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Maas Z, Carson DA, McIntyre RA, Rahiri JL, Wells C, Cribb B, Omundsen M, Holm TM. Comparing return of bowel function after right versus extended right hemicolectomy: a retrospective analysis. ANZ J Surg 2024; 94:697-701. [PMID: 38041237 DOI: 10.1111/ans.18807] [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: 08/03/2023] [Revised: 11/03/2023] [Accepted: 11/18/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Prolonged postoperative ileus (PPOI) is associated with higher morbidity and extended inpatient stay. Although evidence suggests that PPOI is more common following right-sided resections, it is uncertain if return to bowel function is similar following extended right (ERH) versus right hemicolectomy (RH). METHODS The recovery of patients undergoing ERH and RH in a regional hospital in New Zealand was retrospectively compared, from 2012 to 2021. Rates of PPOI, return of bowel function and postoperative complications were compared. Other factors potentially relating to PPOI were analysed. RESULTS 293 patients were included (42 who underwent ERH, and 251 RH). PPOI was more common following ERH than RH (43% vs. 25%, P = 0.02). When accounting for the operative approach, rate of PPOI was not significantly different (42% open ERH vs. 36% open RH; P = 0.56). Excluding PPOI, return of bowel function did not differ between groups. Patient undergoing ERH versus RH had significantly higher length of stay (1 day) and Hb drop (2.5 g/L) postoperatively. CONCLUSION Higher rates of PPOI have been demonstrated in ERH versus RH however when controlling for approach, there was not a significant difference. Further interrogation into rates of PPOI (particularly after laparoscopic surgery) are warranted to tailor locoregional ERAS protocols.
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Affiliation(s)
- Zak Maas
- Department of General Surgery, Tauranga Hospital, Tauranga, New Zealand
| | - Daniel A Carson
- Department of General Surgery, Tauranga Hospital, Tauranga, New Zealand
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Rachel A McIntyre
- Department of Obstetrics & Gynaecology, Tauranga Hospital, Tauranga, New Zealand
| | - Jamie-Lee Rahiri
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Cameron Wells
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Benjamin Cribb
- Department of General Surgery, Tauranga Hospital, Tauranga, New Zealand
| | - Mark Omundsen
- Department of General Surgery, Tauranga Hospital, Tauranga, New Zealand
| | - Teresa M Holm
- Department of General Surgery, Tauranga Hospital, Tauranga, New Zealand
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
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DW, umar A, Filikus AL, Wycliff D, Okunlola A, Abiola O, Adeniyi A, Adeyemo O, Awoyinka B, Babalola O, Bakare A, Buari T, Okunlola C, Adeleye G, Salawu A, Abiyere H, Ogidi A, Orewole T, Abdullahi HI, Akaba G, Achem A, Bassey AO, Ayogu E, Sulaiman B, Isah DA, Akpamgbo CN, Asudo F, Adewole N, Oguche O, Ejembi P, Sani SA, Andrew PC, Isah A, Eniola B, Songden Z, Agida T, Atim T, Mohammed TO, Raji HO, Ibiyemi F, Salawu H, Fasiku O, Solagbade RS, Shiru MM, Ibraheem GH, Oruade J, Ezeoke G, Chawla T, Aziz AB, Marium A, Waheed AA, Aamir FB, Qureshi F, Ather MH, Ali IFM, Tahir I, Akbar MG, Ukrani RD, Raja S, Virani SS, Noordin S, Rehman SU, Golani S, Aamir SR, Mufarrih SM, Waqar U, Taufiq M, Ammar AS, Ejaz A, Sarwar A, Khalid AU, Khattak S, Imran A, Khalid OB, Kaleem U, Muneer U, Kashaf Y, Zafar F, Zaheer A, Ali M, Shafaat A, Qazi A, Tariq AI, Aslam MN, Ali S, Atiq T, Wasim T, Babar D, Zain A, Ibtisam M, Ahmed U, Aqeel STB, Muhib M, Abbal MA, Khan NA, Javed I, Alkaraja L, Amro D, Manasrah G, Hammouri I, Hilail IA, Zalloum J, Alamlih L, Nasereddin M, Rajabi M, Shalalfeh S, Natsheh Z, Elessi K, Jayyab MA, Astal M, Al-Dahdouh M, Salameh AE, Ayyad A, Dawod N, Alsaid H, Matar I, Hassan M, Bakeer M, Malasah M, Abuhashem S, Salem M, Lunca S, Dimofte MG, Morarasu S, Musina AM, Roata CE, Velenciuc N, Butyrskii A, Bozhko M, Ametov A, Chowdhury S, Bagazi D, Domenech J, Rosello-Añon A, Monis A, Chiappe C, Cuneo B, Clemente-Navarro P, Febre J, Sanz-Romera J, Lopez-Vega M, Miranda I, Valverde-Vazquez R, Garcia S, Sanguesa MJ, Balciscueta Z, Ruiz E, Marco E, Talavera E, Farre J, Bacariza L, Duart M, Ureña V, Carre X, Hamid HKS, Abd-Albain MA, Galal-Eldin S, Sarih M, Adam E, Ismail S, Azhari M, Hassan T, Salaheldein M, Abdalla Z, Ahmed W, Alhassan M, Mohamed A, Suliman HMA, Eltayeb MOM, Ahmed RAA, Babekir EMA, Khairy MAT, Mukhtar MMA, Ali RAH, Al-Shambaty YBA, Yousif FI, Mohammed HMH, Osher L, Osher L, Abdelbast M, Yassin M, Moawia N, Abdalsadeg R, Husein A, Elhassan B, Abdelbagi AY, Adam MA, Ali EM, Mohammed IAB, Mohamed M, Abdulaziz M, Akasha M, Hassan M, Hilal N, Mohamed NAA, Abubaker N, Mohammed O, Mohamed S, Osman W, Mustafa F, Salih AA, Ali D, Almakki DMA, Mohamed HE, Elmubark A, Hassan M, Alnour A, Elaagib A, Abdelrahman A, Abdelkhalig M, Eldaim KN, Babiker A, Ahmed E, Ali M, Hussain E, Wedatalla M, Ahmed A, Hamza AA, Mohammed M, Osman O, Ibrahim R, Ahmed R, Ahmed R, Yasir R, Awadallah S, Mohmmed S, Hassan S, Shaban W, Hussein A, Rafea R, Abdalla A, Ahmed A, Mohamed K, Mohammed M, Altahir M, Adam M, Mohamed O, Abdullah W, Fadlalmola H, Abdalla AY, Omer AA, Mustafa AA, Elhadi REH, Banaga EEA, Osman F, Abdalla MGA, Taha HAM, Abdalmahmoud NE, Nafie RH, Jamal S, Ahmed S, Ali RA, Aladna A, Aljoumaa A, Nawfal H, Jamali S, Khouja F, Niazi A, Al Rawashdeh T, Kechiche N, Gara M, Nasr M, Baccar M, Benamor O, Chakroun S, Sanli AN, Yildiz A, Demirkiran MA, Atadag YB, Tandogan YI, Ozkan E, Ozer Y, Ozkan E, Oncel MM, Kalkan S, Gover T, Manoglu B, Oksak I, Kurt I, Rifaioglu K, Sokmen S, Bisgin T, Yildirim Y, Keskin AY, Dogan T, Sahin Bİ, Aydin C, Benek DE, Tiras HN, Arslangilay M, Aslangilay M, Yaytokgil M, Capar MA, Yazgan Y, Bektas S, Alagoz AC, Dagsali AE, Izgis A, Uzel K, Soytas M, Cakir N, Askin AE, Azboy I, Sabuncu K, Aslan M, Sahin M, Oncel M, Okkabaz N, Sivrikaya RK, Saylar A, Saylar A, Yasar M, Erginoz E, Bozkir HO, Zengin K, Ozcelik MF, Uludag SS, Ozdemir Z, Sibic O, Telci H, Bozkurt MA, Kara Y, Tepe MD, Gündoğdu A, Akın B, Pehlivan D, Guner A, Baysallar D, Yıldız B, Cepe H, Reis ME, Yuzgec AN, Kıralı N, Kodalak TA, Ulusahin M, Selim K, Kale A, Gecici ME, Ozbilen M, Düzyol Z, Gemici A, Korkmaz E, Şen E, Taşcı ME, Camkıran E, Elieyioğlu G, Kayabaş İ, Uprak TK, Aral C, Saraçoğlu A, Uğurlu MÜ, Baltacı ZH, Akkaya EN, Fergar C, Tabak EZ, Kocyigit GZ, Kayilioglu I, Polat S, Çolak E, Kara ME, Candan M, Uyanık MS, Sarı AC, Ulkucu A, Certel AT, Dindar A, Durdu B, Bayram C, Kaya E, Akdere H, Cakcak IE, Yavuz I, Omur M, Ajredini M, Aydoğdu EO, Şenödeyici E, Koksoy UC, Kazbek BK, Korkmaz DS, Yavuz D, Yilmaz H, Cetınkaya ZS, Durmus E, Tuzuner F, Hokelekli F, Mutlu M, Akbuz SO, Kus ZC, Kus ZC, Farrell M, Craig-Lucas A, Painter M, Titan A, Narayan A, Fariyike B, Knowlton L, Yue T, Benham E, Nimeri A, Werenski H, Kaiser N, Reinke C. Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries. Br J Surg 2024; 111:znad421. [PMID: 38207169 PMCID: PMC10783642 DOI: 10.1093/bjs/znad421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures. METHODS This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge. RESULTS The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not. CONCLUSION Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely.
