high school/some college: AOR = 0.82, 95% CI: 0.70-0.97, p = 0.02; < high school: AOR = 0.68, 95% CI: 0.47-0.97, p = 0.03) compared to those with at least one college degree. Additionally, being widowed/divorced/separated (widowed/divorced/separated: AOR = 0.72, 95% CI: 0.61-0.86, p < 0.01 vs. married/cohabiting) and uninsured (uninsured: AOR = 0.52, 95% CI: 0.0.34-0.80, p < 0.01 vs. insured) increased the odds of not receiving an SCP. Younger patients were more likely to receive an SCP than those over 65 (18-24 years: AOR = 6.62, 95% CI: 1.87-24.49, p < 0.01 vs. 65+ years). CONCLUSION Among cancer survivors, SDOH such as low educational achievement, widowed/divorced/separated marital status, and being uninsured were associated with a lower likelihood of receiving an SCP. Future studies should evaluate how omission of SCP in these patients influences the quality of care during the transition from oncologists to primary care.
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Affiliation(s)
- Lava R Timsina
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ben Zarzaur
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - David A Haggstrom
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Indianapolis, IN, USA
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Peter C Jenkins
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Maryam Lustberg
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Department of Surgery, Division of Surgical Oncology, The Ohio State University, N924 Doan Hall, 410 West 10th Avenue, Columbus, OH, 43210, USA.
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Sirotkin AV, Parkanyi V, Pivko J. High temperature impairs rabbit viability, feed consumption, growth and fecundity: examination of endocrine mechanisms. Domest Anim Endocrinol 2021; 74:106478. [PMID: 32846372 DOI: 10.1016/j.domaniend.2020.106478] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 09/28/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 01/09/2023]
Abstract
The aim of the present study was to examine the effect of high ambient temperature on rabbit feed consumption, growth, viability, and fecundity, as well as the morphology and endocrine function of gonadal and adrenal cells. Adult does and their offspring were kept at either a comfortable (20°C; control) or high (36°C) temperature throughout pregnancy and up until weaning of pups. Doe mortality and fecundity, and plasma concentrations of hormones were evaluated. In addition, granulosa cells were cultured with and without FSH to assess progesterone production. In the offspring, we assessed mortality, total feed consumption, feed efficiency, growth, plasma hormone concentrations, as well as the microstructure in ovarian granulosa cells, testicular Leydig cells, and adrenocortical cells. We observed greater mortality of both adult animals and offspring at the higher ambient temperature compared with the control. The higher ambient temperature suppressed feed consumption, feed efficiency, and growth of pups. Adult and young females exposed to a high temperature had lower circulating concentrations of progesterone, but not of estradiol, compared with controls. Young males exposed to a high ambient temperature had greater circulating concentrations of testosterone, but not progesterone, compared with controls. High ambient temperature reduced circulating IGF-I concentrations in all the animals. Corticosterone level was increased in plasma of young but not of adult animals. Granulosa cells isolated from the ovaries of does subjected to high temperatures released less progesterone, and they had poorer response to the stimulatory action of FSH than the cells from control does. High temperatures induced fragmentation of nucleoli in ovarian granulosa cells, but they did not alter the state of other organelles in ovarian, testicular, or adrenocortical cells. A negative influence of high temperature on rabbit feed consumption, growth, viability, and fecundity was observed. Taken together, these changes could be due to a decrease in IGF-I and/or progesterone secretion, destruction of ovarian cell nucleoli, and/or impaired ovarian cell response to FSH.
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Affiliation(s)
- A V Sirotkin
- Constantine the Philosopher University, 949 74 Nitra, Slovakia; Research Institute for Animal Production, National Agricultural and Food Centre, 11 Nitra, 951 41 Lužianky, Slovakia.
| | - V Parkanyi
- Research Institute for Animal Production, National Agricultural and Food Centre, 11 Nitra, 951 41 Lužianky, Slovakia
| | - J Pivko
- Research Institute for Animal Production, National Agricultural and Food Centre, 11 Nitra, 951 41 Lužianky, Slovakia
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Ojima Y, Harano M, Sumitani D, Yoshimitsu M, Okajima M. Prognostic value of preoperative carcinoembryonic antigen and D-dimer concentrations in patients undergoing curative resection for colorectal cancer. Surg Today 2021; 51:1108-1117. [PMID: 33386463 DOI: 10.1007/s00595-020-02187-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/07/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Carcinoembryonic antigen (CEA) has limited value as a standalone predictor of the survival in patients with colorectal cancer (CRC). D-dimer (DD) is a predictor of the survival in patients with metastatic CRC. We aimed to predict the prognosis in patients undergoing curative resection for the treatment of CRC by integrating the evaluation of preoperative CEA and DD concentrations with the pathological classification for stage grouping (pStage). METHODS The study enrolled 304 patients between 2007 and 2012. The Combination of DD and CEA Score (CDCS) awarded 1 point each for a CEA concentration of > 5.0 ng/ml and DD concentration of > 1.0 μg/ml. Patients were classified according to the total points: CDCS 2, increased DD and CEA concentrations; CDCS 1, increased concentration of either DD or CEA; CDCS 0, normal concentrations. RESULTS The overall survival (OS) and relapse-free survival (RFS) were significantly lower in patients with CDCS 2 than in those with CDCS 1 or 0. The pStage and CDCS were not independent prognostic predictors of the OS but were predictors of the RFS. The C-index value of the combination of the pStage and CDCS was better than that of either alone for the OS and RFS. CONCLUSION The combination of the pStage and CDCS accurately predicts relapse in patients with CRC.
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Affiliation(s)
- Yasutomo Ojima
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, Japan.
- Department of Surgery, Yoshijima Hospital, 3-2-33 Yoshijimahigashi, Naka-ku, Hiroshima, Hiroshima, Japan.
| | - Masao Harano
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, Japan
| | - Daisuke Sumitani
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, Japan
| | - Masazumi Okajima
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, Japan
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Yannopoulos D, Bartos J, Raveendran G, Walser E, Connett J, Murray TA, Collins G, Zhang L, Kalra R, Kosmopoulos M, John R, Shaffer A, Frascone RJ, Wesley K, Conterato M, Biros M, Tolar J, Aufderheide TP. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. Lancet 2020; 396:1807-1816. [PMID: 33197396 PMCID: PMC7856571 DOI: 10.1016/s0140-6736(20)32338-2] [Citation(s) in RCA: 461] [Impact Index Per Article: 115.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Among patients with out-of-hospital cardiac arrest (OHCA) and ventricular fibrillation, more than half present with refractory ventricular fibrillation unresponsive to initial standard advanced cardiac life support (ACLS) treatment. We did the first randomised clinical trial in the USA of extracorporeal membrane oxygenation (ECMO)-facilitated resuscitation versus standard ACLS treatment in patients with OHCA and refractory ventricular fibrillation. METHODS For this phase 2, single centre, open-label, adaptive, safety and efficacy randomised clinical trial, we included adults aged 18-75 years presenting to the University of Minnesota Medical Center (MN, USA) with OHCA and refractory ventricular fibrillation, no return of spontaneous circulation after three shocks, automated cardiopulmonary resuscitation with a Lund University Cardiac Arrest System, and estimated transfer time shorter than 30 min. Patients were randomly assigned to early ECMO-facilitated resuscitation or standard ACLS treatment on hospital arrival by use of a secure schedule generated with permuted blocks of randomly varying block sizes. Allocation concealment was achieved by use of a randomisation schedule that required scratching off an opaque layer to reveal assignment. The primary outcome was survival to hospital discharge. Secondary outcomes were safety, survival, and functional assessment at hospital discharge and at 3 months and 6 months after discharge. All analyses were done on an intention-to-treat basis. The study qualified for exception from informed consent (21 Code of Federal Regulations 50.24). The ARREST trial is registered with ClinicalTrials.gov, NCT03880565. FINDINGS Between Aug 8, 2019, and June 14, 2020, 36 patients were assessed for inclusion. After exclusion of six patients, 30 were randomly assigned to standard ACLS treatment (n=15) or to early ECMO-facilitated resuscitation (n=15). One patient in the ECMO-facilitated resuscitation group withdrew from the study before discharge. The mean age was 59 years (range 36-73), and 25 (83%) of 30 patients were men. Survival to hospital discharge was observed in one (7%) of 15 patients (95% credible interval 1·6-30·2) in the standard ACLS treatment group versus six (43%) of 14 patients (21·3-67·7) in the early ECMO-facilitated resuscitation group (risk difference 36·2%, 3·7-59·2; posterior probability of ECMO superiority 0·9861). The study was terminated at the first preplanned interim analysis by the National Heart, Lung, and Blood Institute after unanimous recommendation from the Data Safety Monitoring Board after enrolling 30 patients because the posterior probability of ECMO superiority exceeded the prespecified monitoring boundary. Cumulative 6-month survival was significantly better in the early ECMO group than in the standard ACLS group. No unanticipated serious adverse events were observed. INTERPRETATION Early ECMO-facilitated resuscitation for patients with OHCA and refractory ventricular fibrillation significantly improved survival to hospital discharge compared with standard ACLS treatment. FUNDING National Heart, Lung, and Blood Institute.