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Connell CJW, Salkeld AJ, Wells C, Verstappen AC, Poole P, Wilkinson TJ, Bagg W. Sample representativeness and influence of attrition on longitudinal data collected as part of a national medical career tracking project. BMC Med Educ 2023; 23:532. [PMID: 37491266 PMCID: PMC10369717 DOI: 10.1186/s12909-023-04472-1] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 06/23/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND The Medical Schools Outcomes Database and Longitudinal Tracking Project (MSOD) in New Zealand is one example of a national survey-based resource of medical student experiences and career outcomes. Longitudinal studies of medical students are valuable for evaluating the outcomes of medical programs against workforce objectives. As a prospective longitudinal multiple-cohort study, survey response rates at each collection point of MSOD vary. This paper assesses the effects of participant non-response rates on MSOD data. METHODS Demographic variables of MSOD respondents between 2012 and 2018 were compared to the distribution of the demographic variables in the population of all NZ medical graduates to ascertain whether respondent samples at multiple survey collection points were representative of the population. Analysis using logistic regression assessed the impact of participant non-response on variables at collection points throughout MSOD. RESULTS 2874 out of a total population of 2939 domestic medical students graduating between 2012 and 2018 responded to MSOD surveys. Entry and exit surveys achieved response rates around 80% and were broadly representative of the total population on demographic variables. Post-graduation survey response rates were around 50% of the total population of graduates and underrepresented graduates from the University of Auckland. Between the entry and exit and the exit and postgraduation year three samples, there was a significant impact of non-response on ascribed variables, including age at graduation, university, gender and ethnic identity. Between the exit and postgraduation year one sample, non-response significantly impacted ascribed and non-ascribed variables, including future practice intentions. CONCLUSION Samples collected from MSOD at entry and exit are representative, and findings from cross-sectional studies using these datasets are likely generalisable to the wider population of NZ medical graduates. Samples collected one and three years post-graduation are less representative. Researchers should be aware of this bias when utilizing these data. When using MSOD data in a longitudinal manner, e.g. comparing the change in career intentions from one collection point to the next, researchers should appropriately control for bias due to non-response between collection points. This study highlights the value of longitudinal career-tracking studies for answering questions relevant to medical education and workforce development.
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Affiliation(s)
- Charlotte J W Connell
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | | | - Cameron Wells
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Antonia C Verstappen
- The Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Phillippa Poole
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tim J Wilkinson
- Otago Medical School, University of Otago, Christchurch, New Zealand
| | - Warwick Bagg
- School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Khan SM, Wells C, Christou N, Tan CY, Mathur P, El-Hussuna A. Preoperative assessment of blood supply and its role in predicting anastomotic leak. Surgery 2023:S0039-6060(23)00173-3. [PMID: 37156647 DOI: 10.1016/j.surg.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/02/2023] [Accepted: 04/03/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Anastomosis leak is one of the significant postoperative complications after colorectal surgery. The aim of this systematic review was to synthesize the evidence relative to the preoperative assessment of the colon and rectum blood supply and to investigate its role in predicting anastomosis leak. METHOD This systematic review was conducted according to the recommendations of the Cochrane Handbook for Reviews of Interventions and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PubMed, Embase, and the Cochrane Library were searched to identify eligible studies. The main outcome variable was the preoperative assessment of patterns of blood supply to the colon and the impact of these patterns on anastomosis leak. The quality of bias control in the studies was assessed using the Newcastle-Ottawa Scale. Due to the heterogeneous nature of the included studies, no meta-analysis was conducted. RESULTS Fourteen studies were included. The study covered a period from 1978 to 2021. A significant degree of variation in the arterial and/or venous supply of the colon and rectum might influence anastomosis leak rates. Calcification in great blood vessels can be assessed with a preoperative computed tomography scan, which may predict anastomosis leak rates. This is supported by many experimental studies that showed increased rates of anastomosis leak after preoperative ischemia, but the extent of this impact is not well established. CONCLUSION Preoperative assessment of blood supply to the colon and rectum might help in planning the surgical intervention to reduce anastomosis leak rates. Calcium scoring of major arteries might predict anastomosis leak and thus play a crucial role in intraoperative decision-making.
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Affiliation(s)
- Sualeh Muslim Khan
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Cameron Wells
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Niki Christou
- UMR Inserm 1308, Captur Laboratory, Faculty of Medicine, University of Limoges, France; Endocrine, General, and Digestive Surgery Department, CHU of Limoges, France
| | - Chee Yang Tan
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Strings S, Wells C, Bell C, Tomiyama AJ. The association of body mass index and odds of type 2 diabetes mellitus varies by race/ethnicity. Public Health 2023; 215:27-30. [PMID: 36634403 DOI: 10.1016/j.puhe.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/14/2022] [Accepted: 11/25/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to examine the association between body mass index (BMI; weight [kilogram]/height2 [meter]) and type 2 diabetes mellitus (T2DM) among the largest three largest racial/ethnic groups in the United States. METHODS We compiled 10 waves of the continuous National Health and Nutrition Examination Survey from 1999-2000 through 2017-2018. Participants (N = 45,514) were those who had data on BMI, HbA1c, and demographics. We estimated associations between BMI and prediabetes/T2DM odds for Black, Latine, and White participants. RESULTS BMI was associated with 10% higher odds of prediabetes/T2DM vs. having normal HbA1c levels (odds ratio = 1.10, 95% confidence interval = 1.10-1.11) for Latine and White individuals. However, the association between BMI and prediabetes/T2DM was significantly weaker among Black individuals. When focusing on T2DM prevalence, the association with BMI for Black participants was even weaker (odds ratio = 0.97, 95% confidence interval = 0.95-0.98). CONCLUSIONS The unstable associations between BMI and T2DM across race indicate that BMI has received unwarranted focus as a prime predictor of T2DM. Relying on BMI introduces bias in T2DM risk estimations especially in Black individuals. Focusing on BMI places the onus on individuals to change and increases weight stigma, which can worsen health outcomes. Instead, policymakers should focus on social determinants of T2DM and its concomitant racial/ethnic disparities.
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Affiliation(s)
- S Strings
- Department of Sociology, 3151 Social Sciences Plaza A, University of California, Irvine, Irvine CA 92697, USA.
| | - C Wells
- Advanced Research Computing, University of California, Los Angeles, Los Angeles CA, USA
| | - C Bell
- Social, Behavioral, and Population Sciences, School of Public Health & Tropical Medicine, Tulane University, New Orleans LA, USA
| | - A J Tomiyama
- Department of Psychology, University of California, Los Angeles, Los Angeles CA, USA
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Gaborit L, Park M, Raubenheimer K, Mansour LT, Wells C, Varghese C, Xu W. Selection criteria for Australian and New Zealand medical specialist training programs: another under‐recognised driver of research waste. Med J Aust 2022; 216:594. [DOI: 10.5694/mja2.51558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/15/2022] [Accepted: 03/24/2022] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | | | | | | | | | - William Xu
- University of Auckland Auckland New Zealand
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Zaborowski AM, Adamina AAM, Aigner F, d'Allens L, Allmer C, Álvarez A, Anula R, Andric M, Bach SAS, Bala M, Barussaud M, Bausys A, Beggs A, Bellolio F, Bennett MR, Berdinskikh A, Bevan V, Biondo S, Bislenghi G, Bludau M, Brouwer N, Brown C, Bruns C, Buchanan DD, Buchwald P, Burger JW, Burlov N, Campanelli M, Capdepont M, Carvello M, Chew HH, Christoforidis D, Clark D, Climent M, Collinson R, Cologne KG, Contreras T, Croner R, Daniels IR, Dapri G, Davies J, Delrio P, Denost Q, Deutsch M, Dias A, D’Hoore A, Drozdov E, Duek D, Dunlop M, Dziki A, Edmundson A, Efetov S, El-Hussuna A, Elliot B, Emile S, Espin E, Evans M, Faes S, Faiz O, Figueiredo N, Fleming F, Foppa C, Fowler G, Frasson M, Forgan T, Frizelle F, Gadaev S, Gellona J, Glyn T, Goran B, Greenwood E, Guren MG, Guillon S, Gutlic I, Hahnloser D, Hampel H, Hanly A, Hasegawa H, Iversen LH, Hill A, Hill J, Hoch J, Hompes R, Hurtado L, Iaquinandi F, Imbrasaite U, Islam R, Jafari MD, Salido AJ, Jiménez-Toscano M, Kanemitsu Y, Karachun A, Karimuddin AA, Keller DS, Kelly J, Kennelly R, Khrykov G, Kocian P, Koh C, Kok N, Knight KA, Knol J, Kontovounisios C, Korner H, Krivokapic Z, Kronberger I, Kroon HM, Kryzauskas M, Kural S, Kusters M, Lakkis Z, Lankov T, Larson D, Lázár G, Lee KY, Lee SH, Lefèvre JH, Lepisto A, Lieu C, Loi L, Lynch C, Maillou-Martinaud H, Maroli A, Martin S, Martling A, Matzel KE, Mayol J, McDermott F, Meurette G, Millan M, Mitteregger M, Moiseenko A, Monson JRT, Morarasu S, Moritani K, Möslein G, Munini M, Nahas C, Nahas S, Negoi I, Novikova A, Ocares M, Okabayashi K, Olkina A, Oñate-Ocaña L, Otero J, Ozen C, Pace U, Julião GPS, Panaiotti L, Panis Y, Papamichael D, Patel S, Uriburu JCP, Peng SL, Pera M, Perez RO, Petrov A, Pfeffer F, Phang TP, Poskus T, Pringle H, Proud D, Raguz I, Rama N, Rasheed S, Raval MJ, Rega D, Reissfelder C, Meneses JCR, Ris F, Riss S, Rodriguez-Zentner H, Roxburgh CS, Saklani A, Sammour T, Saraste D, Schneider M, Seishima R, Sekulic A, Seppala T, Sheahan K, Shlomina A, Sigismondo G, Singnomklao T, Siragusa L, Smart N, Solis-Peña A, Spinelli A, Staiger RD, Stamos MJ, Steele S, Tan KK, Tanis PJ, Tekkis P, Teklay B, Tengku S, Tsarkov P, Turina M, Ulrich A, Vailati BB, van Harten M, Verhoef C, Warrier S, Wexner S, de Wilt H, Weinberg BA, Wells C, Wolthuis A, Xynos E, You N, Zakharenko A, Zeballos J, Zhou J, Winter DC. Impact of microsatellite status in early-onset colonic cancer. Br J Surg 2022; 109:632-636. [PMID: 35522613 DOI: 10.1093/bjs/znac108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND The molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status. METHODS Anonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated. RESULTS A total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively). CONCLUSION Patients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers.