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Affiliation(s)
- Demetris Yannopoulos
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Jason Bartos
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ganesh Raveendran
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Emily Walser
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - John Connett
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Thomas A Murray
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Gary Collins
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Lin Zhang
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Rajat Kalra
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Marinos Kosmopoulos
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Cardiology, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ranjit John
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Andrew Shaffer
- Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
| | - R J Frascone
- St Paul Fire and Emergency Medical Services, St Paul, MN, USA
| | - Keith Wesley
- M Health Fairview Emergency Medical Services, Minneapolis, MN, USA
| | - Marc Conterato
- North Memorial Emergency Medical Services, Robbinsdale, MN, USA
| | - Michelle Biros
- Department of Emergency Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jakub Tolar
- Center for Resuscitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Tom P Aufderheide
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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Patel SA, Goyal S, Liu Y, Moghanaki D, Patel PR, Hanasoge S, Dhere VR, Shelton JW, Godette KD, Jani AB, Hershatter B, Fischer-Valuck BW. Analysis of Radiation Facility Volume and Survival in Men With Lymph Node-Positive Prostate Cancer Treated With Radiation and Androgen Deprivation Therapy. JAMA Netw Open 2020; 3:e2025143. [PMID: 33301015 PMCID: PMC7729429 DOI: 10.1001/jamanetworkopen.2020.25143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE Long-term control of node-positive (N1) prostate cancer, the incidence of which is increasing, is obtainable with aggressive treatment, and definitive external beam radiation therapy (EBRT) with long-term androgen deprivation therapy (ADT) is an increasingly preferred option. Caring for these patients is complex and may require resources more readily available at high-volume centers. OBJECTIVE To evaluate the association between radiation facility case volume and overall survival (OS) in men with N1 prostate cancer. DESIGN, SETTING, AND PARTICIPANTS This cohort study included 1899 men diagnosed with T1N1M0 to T4N1M0 prostate cancer treated with curative-intent EBRT and ADT between January 2004 and December 2016 at US facilities reporting to the National Cancer Database. Data analysis was performed from March to June 2020. EXPOSURES Treatment at a center with high vs low average cumulative facility volume (ACFV), defined as the total number of prostate radiation cases at an individual patient's treatment facility from 2004 until the year of that patient's diagnosis. MAIN OUTCOMES AND MEASURES OS was assessed between high- vs low-ACFV centers using the Kaplan-Meier method with and without propensity score-based weighted adjustment and multivariable Cox proportional hazards. The nonlinear association between continuous ACFV and OS was examined through a Martingale residual plot, and the optimal ACFV cutoff point that maximized the separation between high vs low ACFV was identified via a bias adjusted log rank test. RESULTS A total of 1899 men met inclusion criteria. The median (interquartile range) age was 66 (60-72) years, 1491 (78.5%) were White individuals, and 1145 (60.3%) were treated at nonacademic centers. The optimal ACFV cutoff point was 66.4 patients treated per year. The median OS for patients treated at high-ACFV vs low-ACFV centers was 111.1 (95% CI, 101.5-127.9) months and 92.3 (95% CI, 87.7-103.9) months, respectively (P = .01). On multivariable analysis, treatment at a low-ACFV center was associated with increased risk of death (HR, 1.22; 95% CI, 1.02-1.46, P = .03) compared with treatment at a high-ACFV center. These results persisted after propensity score-based adjustment. CONCLUSIONS AND RELEVANCE This cohort study found a significant association of facility case volume with long-term outcomes in men with N1 prostate cancer undergoing EBRT with ADT. Specifically, treatment at a facility with high radiation case volume was independently associated with longer OS. Further studies should focus on identifying which factors unique to high-volume centers may be responsible for this benefit.