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Srikumar G, McGuinness MJ, Kau N, Wells C, Harmston C. Cost analysis of index versus delayed cholecystectomy for acute cholecystitis in a New Zealand Provincial Centre. ANZ J Surg 2022; 92:1675-1680. [PMID: 35666130 DOI: 10.1111/ans.17829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 05/22/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Evidence suggests index cholecystectomy (IC) in patients with acute cholecystitis is safe, has decreased hospital stay and is cheaper than delayed cholecystectomy (DC). Costs of cholecystectomy have not previously been investigated in New Zealand. The aim of this study was to compare cost of IC with DC for patients with acute cholecystitis. METHODS A retrospective analysis of adults admitted to Northland hospitals with acute cholecystitis between 1 January 2015 and 31 December 2019 who underwent subsequent cholecystectomy, was performed. Actual patient-level costs were utilized for cost comparison between IC and DC. Factors associated with increased costs were assessed using multivariate analysis. RESULTS Two hundred and eleven patients were included in the study; 72 (34%) underwent IC and 139 (65%) DC. There was no significant difference in total cost for IC ($12 767) versus DC ($12 029) (p = 0.192); this persisted on multivariate analysis. Patients having IC had more severe cholecystitis, and 90-day representation rate following DC was 35%. Costs were increased by severity of cholecystitis, age, American Society of Anesthesiology score (ASA) and travel distance. CONCLUSION This study showed there is no significant difference in cost between IC and DC for patients with acute cholecystitis in Northland, New Zealand. Severity, increasing age, ASA and travel distance were drivers of costs. To recognize the cost benefits of IC, it is likely that increased rates of IC are needed.
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Affiliation(s)
- Gajan Srikumar
- Department of General Surgery, Whangarei Hospital, Northland District Health Board, Whangarei, New Zealand
| | - Matthew James McGuinness
- Department of General Surgery, Whangarei Hospital, Northland District Health Board, Whangarei, New Zealand.,Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Niki Kau
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Cameron Wells
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Christopher Harmston
- Department of General Surgery, Whangarei Hospital, Northland District Health Board, Whangarei, New Zealand.,Department of Surgery, The University of Auckland, Auckland, New Zealand
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Bhoopathi V, Wells C, Ramos-Gomez F, Atchison KA. Difficulty with Oral Health Complications in Adolescents with Developmental Disability and Obesity. JDR Clin Trans Res 2022:23800844221090447. [PMID: 35442123 DOI: 10.1177/23800844221090447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Developmental disabilities (DDs), obesity, and dental caries are highly prevalent health conditions among adolescents. Evidence indicates that a significant proportion of adolescents with DDs are obese, and those with obesity and dental caries share common risk factors. OBJECTIVE In this first-ever US-based cross-sectional national study, we assessed the likelihood of adolescents with DDs and obesity experiencing chronic difficulty with decayed teeth, toothaches, bleeding gums, and eating and swallowing due to a health condition among adolescents with DDs and obesity compared to adolescents with no DDs or obesity. METHODS For this secondary data analysis study, we used data of 68,942 adolescents aged 10 to 17 y from the 2016 through 2019 National Survey of Children's Health. Weighted descriptive and bivariate analyses were conducted. Four multiple logistic regression models predicting chronic difficulty in the past 12 mo with decayed teeth, toothaches, bleeding gums, and eating and swallowing due to a health condition were conducted, controlling for other variables. RESULTS The adjusted odds ratio (aOR) of experiencing chronic difficulty in the past 12 mo for adolescents with no DDs or obesity was significantly lower for decayed teeth (aOR, 0.64; 95% confidence interval [CI], 0.51-0.80; P < 0.0001), toothaches (aOR, 0.43; 95% CI, 0.30-0.60; P < 0.0001), bleeding gums (aOR, 0.48; 95% CI, 0.33-0.70; P < 0.0001), and eating or swallowing due to a health condition (aOR, 0.34; 95% CI, 0.20-0.57; P < 0.0001) compared to adolescents with both DDs and obesity. CONCLUSIONS Results from this study indicate that DD adolescents with obesity have more/greater impending oral health needs than adolescents with no DDs or obesity. KNOWLEDGE TRANSFER STATEMENT Results of this study highlight the high oral health needs and the chronic difficulty adolescents with developmental disabilities and obesity experience compared to adolescents without developmental disabilities and obesity. Targeted oral health policies and interventions that will promote oral health among this high-risk group are recommended.
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Affiliation(s)
- V Bhoopathi
- Section of Public and Population Oral Health, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - C Wells
- Statistical Methods and Data Analytics, University of California at Los Angeles Office of Advanced Research Computing, Los Angeles, CA, USA
| | - F Ramos-Gomez
- Division of Preventative and Restorative Sciences, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - K A Atchison
- Section of Public and Population Oral Health, University of California at Los Angeles School of Dentistry, Los Angeles, CA, USA
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Varghese A, Ryan A, Wells C, Li G, Baer D, Parker E, Buko A, Kaza V, Banga A, Bollineni S, Mahan L, Mohanka M, Lawrence A, Joerns J, Torres F, Wait M, Iacono A, Verceles A, Terada L, Terrin M, Timofte I. Post-Transplant Metabolomics Profiles in Patients Undergoing Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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11
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Zaborowski AM, Abdile A, Adamina M, Aigner F, d'Allens L, Allmer C, Álvarez A, Anula R, Andric M, Atallah S, Bach S, Bala M, Barussaud M, Bausys A, Beggs A, Bellolio F, Bennett MR, Berdinskikh A, Bevan V, Biondo S, Bislenghi G, Bludau M, Brouwer N, Brown C, Bruns C, Buchanan DD, Buchwald P, Burger JWA, Burlov N, Campanelli M, Capdepont M, Carvello M, Chew HH, Christoforidis D, Clark D, Climent M, Collinson R, Cologne KG, Contreras T, Croner R, Daniels IR, Dapri G, Davies J, Delrio P, Denost Q, Deutsch M, Dias A, D'Hoore A, Drozdov E, Duek D, Dunlop M, Dziki A, Edmundson A, Efetov S, El-Hussuna A, Elliot B, Emile S, Espin E, Evans M, Faes S, Faiz O, Figueiredo N, Fleming F, Foppa C, Fowler G, Frasson M, Forgan T, Frizelle F, Gadaev S, Gellona J, Glyn T, Goran B, Greenwood E, Guren MG, Guillon S, Gutlic I, Hahnloser D, Hampel H, Hanly A, Hasegawa H, Iversen LH, Hill A, Hill J, Hoch J, Hompes R, Hurtado L, Iaquinandi F, Imbrasaite U, Islam R, Jafari MD, Salido AJ, Jiménez Toscano M, Kanemitsu Y, Karachun A, Karimuddin AA, Keller DS, Kelly J, Kennelly R, Khrykov G, Kocian P, Koh C, Kok N, Knight KA, Knol J, Kontovounisios C, Korner H, Krivokapic Z, Kronberger I, Kroon HM, Kryzauskas M, Kural S, Kusters M, Lakkis Z, Lankov T, Larson D, Lázár G, Lee KY, Lee SH, Lefèvre JH, Lepisto A, Lieu C, Loi L, Lynch C, Maillou-Martinaud H, Maroli A, Martin S, Martling A, Matzel KE, Mayol J, McDermott F, Meurette G, Millan M, Mitteregger M, Moiseenko A, Monson JRT, Morarasu S, Moritani K, Möslein G, Munini M, Nahas C, Nahas S, Negoi I, Novikova A, Ocares M, Okabayashi K, Olkina A, Oñate-Ocaña L, Otero J, Ozen C, Pace U, Julião GPS, Panaiotti L, Panis Y, Papamichael D, Patel S, Uriburu JCP, Peng SL, Pera M, Perez RO, Petrov A, Pfeffer F, Phang TP, Poskus T, Pringle H, Proud D, Raguz I, Rama N, Rasheed S, Raval MJ, Rega D, Reissfelder C, Meneses JCR, Ris F, Riss S, Rodriguez-Zentner H, Roxburgh CS, Saklani A, Sammour T, Saraste D, Schneider M, Seishima R, Sekulic A, Seppala T, Sheahan K, Shlomina A, Sigismondo G, Singnomklao T, Siragusa L, Smart N, Solis-Peña A, Spinelli A, Staiger RD, Stamos MJ, Steele S, Tan KK, Tanis PJ, Tekkis P, Teklay B, Tengku S, Tsarkov P, Turina M, Ulrich A, Vailati BB, van Harten M, Verhoef C, Warrier S, Wexner S, de Wilt H, Weinberg BA, Wells C, Wolthuis A, Xynos E, You N, Zakharenko A, Zeballos J, Zhou J, Winter DC. Microsatellite instability in young patients with rectal cancer: molecular findings and treatment response. Br J Surg 2022; 109:251-255. [PMID: 35030243 DOI: 10.1093/bjs/znab437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 11/22/2021] [Indexed: 12/27/2022]
Abstract
In this study of 400 patients with early-onset rectal cancer, 12.5 per cent demonstrated microsatellite instability (MSI). MSI was associated with a reduced likelihood of nodal positivity, an increased rate of pathological complete response, and improved disease-specific survival.
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12
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Walsh A, Lala S, Wells C, Upadhyay V. Hyponatremia an indicator of complicated appendicitis in children: Starship experience. ANZ J Surg 2021; 92:747-752. [PMID: 34927323 DOI: 10.1111/ans.17425] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/10/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Timely preoperative recognition of children with complicated appendicitis allows for planning and effective management. The aim of this study was to evaluate hyponatremia, an objective biochemical marker, as a predictor of complicated appendicitis. METHODS A retrospective review of 1283 paediatric patients (≤15 years) who underwent acute appendicectomy from January 2016 to December 2020 (5-year period) was performed. Complicated appendicitis was defined by intraoperative findings of; macroscopic perforation, free pus, gangrene, faecal contamination or intraabdominal abscess. Comparison groups consisted of patients with complicated appendicitis, patients with uncomplicated appendicitis and patients with presumed appendicitis who went on to have no appendicitis on histology (no appendicitis group). Preoperative hyponatremia was defined as serum sodium <135 mmol/L. RESULTS Of the 1283 children; 35% (443/1283) had complicated appendicitis, 54% (690/1283) had uncomplicated appendicitis and 12% (150/1283) had no appendicitis. Rates of hyponatremia were much greater in the complicated group (31.4%; 139/443) than in the uncomplicated group (3.8%; 26/690) (p < 0.0001) or the no appendicitis group 10.7% (16/150) (p < 0.0001). The no appendicitis group had higher rates of hyponatremia than the uncomplicated group (p = 0.001), an unexpected finding. The receiver operating characteristic curve for diagnosis of complicated appendicitis versus uncomplicated appendicitis, using a cut-off serum sodium of <135 mmol/L will identify complicated appendicitis with sensitivity 31.4% and specificity of 95.7% (area under the curve of 0.76). CONCLUSION Hyponatremia is a discriminating predictor of complicated appendicitis in a paediatric population.
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Affiliation(s)
- Abby Walsh
- Paediatric Surgery Department, Starship Hospital, Auckland, New Zealand
| | - Shareena Lala
- Paediatric Surgery Department, Starship Hospital, Auckland, New Zealand
| | - Cameron Wells
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Vipul Upadhyay
- Paediatric Surgery Department, Starship Hospital, Auckland, New Zealand
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13
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Varghese C, Wells C, Lee S, Ammar K, Pandanaboyana S. P-P02 Incidence and risk factors for chyle leak after pancreatic surgery: a systematic review and meta-analysis. Br J Surg 2021. [DOI: 10.1093/bjs/znab430.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
The incidence of, and risk factors for chyle leak, as defined by the 2017 International Study Group on Pancreatic Surgery (ISGPS), remain unknown.
Methods
MEDLINE, EMBASE, and Scopus were systematically searched for studies of patients undergoing pancreatectomy that reported chyle leak according to the 2017 ISGPS definition. The primary outcomes were the incidence of overall and clinically-relevant chyle leak. A random-effects pairwise meta-analysis was used to identify risk factors where possible.
Results
Thirty-five studies including 7083 patients were included in the meta-analysis. The weighted incidence of overall chyle leak was 6.8% (95% CI 5.6 - 8.2) and clinically-relevant chyle leak was 5.5% (95% CI 3.8 - 7.7). Pancreaticoduodenectomy, total pancreatectomy and distal pancreatectomy were associated with a CL incidence of 7.3%, 4.3%, 5.8% respectively. Fourteen individual risk factors for chyle leak were identified from included studies. Younger age, low prognostic nutritional index, para-aortic node manipulation, lymphatic involvement, and post-pancreatectomy pancreatitis were significantly associated with chyle leak, all from individual studies.
Conclusions
The incidence of overall chyle leak and clinically relevant chyle leak after pancreatic surgery, as defined by the 2017 ISGPS definition is 6.8% and 5.5% respectively. Several risk factors for chyle leak were identified in the present review, however, larger high-quality studies are needed to more accurately define these risks.
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Affiliation(s)
| | | | - Shiela Lee
- Freeman Hospital, Newcastle, United Kingdom
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14
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Holloway Z, Hawkey AB, Pippen E, White H, Katragadda V, Kenou B, Wells C, Murphy SK, Rezvani AH, Levin ED. Corrigendum to "Paternal cannabis extract exposure in rats: Preconception timing effects on neurobehavioral effects in offspring" [Neurotoxicology 81 (2020) 180-188]. Neurotoxicology 2021; 87:258. [PMID: 34483001 DOI: 10.1016/j.neuro.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - E Pippen
- Duke University Medical Center, USA
| | - H White
- Duke University Medical Center, USA
| | | | - B Kenou
- Duke University Medical Center, USA
| | - C Wells
- Duke University Medical Center, USA
| | | | | | - E D Levin
- Duke University Medical Center, USA.
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15
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Zaborowski AM, Abdile A, Adamina M, Aigner F, d'Allens L, Allmer C, Álvarez A, Anula R, Andric M, Atallah S, Bach S, Bala M, Barussaud M, Bausys A, Bebington B, Beggs A, Bellolio F, Bennett MR, Berdinskikh A, Bevan V, Biondo S, Bislenghi G, Bludau M, Boutall A, Brouwer N, Brown C, Bruns C, Buchanan DD, Buchwald P, Burger JWA, Burlov N, Campanelli M, Capdepont M, Carvello M, Chew HH, Christoforidis D, Clark D, Climent M, Cologne KG, Contreras T, Croner R, Daniels IR, Dapri G, Davies J, Delrio P, Denost Q, Deutsch M, Dias A, D'Hoore A, Drozdov E, Duek D, Dunlop M, Dziki A, Edmundson A, Efetov S, El-Hussuna A, Elliot B, Emile S, Espin E, Evans M, Faes S, Faiz O, Fleming F, Foppa C, Fowler G, Frasson M, Figueiredo N, Forgan T, Frizelle F, Gadaev S, Gellona J, Glyn T, Gong J, Goran B, Greenwood E, Guren MG, Guillon S, Gutlic I, Hahnloser D, Hampel H, Hanly A, Hasegawa H, Iversen LH, Hill A, Hill J, Hoch J, Hoffmeister M, Hompes R, Hurtado L, Iaquinandi F, Imbrasaite U, Islam R, Jafari MD, Kanemitsu Y, Karachun A, Karimuddin AA, Keller DS, Kelly J, Kennelly R, Khrykov G, Kocian P, Koh C, Kok N, Knight KA, Knol J, Kontovounisios C, Korner H, Krivokapic Z, Kronberger I, Kroon HM, Kryzauskas M, Kural S, Kusters M, Lakkis Z, Lankov T, Larson D, Lázár G, Lee KY, Lee SH, Lefèvre JH, Lepisto A, Lieu C, Loi L, Lynch C, Maillou-Martinaud H, Maroli A, Martin S, Martling A, Matzel KE, Mayol J, McDermott F, Meurette G, Millan M, Mitteregger M, Moiseenko A, Monson JRT, Morarasu S, Moritani K, Möslein G, Munini M, Nahas C, Nahas S, Negoi I, Novikova A, Ocares M, Okabayashi K, Olkina A, Oñate-Ocaña L, Otero J, Ozen C, Pace U, São Julião GP, Panaiotti L, Panis Y, Papamichael D, Park J, Patel S, Patrón Uriburu JC, Pera M, Perez RO, Petrov A, Pfeffer F, Phang PT, Poskus T, Pringle H, Proud D, Raguz I, Rama N, Rasheed S, Raval MJ, Rega D, Reissfelder C, Reyes Meneses JC, Ris F, Riss S, Rodriguez-Zentner H, Roxburgh CS, Saklani A, Salido AJ, Sammour T, Saraste D, Schneider M, Seishima R, Sekulic A, Seppala T, Sheahan K, Shine R, Shlomina A, Sica GS, Singnomklao T, Siragusa L, Smart N, Solis A, Spinelli A, Staiger RD, Stamos MJ, Steele S, Sunderland M, Tan KK, Tanis PJ, Tekkis P, Teklay B, Tengku S, Jiménez-Toscano M, Tsarkov P, Turina M, Ulrich A, Vailati BB, van Harten M, Verhoef C, Warrier S, Wexner S, de Wilt H, Weinberg BA, Wells C, Wolthuis A, Xynos E, You N, Zakharenko A, Zeballos J, Winter DC. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review. JAMA Surg 2021; 156:865-874. [PMID: 34190968 DOI: 10.1001/jamasurg.2021.2380] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Observations Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. Conclusions and Relevance The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.