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Affiliation(s)
- Sagar A. Patel
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Subir Goyal
- Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Yuan Liu
- Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, Georgia
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | - Drew Moghanaki
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Pretesh R. Patel
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Sheela Hanasoge
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Vishal R. Dhere
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Jay W. Shelton
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Karen D. Godette
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Ashesh B. Jani
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Bruce Hershatter
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
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Kellerborg K, Perry-Duxbury M, de Vries L, van Baal P. Practical Guidance for Including Future Costs in Economic Evaluations in The Netherlands: Introducing and Applying PAID 3.0. Value Health 2020; 23:1453-1461. [PMID: 33127016 DOI: 10.1016/j.jval.2020.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 01/20/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 05/16/2023]
Abstract
OBJECTIVES A consensus has been reached in The Netherlands that all future medical costs should be included in economic evaluations. Furthermore, internationally, there is the recognition that in countries that adopt a societal perspective estimates of future nonmedical consumption are relevant for decision makers as much as production gains are. The aims of this paper are twofold: (1) to update the tool Practical Application to Include Future Disease Costs (PAID 1.1), based on 2013 data, for the estimation of future unrelated medical costs and introduce future nonmedical consumption costs, further standardizing and facilitating the inclusion of future costs; and (2) to demonstrate how to use the tool in practice, showing the impact of including future unrelated medical costs and future nonmedical consumption in a case-study where a life is hypothetically saved at different ages and 2 additional cases where published studies are updated by including future costs. METHODS Using the latest published cost of illness data from the year 2017, we model future unrelated medical costs as a function of age, sex, and time to death, which varies per disease. The Household Survey from Centraal Bureau Statistiek is used to estimate future nonmedical consumption by age. RESULTS The updated incremental cost-effectiveness ratios (ICERs) from the case studies show that including future costs can have a substantial effect on the ICER, possibly affecting choices made by decision makers. CONCLUSION This article improves upon previous work and provides the first tool for the inclusion of future nonmedical consumption in The Netherlands.
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Affiliation(s)
- Klas Kellerborg
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Meg Perry-Duxbury
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Linda de Vries
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter van Baal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Luyendijk M, Vernooij RWM, Blommestein HM, Siesling S, Uyl-de Groot CA. Assessment of Studies Evaluating Incremental Costs, Effectiveness, or Cost-Effectiveness of Systemic Therapies in Breast Cancer Based on Claims Data: A Systematic Review. Value Health 2020; 23:1497-1508. [PMID: 33127021 DOI: 10.1016/j.jval.2020.05.008] [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] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/10/2020] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Large secondary databases, such as those containing insurance claims data, are increasingly being used to compare the effects and costs of treatments in routine clinical practice. Despite their appeal, however, caution must be exercised when using these data. In this study, we aimed to identify and assess the methodological quality of studies that used claims data to compare the effectiveness, costs, or cost-effectiveness of systemic therapies for breast cancer. METHODS We searched Embase, the Cochrane Library, Medline, Web of Science, and Google Scholar for English-language publications and assessed the methodological quality using the Good Research for Comparative Effectiveness principles. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42018103992. RESULTS We identified 1251 articles, of which 106 met the inclusion criteria. Most studies were conducted in the United States (74%) and Taiwan (9%) and were based on claims data sets (35%) or claims data linked to cancer registries (58%). Furthermore, most included large samples (mean 17 130 patients) and elderly patients, and they covered various outcomes (eg, survival, adverse events, resource use, and costs). Key methodological shortcomings were the lack of information on relevant confounders, the risk of immortal time bias, and the lack of information on the validity of outcomes. Only a few studies performed sensitivity analyses. CONCLUSIONS Many comparative studies of cost, effectiveness, and cost-effectiveness have been published in recent decades based on claims data, and the number of publications has increased over time. Despite the availability of guidelines to improve quality, methodological issues persist and are often inappropriately addressed or reported.