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Affiliation(s)
| | - Ahmed Abdile
- Department of Surgery, Middlemore Hospital, Auckland, New Zealand
| | - Michel Adamina
- Department of Surgery, Cantonal Hospital, Winterthur, Switzerland
| | - Felix Aigner
- Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria
| | - Laura d'Allens
- Department of Surgery, Cantonal Hospital, Winterthur, Switzerland
| | - Caterina Allmer
- Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria
| | - Andrea Álvarez
- Department of Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - Rocio Anula
- Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain
| | - Mihailo Andric
- Department of Surgery, University Hospital Magdeburg, Magdeburg, Germany
| | - Sam Atallah
- Department of Colorectal Surgery, AdventHealth, Orlando, Florida
| | - Simon Bach
- Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Miklosh Bala
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Marie Barussaud
- Department of Surgery, University Hospital Poitiers, Poitiers, France
| | - Augustinas Bausys
- Department of Surgery, National Cancer Institute, Vilnius, Lithuania
| | - Brendan Bebington
- Department of Surgery, Wits Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Andrew Beggs
- Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Felipe Bellolio
- Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | - Anton Berdinskikh
- Department of Surgery, St-Petersburg Clinical Scientific and Practical Centre, St Petersburg, Russia
| | - Vicki Bevan
- Department of Surgery, Morriston Hospital, Swansea, Wales, United Kingdom
| | - Sebastiano Biondo
- Department of Surgery, Bellvitge University Hospital, Barcelona, Spain
| | | | - Marc Bludau
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - Adam Boutall
- Department of Surgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Nelleke Brouwer
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carl Brown
- Department of Surgery, St Paul's Hospital, the University of British Columbia, Vancouver, British Columbia, Canada
| | - Christiane Bruns
- Department of Surgery, University Hospital Cologne, Cologne, Germany
| | - Daniel D Buchanan
- Department of Clinical Pathology, the University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - Pamela Buchwald
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | | | - Nikita Burlov
- Department of Surgery, Leningrad Regional Clinical Oncology Dispensary, Leningrad, Russia
| | | | - Maylis Capdepont
- Department of Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Michele Carvello
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Hwee-Hoon Chew
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
| | | | - David Clark
- Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Marta Climent
- Department of Surgery, Bellvitge University Hospital, Barcelona, Spain
| | - Kyle G Cologne
- Department of Surgery, Keck Hospital, University of Southern California, Los Angeles
| | - Tomas Contreras
- Department of Surgery, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Roland Croner
- Department of Surgery, University Hospital Magdeburg, Magdeburg, Germany
| | - Ian R Daniels
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Giovanni Dapri
- Department of Surgery, St-Pierre University Hospital, Brussels, Belgium
| | - Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Paolo Delrio
- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale" IRCSS, Naples, Italy
| | - Quentin Denost
- Department of Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Michael Deutsch
- Department of Surgery, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Andre Dias
- Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil
| | | | - Evgeniy Drozdov
- Department of Surgery, Siberian State Medical University, Tomsk, Russia
| | - Daniel Duek
- Department of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Malcolm Dunlop
- Department of Surgery, Western General Hospital, Edinburgh, United Kingdom
| | - Adam Dziki
- Department of Surgery, Military Medical Academy University Teaching Hospital, Łódź, Poland
| | - Aleksandra Edmundson
- Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Sergey Efetov
- Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Alaa El-Hussuna
- Department of Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Brodie Elliot
- Department of Surgery, Whangarei Hospital, Whangarei, New Zealand
| | - Sameh Emile
- Department of Surgery, Mansoura University Hospital, Mansoura, Egypt
| | - Eloy Espin
- Colorectal Surgery Unit, General Surgery Service, Hospital Vall de Hebron, Barcelona, Spain
| | - Martyn Evans
- Department of Surgery, Morriston Hospital, Swansea, Wales, United Kingdom
| | - Seraina Faes
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland
| | - Omar Faiz
- Department of Surgery, St Mark's Hospital, London, United Kingdom
| | - Fergal Fleming
- Department of Surgery, University of Rochester, New York
| | - Caterina Foppa
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - George Fowler
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Matteo Frasson
- Department of Surgery, University Hospital La Fe, Valencia, Spain
| | - Nuno Figueiredo
- Department of Surgery, Champalimaud Clinical Centre, Lisbon, Portugal
| | - Tim Forgan
- Department of Surgery, Tygerberg Academic Hospital, Cape Town, South Africa
| | - Frank Frizelle
- Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Shamil Gadaev
- Fourth Coloproctology Department, St Petersburg Oncology Center, St Petersburg, Russia
| | - Jose Gellona
- Department of Colorectal Surgery, Clínica Santa María, Santiago, Chile
- Department of Colorectal Surgery, Hospital Militar de Santiago, Le Reina, Chile
| | - Tamara Glyn
- Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Jianping Gong
- Department of Surgery, Tongji Hospital, Wuhan, China
| | - Barisic Goran
- Department of Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Emma Greenwood
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | | | - Stephanie Guillon
- Department of Surgery, Bordeaux University Hospital, Bordeaux, France
| | - Ida Gutlic
- Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Dieter Hahnloser
- Department of Visceral Surgery, University Hospital Lausanne, Lausanne, Switzerland
| | - Heather Hampel
- Division of Human Genetics, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Ann Hanly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Hirotoshi Hasegawa
- Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | | | - Andrew Hill
- Department of Surgery, Middlemore Hospital, Auckland, New Zealand
| | - James Hill
- Department of Surgery, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Jiri Hoch
- Department of Surgery, Motol University Hospital, Prague, Czech Republic
| | | | - Roel Hompes
- Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Luis Hurtado
- Department of Surgery, University Hospital La Fe, Valencia, Spain
| | | | | | - Rumana Islam
- Department of Surgery, Austin Hospital, Melbourne, Australia
| | | | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Aleksei Karachun
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Ahmer A Karimuddin
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Deborah S Keller
- Division of Colorectal Surgery, Department of Surgery, University of California at Davis Medical Center, Sacramento
| | - Justin Kelly
- Advent Health Colorectal Surgery, Orlando, Florida
| | - Rory Kennelly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Gleb Khrykov
- Department of Surgery, Leningrad Regional Clinical Oncology Dispensary, Leningrad, Russia
| | - Peter Kocian
- Department of Surgery, Motol University Hospital, Prague, Czech Republic
| | - Cherry Koh
- Department of Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - Neils Kok
- Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Joep Knol
- Department of Surgery, Ziekenhuis Oost-Limburg, Belgium
| | | | - Hartwig Korner
- Department of Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Zoran Krivokapic
- Department of Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | | | - Hidde Maarten Kroon
- Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia
| | | | - Said Kural
- School of Medicine, Uludag University, Bursa, Turkey
| | - Miranda Kusters
- Department of Surgery, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
| | - Zaher Lakkis
- Department of Surgery, University Hospital Besançon, Besançon, France
| | - Timur Lankov
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Dave Larson
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - György Lázár
- Department of Surgery, University of Szeged, Szeged, Hungary
| | - Kai-Yin Lee
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore, Singapore
| | - Suk Hwan Lee
- Kyung Here University Hospital at Gangdong, Seoul, South Korea
| | - Jérémie H Lefèvre
- Sorbonne Université, Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, Paris, France
| | - Anna Lepisto
- Department of Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Christopher Lieu
- Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora
| | - Lynette Loi
- University of Glasgow, Glasgow, United Kingdom
| | - Craig Lynch
- Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | | | - Annalisa Maroli
- Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Sean Martin
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Anna Martling
- Department of Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Klaus E Matzel
- Department of Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Julio Mayol
- Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain
| | - Frank McDermott
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | | | - Monica Millan
- Department of Surgery, La Fe University Hospital, Valencia, Spain
| | - Martin Mitteregger
- Department of Surgery, Barmherzige Brüder Krankenhaus Graz, Graz, Austria
| | - Andrei Moiseenko
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - John R T Monson
- AdventHealth Medical Group Colorectal Surgery, AdventHealth, Orlando, Florida
| | - Stefan Morarasu
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Konosuke Moritani
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Gabriela Möslein
- Department for Hereditary Tumors, Evangelisches Krankenhaus Bethesda, Duisburg, Germany
| | - Martino Munini
- Department of Surgery, Lugano Regional Hospital, Lugano, Switzerland
| | - Caio Nahas
- Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil
| | - Sergio Nahas
- Department of Surgery, Institute of Cancer of São Paulo, São Paulo, Brazil
| | - Ionut Negoi
- Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Anastasia Novikova
- Department of Surgery, Pavlov First St Petersburg State Medical University's Clinic, St Petersburg, Russia
| | - Misael Ocares
- Department of Surgery, University Hospital Concepción, Concepción, Chile
| | | | - Alexandra Olkina
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
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- Department of Surgery, National Cancer Institute, Mexico City, Mexico
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- Department of Surgery, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Madrid, Spain
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- Department of Surgery, Aalborg University Hospital, Aalborg, Denmark
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- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale" IRCSS, Naples, Italy
| | | | - Lidiia Panaiotti
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Yves Panis
- Department of Surgery, Beaujon Hospital, Paris, France
| | | | - Jason Park
- Department of Surgery, St Boniface General Hospital, Winnipeg, Manitoba, Canada
| | - Swati Patel
- Department of Gastroenterology, University of Colorado Anschutz Medical Campus, Aurora
| | | | - Miguel Pera
- Department of Surgery, Hospital del Mar, Barcelona, Spain
| | - Rodrigo O Perez
- Colorectal Surgery Division, Angelita and Joaquim Gama Institute, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Alexei Petrov
- Surgical Department of Abdominal Oncology, N. N. Petrov National Medical Research Centre of Oncology, St Petersburg, Russia
| | - Frank Pfeffer
- Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - P Terry Phang
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Tomas Poskus
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Heather Pringle
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - David Proud
- Department of Surgery, Austin Hospital, Melbourne, Australia
| | - Ivana Raguz
- Department of Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nuno Rama
- Department of Surgery, Centro Hospitalar de Leiria, Leiria, Portugal
| | - Shahnawaz Rasheed
- Department of Surgery, Royal Marsden Hospital, London, United Kingdom
| | - Manoj J Raval
- Department of Surgery, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Daniela Rega
- Colorectal Surgical Oncology, Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, "Fondazione G. Pascale" IRCSS, Naples, Italy
| | | | | | - Frederic Ris
- Department of Surgery, University Hospital Geneva, Geneva, Switzerland
| | - Stefan Riss
- Department of Surgery, Medical University Vienna, Vienna, Austria
| | | | - Campbell S Roxburgh
- Glasgow Royal Infirmary, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Tarik Sammour
- Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia
| | - Deborah Saraste
- Department of Surgery, Stockholm South General Hospital, Stockholm, Sweden
| | - Martin Schneider
- Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ryo Seishima
- Department of Surgery, Keio University, Tokyo, Japan
| | | | - Toni Seppala
- Department of Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Kieran Sheahan
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Rebecca Shine
- Department of Surgery, Austin Hospital, Melbourne, Australia
| | - Alexandra Shlomina
- Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | | | | | | | - Neil Smart
- Department of Surgery, Royal Devon and Exeter Hospital, Exeter, United Kingdom
| | - Alejandro Solis
- Colorectal Surgery Unit, General Surgery Service, Hospital Vall de Hebron, Barcelona, Spain
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Roxane D Staiger
- Department of Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Scott Steele
- Department of Surgery, Cleveland Clinic, Cleveland, Ohio
| | | | - Ker-Kan Tan
- Department of Surgery, School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pieter J Tanis
- Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, The Netherlands
| | - Paris Tekkis
- Department of Surgery, Royal Marsden Hospital, London, United Kingdom
| | - Biniam Teklay
- Department of Surgery, Åbenrå Hospital, Åbenrå, Denmark
| | | | | | - Petr Tsarkov
- Department of Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Matthias Turina
- Department of Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Alexis Ulrich
- Department of Surgery, Lukas Hospital, Neuss, Germany
| | - Bruna B Vailati
- Department of Surgery, Angelita and Joaquim Gama Institute, São Paulo, Brazil
| | - Meike van Harten
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Cornelis Verhoef
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Satish Warrier
- Department of Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Steve Wexner
- Department of Surgery, Cleveland Clinic Florida, Weston
| | - Hans de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Benjamin A Weinberg
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Cameron Wells
- Department of Surgery, Auckland City Hospital, Auckland, New Zealand
| | | | - Evangelos Xynos
- Department of Surgery, Creta Inter-Clinic Hospital, Heraklion, Crete, Greece
| | - Nancy You
- Department of Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Alexander Zakharenko
- Department of Surgery, Pavlov First St Petersburg State Medical University's Clinic, St Petersburg, Russia
| | | | - Des C Winter
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
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Franzen-Castle L, Schwarz C, Brison C, Larvick C, Aufdenkamp B, Frecks N, Jones G, Urbanec N, Wells C. Home Food Preservation Virtual Learning Series Increases Knowledge, Understanding, and Confidence for Preserving Food. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Timofte I, Wells C, Hersi K, Ryan A, Varghese A, Vesselinov R, Iacono A, Assadi J, Davis D, Li G, Herr D, Harrington T, Griffith B, Lau C, Krupnick A, Madathil R, Rabin J, Alon G, Parker E, Baer D, Magder L, Terrin M, Verceles A. Nutritional Supplementation and Neuromuscular Electrical Stimulation in Lung Transplant Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Wells C, Brennan S, Keon M, Ooi L. The role of amyloid oligomers in neurodegenerative pathologies. Int J Biol Macromol 2021; 181:582-604. [PMID: 33766600 DOI: 10.1016/j.ijbiomac.2021.03.113] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/18/2021] [Accepted: 03/19/2021] [Indexed: 11/25/2022]
Abstract
Many neurodegenerative diseases are rooted in the activities of amyloid-like proteins which possess conformations that spread to healthy proteins. These include Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD) and amyotrophic lateral sclerosis (ALS). While their clinical manifestations vary, their protein-level mechanisms are remarkably similar. Aberrant monomeric proteins undergo conformational shifts, facilitating aggregation and formation of solid fibrils. However, there is growing evidence that intermediate oligomeric stages are key drivers of neuronal toxicity. Analysis of protein dynamics is complicated by the fact that nucleation and growth of amyloid-like proteins is not a linear pathway. Feedback within this pathway results in exponential acceleration of aggregation, but activities exerted by oligomers and fibrils can alter cellular interactions and the cellular environment as a whole. The resulting cascade of effects likely contributes to the late onset and accelerating progression of amyloid-like protein disorders and the widespread effects they have on the body. In this review we explore the amyloid-like proteins associated with AD, PD, HD and ALS, as well as the common mechanisms of amyloid-like protein nucleation and aggregation. From this, we identify core elements of pathological progression which have been targeted for therapies, and which may become future therapeutic targets.
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Affiliation(s)
- Cameron Wells
- GenieUs Genomics, Sydney, NSW 2010, Australia; University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Matt Keon
- GenieUs Genomics, Sydney, NSW 2010, Australia
| | - Lezanne Ooi
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia; School of Chemistry and Molecular Bioscience, and Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia; GenieUs Genomics, Sydney, NSW 2010, Australia