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Affiliation(s)
- Marianne Luyendijk
- Department of Research and Development, Netherlands Comprehensive Cancer Center, Utrecht, The Netherlands; Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
| | - Robin W M Vernooij
- Department of Research and Development, Netherlands Comprehensive Cancer Center, Utrecht, The Netherlands
| | - Hedwig M Blommestein
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Center, Utrecht, The Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Carin A Uyl-de Groot
- Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
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Saad AB, Migaou A, Mhamed SC, Fahem N, Rouatbi N, Joobeur S. [Bronchial dilatations in patients with chronic obstructive pulmonary disease in a Tunisian center: effect on disease progression and prognosis]. Pan Afr Med J 2020; 37:200. [PMID: 33505569 PMCID: PMC7813652 DOI: 10.11604/pamj.2020.37.200.24448] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/12/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION bronchial dilations (BDs) seem to have a major role in the natural history of chronic obstructive pulmonary disease (COPD). The purpose of our study was to evaluate the impact of BDs on the severity and progression of COPD as well as on patients' prognosis. METHODS we conducted a retrospective, single-center, analytical study over the period 1995- 2017. The study was based on data from the medical records of patients with COPD who had undergone chest CT scan during the follow-up period. We compared two groups (G) of patients: G1: COPD with BDs; G2: COPD without BDs. RESULTS our study included 466 patients with COPD. Among them 101 (21.6%) had BDs associated with COPD. G1 patients had lower maximum expiratory volume in the first second (FEV1) (G1: 1.21 L, G2: 1.37 L, p = 0.015), lower forced vital capacity (FVC) (p = 0.014), a lower PaO2 at steady state (p = 0.049), a higher rate of acute exacerbations (AE) per year (G1: 3.31, G2: 2.44, p = 0.001) and a higher rate of hospitalizations in the Intensive Care Unit per year (p = 0.02). G1 patients with AE receiving treatment in hospital had lower PaO2 3) on admission (G1: 60 mmHg, G2: 63.7 mmHg, p = 0.02 G2: 63.7 mmHg, p = 0.023), more elevated carbon dioxide (CO2) levels (p = 0.001) and were characterized by a higher use of non-invasive ventilation (NIV) (p = 0.044) and invasive mechanical ventilation (p = 0.011). G2 patients had better overall survival (p = 0.002). CONCLUSION bronchial dilatations are an indicator of poor prognosis in patients with chronic obstructive pulmonary disease, expecially because of the higher rate and severity of exacerbations, airway obstructions and mortality.
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Affiliation(s)
- Ahmed Ben Saad
- Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie
| | - Asma Migaou
- Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie
| | - Saousen Cheikh Mhamed
- Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie
| | - Nesrine Fahem
- Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie
| | - Naceur Rouatbi
- Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie
| | - Samah Joobeur
- Service de Pneumologie et d´Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1er juin, 5000 Monastir, Monastir, Tunisie
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Barth T, McKay MP, Smith R. Survivability of a Tesla collision into a non-operational crash attenuator in Mountain View, CA. Traffic Inj Prev 2020; 21:S154-S156. [PMID: 33179965 DOI: 10.1080/15389588.2020.1829910] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE On March 23, 2018 a Tesla Model X driver was killed in Mountain View, CA after colliding with a previously collapsed crash attenuator at a speed of 31.7 m/s (70.8 mph). The attenuator, which must be repaired following a collision, had been struck 11 days prior by a 2010 Toyota Prius at a minimum speed of 33.9 m/s (75.8 mph). The Toyota driver survived. The maintenance of traffic safety hardware and benefit of the crash attenuator are evaluated. METHODS Public information from an NTSB investigation is used to evaluate crash impact severity. Vehicle crash data from Event Data Recorders (EDRs) are compared with test data for the SCI Smart Cushion 100GM crash attenuator. An idealized triangular crash pulse is used to estimate longitudinal peak impact acceleration, and longitudinal impact energy is calculated. The medical outcomes for drivers are considered. RESULTS The California Department of Transportation (Caltrans) maintenance and repair program for safety critical traffic safety hardware was found to be ineffective. The Tesla collision into the nonfunctional attenuator was estimated have roughly three times the impact force to the passenger compartment as it would have been if striking a functional attenuator. CONCLUSIONS The Tesla driver could have survived the collision had the crash attenuator been functional. Roadway management and timely maintenance of safety critical traffic hardware are necessary to ensure safety.