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Nassar M, Abdelhady S, Abdelrazek A, Abdelsalam I, El-Sawy A, Essam E, Gadelkarim M, Ghaly K, Hassabalnaby M, Masarani R, Mohamed Shaaban N, Sabry A, Salem M, Soliman NA, Zahran D, Abou El.soud MR, Badr ET, Borham H, Elmeslemany N, Elsayed M, Elsherif F, Eslam S, Gaber G, Ibrahim S, Kamh Y, Mahmoud A, Mohamed SG, Morshedy E, Omar C, Salem Soliman F, Abdelkawy S, Abdelmohsen N, Abdelshakour M, Dahy A, Gamal N, Gamal M, Hasan A, Hetta H, Mousa N, Omar M, Rabie S, Saad M, Saleh B, Sayed Mohamed M, Shawqi M, Abdelhady Mousa H, Alnoury M, Elbealawy M, Elshafey A, Essam Ibrahim El Desouki Muhammad Ahmed M, Ghonaim M, Hgag F, Ibrahim M, Morsy M, Reda Loaloa M, Refaat A, Samir H, Shahien F, Sobhy M, Sroor F, Abdellatif E, Adel M, Afifi AA, Afifi E, Antaky M, Dawoud A, El Zoghby N, El-remaily A, Elzanfaly AA, Gadallah A, Gamal FA, Hashem O, Medhat Youssef S, Muhammad Attyah A, Munir M, Shazly O, Taha E, Wilson K, Adel S, Ali A, Eid E, Elhelow E, Elmahdy M, Elshatby B, Hossam el-din Zakaria A, Hossny A, Ibrahim E, M.Yonis A, Metwalli M, Yousry B, Zid E, A Yacoub M, Abdelhakim A, Abouelsoad N, Alkhatib M, Ashraf A, Ashraf A, Elazab Y, Elfanty M, Elkabir O, Elsayed M, Elshimy A, Elsobky H, Eskander J, Gad A, Hamsho W, Khaled Abdelwahed N, Magdy M, Moharam D, Osama A, Ramadan S, Roum R, Sayed T, Shehada T, Zidan AM, Abbas K, Ali A, Attia M, Balata M, El Nakeeb A, Elewaily MIE, Elfallal A, Elfeki H, Elkhadragy A, Emile S, Ezzat H, Hosni H, Mansour I, Omar W, Othman G, Sadek K, Shalaby M, Shehab-Eldeen N, Anas khalifa R, Badr H, Eldeep M, Eldeep A, Eldoseuky mohammed A, Khallaf S, Magdy Hegazy E, Mahmoud R, Mikhail P, Morsi M, Mowafy S, Raafat D, Safy A, Sera M, Sera AS, AbdAllah MSM, Abdelkader M, Abdou AO, Ahmed A, Gaafar S, Ibrahim negm F, Lapic M, Maher A, Mahmoud H, Mostafa A, Samir M, Samy F, Semeda N, Shalaby HI, El-taweel A, Galal Elnagar A, Hemidan AG, Hussein M, Kandil A, Moawad M, Nasser Hamamah AA, Soliman M, Abdelkhalek M, Abdelmaksoud Tawakel N, Abdelwahed AM, Abdou A, Atallah K, Elsherbeny MY, Emara E, Hamdy M, Hamdy O, Haron A, Ismail S, Metwally IH, Mohamed Hamed Elgaml N, Nassar A, Refky B, Sadek M, Saleh M, Yunes A, Zakaria M, Zuhdy M, Fayed N, Mohammed MMH, Kütner S, Melnik P, Seire I, Teras J, Ümarik T, Ainoa E, Eerola V, Koppatz H, Koskenvuo L, Sallinen V, Takala S, Katunin J, Kechagias A, Turunen A, Christou N, Mathonnet M, Lavoue V, Nyangoh Timoh K, Soulabaille L, Lesourd R, Merdrignac A, Sulpice L, André B, Chantalat E, Vaysse C, Dousset B, Gaujoux S, Martin G, Clonda O, Juodis D, Kienle K, Mravik A, Palmer S, Szabadhegyi G, Agbeko AE, Gyabaah S, Gyamfi FE, Naabo N, Owusu senior A, Yorke J, Owusu F, Abantanga F, Anyomih TTK, Muntaka AJM, Owusu Abem E, Sheriff M, Tabiri S, Wondoh PM, Balalis D, Korkolis D, Gkiokas G, Pantiora E, Theodosopoulos T, Ioannidis A, Konstantinidis K, Konstantinidou S, Machairas N, Paspala A, Prodromidou A, Chouliaras C, Papadopoulos K, Baloyiannis I, Mamaloudis I, Tzovaras G, Akrida I, Argentou MI, Germanos S, Iliopoulos E, Maroulis I, Skroubis G, Theofanis G, Chatzakis C, Ioannidis O, Loutzidou L, Kalles V, Karathanasis P, Michalopoulos N, Theodoropoulos C, Theodorou D, Triantafyllou T, Garoufalia Z, Hasemaki N, Kontos M, Kouraklis G, Kykalos S, Liakakos T, Mpaili E, Papalampros A, Schizas D, Syllaios A, Tampaki EC, Tsimpoukelis A, Antonopoulou MI, Deskou E, Manatakis DK, Papageorgiou D, Zoulamoglou M, Anthoulakis C, Margaritis M, Nikoloudis N, Campo V, Ceballos A, Flores MA, Giron W, Ko D, Martinez G, Recinos G, Rivera Lara V, Rueda N, Sanchez A, Tejeda Garrido JCG, Aguilera-Arevalo ML, Alvarez Rivera AE, Bamaca Ixcajoc EB, Barreda Zelaya LE, Chacòn-Herrera P, Corea Ruiz LM, Echeverria-Davila G, Garcia M, García D, Gutiérrez Mayen EF, José N, Mazariegos N, Méndez D, Paniagua Espinoza M, Baranyai Z, Bardos D, Benke M, Illes K, Kokas BA, Szabó R, Appukuttan A, Asok A, D.k V, Malik K, Ravishankaran P, Tapkire R, Moorthy G, Abraham J, Muthuvel R, Alapatt J, Kattepur A, Pareekutty N, Garod M, 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Belais F, Butt E, Joshi K, Kapur M, Shaw M, Townson A, Williams CYK, Gray T, Greig R, Husain M, Murray E, Mustafa A, Asif A, Gokul A, Shah M, Akitikori MT, Charalabopoulos A, Davidson S, McNally S, Rupani S, Juma F, Mills SC, Muirhead L, Sellars K, Walsh U, Warren O, Chambers A, Hunt R, Teasdale E, Boyce S, Cornwall H, Tol I, Argyriou EO, Eardley N, Povey M, Aithie JMS, Irfan A, McGuigan MC, Starr R, Warren CR, Archibald J, Kirby G, Kisyov I, Khoo CK, Lee R, Photiou D, Davis R, Prasad U, Yang PZ, Bird J, Leung E, Summerour V, Currow C, Kiam J, Tan GJS, Muthusami A, Pegba-Otemolu I, Urbonas T, Nunoo-Mensah J, Smolskas E, Boddy A, Gravante G, Hunter D, Andrew D, Koh A, Thompson A, Adams L, Clements HA, De Silva K, Ekpete O, Haque S, Henderson S, Ibrahim B, Jayasinghe T, Livie J, Mailley K, Nair G, Tan D, Baggaley C, Dawidziuk A, Szyszka B, Barter C, Gandhi N, Hassell K, Hitchin S, Kelsall J, Nagy E, Nessa A, Whisker L, Yanni F, Ali M, Arora D, Hediwattege S, Kumarasinghe N, Rathore M, Tennakoon A, Ali Ahmad SM, Bajomo O, Nadira F, Celentano V, Bhangu A, Glasbey J, Griffiths E, Karri RS, Mak JKC, Nepogodiev D, Pipe M, Bhatti MI, Rabie M, Boyle C, Hamilton D, Mihuna A, Ng JCK, Nicholson G, Oliwa A, Pearson R, Rose A, Yong SQ, Boereboom C, Hanna M, Walter C, Greensmith TS, Mitchell R, Monaghan E, Crawford J, Moug S, Blackwell J, Boyd-Carson H, Herrod P, Al-Allaf O, Beattie M, Bullock C, Burman S, Clark G, Flamey N, Flannery O, Harding A, Kodiatt B, Lawday S, Mahapatra S, Mukundu Nagesh N, Ng M, Rye D, Yoong A, Clark L, Deans C, Edirisooriya M, Fairfield CJ, Harrison EM, Carrington EV, Wong TLE, Yusuf B, Chamberlain C, Duke K, Kmiotek E, Botes A, Condie N, Schrire T, Shah R, Thomas-Jones I, Yates C, Anthony N, Matthews E, Sahnan K, Tankel J, Tucker S, Winter Beatty J, Ziprin P, Duggan W, Kantartzi A, Sridhar S, Khaw RA, Srivastava P, Underwood C, Alves do Canto Brum H, Chopra S, Davis L, Hughes R, Tulley J, Alberts J, Athisayaraj T, Olugbemi M, Ahmad K, Chan C, Chapman G, Fleming H, Fox B, Grewar J, Hulse K, Rutherford D, Sinead M, Smith S, Speake D, Vaughan-Shaw PG, Christodoulides N, Kudhail S, Welch M, Husaini SM, Lambracos S, Anyanwu C, Suresh R, Thomas JS, Gleeson E, Platoff R, Saif A, Enumah Z, Etchill E, Gabre-Kidan A, Bernstein M, Carrano FM, Connors J, Lynn P, Melis M, Newman E, Foster DS, Perrone K, Titan A, Weiser TG, Ahmad S, Bafford ACM, Dal Molin M, Hanna N, Zafar SN, Hemmila M, Napolitano L, Wong JJ, Chandler J, Wood L, Wren S, Ottesen T, You L, Yu K, Arciénega Yañez MDP, Ferreira Fernandes M, González D, Cubas S, González MC, Zubiaurre V, Demolin R, Giroff N, Sciuto P, Campos M, Rodríguez Cantera G, Wagner G, Deepika G, Maimbo M, Simuchimba E, Bulaya A, Chibuye C, Chirengendure B, Kabale MR, Kabongo K, Linyama D, Munthali J, Mweso O, Pikiti F, Otieno J, Chan E, Lai LT, Blackman B, Richards S, Subramaniam S, Karim R, Kok N, Lee YD, Ali S, Sinha A, Corrigan R, Barnes N, Wong F, Dennis G, Jedamzik J, Phillips E, Piette W, Van hentenryck M, Koco H, Lawani S, Kassa MW, Santos Bezerra T, Gribnev P, Dimitrov D, Krastev P, Oum S, Bonghaseh DT, Al Farsi M, Alsharqawi N, Agarwal A, Acevedo V, Castillo Barbosa AC, Giron F, Leon Rodriguez JP, Kucan D, Rosko D, Barsic N, Župan D, Hegazi A, Truncíková V, Fryba V, Mohamed M, Sultan A, Nagi A, Rashad Temerik A, Elshawy ME, Mahmoud MI, Omar S, Anwar M, Rageh T, Elmokadem A, Gaballa K, Teppo S, Turunen A, Pengermä P, Ballouhey Q, Bergeat D, Weyl A, Hain E, Gyedu A, Yenli E, Osei-Poku D, Rompou VA, Zoikas A, Gaitanidis A, Koukis G, Perivoliotis K, Tavlas P, Galanos-Demiris K, Zografos G, Karavokyros I, Xanthopoulou G, Iordanidou E, Ayau F, Garcia A, Damján P, Wason D, B L A, Rangganata E, Kamath P, O'Connor DB, Pinto M, Perrone F, Tropeano FP, Troilo F, Bossi D, Scala D, Pulitanò L, Carella M, Pietrabissa A, Gori A, Giraudo G, De Simone V, Russo AA, Braccio B, Al-Taher R, Athamneh S, Parker A, Sawiee A, Kattia A, Salem M, Tababa O, Shaeeb Z, Syminas V, Jurgaitis J, Damuleviciene G, Svagzdys S, Poskus T, Razafimanjato NNM, Chieng Loo L, Tiong IC, Wan Muhmad WF, Vijeyan H, Li Ying T, Grech G, Arrangoiz R, Jimenez Ley VB, Arizpe D, Jimenez Ley VB, Lagunes Lara E, Castro López EV, Eaazim J, Gordinou de Gouberville M, Bastiaenen V, Rottier S, Nahab F, Ji MY, Seyoji M, Nwachukwu C, Emeghara O, Muhammed SE, Idowu A, Sowemimo O, Ogundoyin O, Akande O, Lott A, Nadeem M, Laghari AA, Loya A, Mushtaq H, Abdullah MT, Abuhilal B, Atawneh M, Hamdan H, Alhabil B, Srour A, Mousa I, Da Silva Medina L, Sacdalan MD, Lapitan MC, Sacdalan MD, Sacdalan MD, Bartosiak K, Ferreira P, Francisco V, Lemos R, Frutuoso L, Fernandes S, Fonseca T, Pereira J, Rachadell J, Torre A, Madeira Martins F, Carvalho AC, Rodrigues Ferreira J, Ribeiro da Silva B, Devesa H, Vieira A, Mónica I, Amaro M, Sousa D, Reia M, Louro J, Martins A, Dominguez J, Santos I, Freitas Oliveira NM, Pereira JC, Silva-Vaz P, Freire L, Escrevente R, Negoita VM, Shakhmatov D, Nezerwa Y, Radulovic R, Moore R, Obery G, Viljoen F, Mendes T, Suarez A, Moncada E, Fernandez-Hevia M, Curtis Martínez C, Gil Garcia JM, González Zunzarren M, Idris T, Eklöv K, Grahn O, Amin L, Blomqvist M, Ajani C, Kraus R, Seeger N, Willemin M, Rayya F, Ayash M, Msouti R, Kannas I, Abazid E, Esper A, Slim S, Kavcar AS, Aytac E, Dural AC, Ilker A, Eray IC, Kurnaz E, Altiner S, Tepe MD, Sahin C, Savli E, Innocent A, Babirye L, Diachenko A, Hordoskiy V, Curry H, Chau CYC, Robertson H, Mahmoud A, Lennon H, Loi L, Kirkham E, McCann C, Watts D, Gurung B, Wilson M, Tribedi T, Garofalo E, Zahra B, MacDonald S, Daniels I, Ng N, Khosla S, Olivier J, Yue SYP, Suresh G, Wellington J, Lorejo E, Mossaad M, Tryliskyy Y, Crutcher M, Alimi M, Baiu I, Abdou H, Conway A, Peck C, Wagner G, Perdomo Perez MA, Trostchansky I, Zulu S, Nakazwe M, Knight SR, Drake TM, Nepogodiev D, Fitzgerald JE, Ademuyiwa A, Alexander P, Ingabire JA, Al-Saqqa SW, Biccard BM, Borda-Luque G, Borowski DW, Burger S, Chu K, Clarke D, Costas-Chavarri A, Davies J, Donaldson R, Ede C, Garden OJ, Ghosh D, Glasbey J, Kingham TP, Salem HK, Anyomih TTK, Koto MZ, Lapitan MC, Lawani I, Lesetedi C, Aguilera-Arevalo ML, Mabedi C, Maimbo M, Magill L, Makinde Alakaloko F, Makupe A, Martin J, Ramos-De la Medina A, Monahan M, Moore R, Msosa V, Mulira S, Mutabazi AZ, Muller E, Musowoyo J, Adisa AO, Olory-Togbe JL, Pius R, Qureshi AU, Rayne S, Roberts T, Sacdalan MD, Shaw CA, Smart N, Smith M, Spence R, Van Straten S, Tabiri S, Tayler V, Weiser TG, Windsor J, Yorke J, Yepez R, Lilford R, Morton D, Bhangu A, Sundar S, Harrison EM, Runigamugabo E, Verjee A, Chen J, Daya L, El Aroussi N, Farina V, Gnintedeme Olivier T, Gonzales Nacarino M, Hammani A, Honjo S, Jacobs R, Kimura H, Litvin A, Nkoronko M, Nour I, Oscullo Yepez JJ, Pagano G, Pata F, Pin Hung W, Raj A, Romani Pozo A, Rommaneh M, Sassamela Fabiano SC, Shiroma Gago CM, Shu Yip S, Srinivas A, Sung CY, Tai A, Valle Aranda YC, Venturini S, Vervoort D, Wilguens Lartigue J. Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries. Lancet 2021; 397:387-397. [PMID: 33485461 PMCID: PMC7846817 DOI: 10.1016/s0140-6736(21)00001-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. METHODS This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. FINDINGS Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70-8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39-8·80) and upper-middle-income countries (2·06, 1·11-3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26-11·59) and upper-middle-income countries (3·89, 2·08-7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. INTERPRETATION Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. FUNDING National Institute for Health Research Global Health Research Unit.