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Affiliation(s)
- Thomas Barth
- National Transportation Safety Board, Washington, DC
| | | | - Ryan Smith
- National Transportation Safety Board, Washington, DC
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Zhu M, Liu X, Zhou C, Li J. Effect of sodium cantharidinate/vitamin B6 injection on survival, liver function, immune function, and quality of life in patients with hepatocellular carcinoma: Protocol for a meta-analysis. Medicine (Baltimore) 2020; 99:e21952. [PMID: 32846865 PMCID: PMC7447480 DOI: 10.1097/md.0000000000021952] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sodium cantharidinate/vitamin B6 (SC/VB6) injection, a famous insect-derived traditional Chinese medicine preparation, has been widely applied as a promising adjunctive drug for hepatocellular carcinoma (HCC). However, its exact clinical efficacy and safety is still not well investigated. In this study, we aimed to summarize the efficacy of SC/VB6 injection on survival, liver function, immune function, and quality of life (QoL) in patients with HCC through the meta-analysis. METHODS All available randomized controlled trials (RCTs) and high-quality prospective cohort studies that investigated the efficacy and safety of SC/VB6 for patients with HCC were searched from ten electronic databases including PubMed, Google Scholar, Cochrane Library, Excerpt Medica Database (Embase), Medline, Web of Science (WOS), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Scientific Journal Database (CSJ), and Wanfang Database. Papers in Chinese or English published from January 2000 to July 2020 will be included without any restrictions.Study selection and data extraction will be performed independently by 2 researchers. The clinical outcomes including overall survival (OS), QoL, liver function, immune function, and adverse events, were systematically evaluated. Review Manager 5.3 and Stata 14.0 were used for data analysis, and the quality of the clinical trials was also evaluated. RESULTS The results of this study will be published in a peer-reviewed journal, and provide a helpful evidence for clinicians to formulate the best postoperative adjuvant treatment strategy for HCC patients. CONCLUSION Our study will draw an objective conclusion of the efficacy of SC/VB6 on survival, liver function, immune function, and QoL in patients with HCC. INPLASY REGISTRATION NUMBER INPLASY202070121.
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Affiliation(s)
- Min Zhu
- Department of Clinical Laboratory
| | | | - Changhui Zhou
- Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng, Shandong Province, P.R. China
| | - Juan Li
- Department of Clinical Laboratory
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Zhang Z, Lu S, Dunmall LSC, Wang Z, Cheng Z, Zhang Z, Yan W, Chu Y, Gao D, Wang N, Li Y, Wang J, Li Y, Ji Y, Shan D, Li K, Wang P, Dong Y, Dong J, Lemoine NR, Pei D, Zhang L, Wang Y. Treatment and Prevention of Lung Cancer Using a Virus-Infected Reprogrammed Somatic Cell-Derived Tumor Cell Vaccination (VIReST) Regime. Front Immunol 2020; 11:1996. [PMID: 32903551 PMCID: PMC7438408 DOI: 10.3389/fimmu.2020.01996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/23/2020] [Indexed: 12/25/2022] Open
Abstract
Lung cancer is one of the most commonly diagnosed cancer and despite therapeutic advances, mortality remains high. The long period of clinical latency associated with lung cancer provides an ideal window of opportunity to administer vaccines to at-risk individuals that can prevent tumor progression and initiate long-term anti-tumor immune surveillance. Here we describe a personalized vaccination regime that could be applied for both therapeutic and prophylactic prevention of lung cancer, based on the derivation of lung cancer cells from induced pluripotent stem cells. Stem cells from healthy mice were modified to express Cre-dependent KRASG12D and Trp53R172H prior to differentiation to lung progenitor cells. Subsequent viral delivery of Cre caused activation of exogenous driver mutations, resulting in transformation and development of lung cancer cells. iPSC-derived lung cancer cells were highly antigenically related to lung cancer cells induced in LSL-KRASG12D/+; Trp53R172H/+ transgenic mice and were antigenically unrelated to original pluripotent stem cells or pancreatic cancer cells derived using the same technological platform. For vaccination, induced lung cancer cells were infected with oncolytic Adenovirus or Vaccinia virus, to act as vaccine adjuvants, prior to delivery of vaccines sequentially to a murine inducible transgenic model of lung cancer. Application of this Virus-Infected, Reprogrammed Somatic cell-derived Tumor cell (VIReST) regime primed tumor-specific T cell responses that significantly prolonged survival in both subcutaneous post-vaccine challenge models and induced transgenic models of lung cancer, demonstrating that stem cell-derived prophylactic vaccines may be a feasible intervention for treatment or prevention of lung cancer development in at-risk individuals.
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Affiliation(s)
- Zhe Zhang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Shuangshuang Lu
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Louisa S. Chard Dunmall
- Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Zhizhong Wang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhenguo Cheng
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhongxian Zhang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Wenli Yan
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yongchao Chu
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Dongling Gao
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Na Wang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yang Li
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Jiwei Wang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yuenan Li
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yupei Ji
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Danyang Shan
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Keke Li
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Panpan Wang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yunshu Dong
- CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Jianzeng Dong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Nick R. Lemoine
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Duanqing Pei
- CAS Key Laboratory of Regenerative Biology, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Lirong Zhang
- School of Basic Medical Sciences, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Yaohe Wang
- National Center for International Research in Cell and Gene Therapy, Sino-British Research Centre for Molecular Oncology, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
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Tedoldi F, Ravanelli D, Braito G, Dallago M, Menotti A, Muraglia S, Menegotti L, Bonmassari R. [Risk assessment and early predictors of survival after out-of-hospital cardiac arrest in the province of Trento, Italy]. G Ital Cardiol (Rome) 2020; 21:647-653. [PMID: 32686792 DOI: 10.1714/3405.33899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Early prognostication of patients experiencing out-of-hospital cardiac arrest (OHCA) remains difficult, with no recommended risk assessment tool. The aim of this study was to determine and assess the association between available variables with survival at discharge of patients with OHCA in our regional reality. METHODS We conducted a retrospective observational study in a single-center cohort of 236 consecutive patients with OHCA and return of spontaneous circulation admitted to the S. Chiara Hospital (Trento, Italy) from 2012 to 2015. We applied a backward stepwise multivariable logistic regression performed on 26 variables significantly related to outcome to identify predictors. The final model was evaluated for discrimination with area under the curve (AUC) of a receiver operating characteristic curve and for calibration with Hosmer-Lemeshow test and with calibration belt. RESULTS We identified four independent factors predictive of outcome: age, arterial blood pH, coronary angiography execution and intervention of helicopter. The final model presented good discrimination with an average AUC of 0.78 (95% confidence interval 0.72-0.84) and was well calibrated, as confirmed by the Hosmer-Lemeshow test (p=0.45) and the calibration belt plot (p=0.597). CONCLUSIONS Age, arterial blood pH, coronary angiography execution and intervention of helicopter were variables predictive of outcome. Identified predictors are in agreement with the literature and relate to local reality. Accurate prognostic assessment would facilitate an earlier identification of patients who may benefit from intensive advanced post-resuscitation care.
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Affiliation(s)
| | | | | | | | | | | | - Loris Menegotti
- Dipartimento di Fisica Sanitaria, Ospedale Santa Chiara, Trento
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Affiliation(s)
- Mildred Z Solomon
- From the Hastings Center, Garrison, NY (M.Z.S.); the Department of Global Health and Social Medicine, Harvard Medical School, Boston (M.Z.S.); the University of Colorado Center for Bioethics and Humanities, Department of Medicine, University of Colorado School of Medicine, and the Department of Health Systems Management and Policy, Colorado School of Public Health, Anschutz Medical Campus, Aurora (M.K.W.); and the O'Neill Institute for National and Global Health Law, Georgetown Law School, Georgetown University, Washington, DC (L.O.G.)
| | - Matthew K Wynia
- From the Hastings Center, Garrison, NY (M.Z.S.); the Department of Global Health and Social Medicine, Harvard Medical School, Boston (M.Z.S.); the University of Colorado Center for Bioethics and Humanities, Department of Medicine, University of Colorado School of Medicine, and the Department of Health Systems Management and Policy, Colorado School of Public Health, Anschutz Medical Campus, Aurora (M.K.W.); and the O'Neill Institute for National and Global Health Law, Georgetown Law School, Georgetown University, Washington, DC (L.O.G.)
| | - Lawrence O Gostin
- From the Hastings Center, Garrison, NY (M.Z.S.); the Department of Global Health and Social Medicine, Harvard Medical School, Boston (M.Z.S.); the University of Colorado Center for Bioethics and Humanities, Department of Medicine, University of Colorado School of Medicine, and the Department of Health Systems Management and Policy, Colorado School of Public Health, Anschutz Medical Campus, Aurora (M.K.W.); and the O'Neill Institute for National and Global Health Law, Georgetown Law School, Georgetown University, Washington, DC (L.O.G.)
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