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Perrin J, Ratnayake B, Wells C, Windsor JA, Loveday BPT, MacLennan N, Lindsay H, Pandanaboyana S. Epidural Versus Transabdominal Wall Catheters: A Comparative Study of Outcomes After Pancreatic Resection. J Surg Res 2020; 259:473-479. [PMID: 33070995 DOI: 10.1016/j.jss.2020.09.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 08/22/2020] [Accepted: 09/22/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study compared epidural analgesia with local anesthetic administration via transabdominal wall catheters (TAWC), to determine the effect on perioperative outcomes in pancreatic surgery. MATERIALS AND METHODS A retrospective review of patients undergoing open pancreatic surgery at Auckland City Hospital from 2015 to 2018 was undertaken. Data collected included patient demographics, type of perioperative analgesia, intravenous fluid and vasopressor use, length of high dependency unit stay, postoperative complications, and length of hospital stay. RESULTS Seventy-two patients underwent pancreatic surgery, of which 47 had epidural analgesia and 25 TAWC. The median age was 64 y (range 29-85). Failure of analgesia method occurred in 45% of epidural patients and 28% of TAWC patients (P = 0.209). There was no significant difference in volume of intravenous fluid given or need for vasopressors in the first 3 postoperative days, length of high dependency unit stay (median 1 d, P = 0.2836), rates of postoperative pancreatic fistula (32% versus 40%, P = 0.6046), postoperative complications (38% versus 20%, P = 0.183), or mortality (0.04% versus 0.04%, P = 1.0). CONCLUSIONS Epidural analgesia and TAWC may have comparable perioperative outcomes in patients undergoing pancreatic surgery. Further randomized studies with a larger cohort of patients are warranted to identify the best postoperative analgesic method in patients undergoing pancreatic resection.
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Affiliation(s)
- Jenni Perrin
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland New Zealand; Department of General Surgery, HPB Unit, Auckland City Hospital, Auckland, New Zealand
| | - Bathiya Ratnayake
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland New Zealand; Department of General Surgery, HPB Unit, Auckland City Hospital, Auckland, New Zealand
| | - Cameron Wells
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland New Zealand; Department of General Surgery, HPB Unit, Auckland City Hospital, Auckland, New Zealand
| | - John A Windsor
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland New Zealand; Department of General Surgery, HPB Unit, Auckland City Hospital, Auckland, New Zealand
| | | | - Neil MacLennan
- Department of Anaesthesiology, Auckland City Hospital, Auckland, New Zealand
| | - Helen Lindsay
- Department of Anaesthesiology, Auckland City Hospital, Auckland, New Zealand
| | - Sanjay Pandanaboyana
- HPB and Transplant Unit, Freeman Hospital, Newcastle Upon Tyne, United Kingdom; Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom.
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Wells C, Dubow J, Fenton M, Patel D, Tyler C, Seiden D. 0747 Study Design of an Open-Label Extension and Switch Study for Once Nightly Sodium Oxybate, FT218, in NT1 and NT2 Patients. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Avadel Pharmaceuticals has developed FT218, a once nightly sodium oxybate (SO) formulation for the treatment of excessive daytime sleepiness (EDS) and cataplexy in narcoleptic patients. REST-ON, a pivotal efficacy/safety study is expected to be completed in the first half of 2020. Previous Phase 1 studies have demonstrated FT218 delivers a pharmacokinetic profile needed for once-nightly dosing. The purpose of this study is to evaluate long-term safety of FT218 in REST-ON completers and dosing strategy when switching from twice-nightly SO to FT218.
Methods
The study will enroll NT1/NT2 patients who completed REST-ON or patients switching from stable dose of twice-nightly SO to FT218. REST-ON completers will initiate FT218 at 4.5 g and increase by 1.5 g to the highest tolerated dose or the dose deemed effective (up to 9 g). Switch patients will initiate FT218 at the equivalent/closest dose to their current twice-nightly SO and titrate in accord with safety/efficacy. The study will enroll approximately 250 patients for a duration of two years.
Results
The primary endpoint for REST-ON completers will be safety and tolerability. Secondary endpoints for REST-ON completers will include changes in ESS, reported cataplexy and other REM associated phenomena as well as changes in clinician and patient global impression. For switch patients, endpoints will include percentage of subjects that stay on the same, higher or lower dose of FT218 compared to twice-nightly SO, as well as the percentage of subjects who report a preference for the once-nightly dosing regimen.
Conclusion
The results of this open label extension/switch study will further elucidate the potential benefits of once-nightly FT218 regarding long term safety/tolerability, nocturnal safety/tolerability and efficacy, and importantly provide dosing and preference data for patients switching from twice-nightly SO to once-nightly FT218.
Support
This work was supported by Avadel Pharmaceuticals.
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Affiliation(s)
- C Wells
- Avadel Pharmaceuticals, Chesterfield, MO
| | - J Dubow
- Avadel Pharmaceuticals, Chesterfield, MO
| | - M Fenton
- Avadel Pharmaceuticals, Chesterfield, MO
| | - D Patel
- Avadel Pharmaceuticals, Chesterfield, MO
| | - C Tyler
- Avadel Pharmaceuticals, Chesterfield, MO
| | - D Seiden
- Avadel Pharmaceuticals, Chesterfield, MO
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Ratnayake CBB, Wells C, Hammond J, French JJ, Windsor JA, Pandanaboyana S. Network meta-analysis comparing techniques and outcomes of stump closure after distal pancreatectomy. Br J Surg 2019; 106:1580-1589. [DOI: 10.1002/bjs.11291] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/27/2019] [Accepted: 05/30/2019] [Indexed: 12/24/2022]
Abstract
Abstract
Background
The incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy remains high, and different pancreatic stump closure techniques have been used to reduce the incidence. A network meta-analysis was undertaken to compare the most frequently performed pancreatic stump closure techniques after distal pancreatectomy and determine the technique associated with the lowest POPF rate.
Methods
A systematic search of the Scopus, PubMed, MEDLINE and Embase databases was conducted to identify eligible RCTs. The primary outcome was the occurrence of clinically relevant POPF. Secondary outcomes were duration of operation, blood loss, intrabdominal collections, postoperative complications and 30-day mortality.
Results
Sixteen RCTs including 1984 patients and eight different pancreatic stump closure techniques were included in the network meta-analysis. Patch coverage of the pancreatic stump (round ligament or seromuscular patch) after stapler or suture closure ranked best, with the lowest rates of clinically relevant POPF, lowest volume of intraoperative blood loss, fewer intra-abdominal abscesses, and lower rates of overall complications and 30-day mortality. Round ligament patch closure outperformed seromuscular patch closure in preventing clinically relevant POPF with a significantly larger cohort for comparative analysis. Pancreaticoenteric anastomotic closure consistently ranked poorly for most reported postoperative outcomes.
Conclusion
Patch coverage after stapler or suture closure has the lowest POPF rate and best outcomes among stump closure techniques after distal pancreatectomy.
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Affiliation(s)
- C B B Ratnayake
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hepatopancreatobiliary Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - C Wells
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hepatopancreatobiliary Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - J Hammond
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - J J French
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - J A Windsor
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Hepatopancreatobiliary Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand
| | - S Pandanaboyana
- Hepatopancreatobiliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
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Ratnayake CBB, Wells C, Olsson M, Windsor JA, Pandanaboyana S. Sarcopenic obesity and post‐operative morbidity after pancreatic surgery: a cohort study. ANZ J Surg 2019; 89:1587-1592. [DOI: 10.1111/ans.15431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/14/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Chathura B. B. Ratnayake
- Department of Surgery, Faculty of Medical and Health SciencesThe University of Auckland Auckland New Zealand
- HPB Unit, Department of General SurgeryAuckland City Hospital Auckland New Zealand
| | - Cameron Wells
- Department of Surgery, Faculty of Medical and Health SciencesThe University of Auckland Auckland New Zealand
- HPB Unit, Department of General SurgeryAuckland City Hospital Auckland New Zealand
| | - Magda Olsson
- Institute of MedicineGothenburg University Gothenburg Sweden
| | - John A. Windsor
- Department of Surgery, Faculty of Medical and Health SciencesThe University of Auckland Auckland New Zealand
- HPB Unit, Department of General SurgeryAuckland City Hospital Auckland New Zealand
| | - Sanjay Pandanaboyana
- Department of Surgery, Faculty of Medical and Health SciencesThe University of Auckland Auckland New Zealand
- HPB Unit, Department of General SurgeryAuckland City Hospital Auckland New Zealand
- HPB and Transplant UnitFreeman Hospital Newcastle Upon Tyne UK
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Wells C, Brennan SE, Keon M, Saksena NK. Prionoid Proteins in the Pathogenesis of Neurodegenerative Diseases. Front Mol Neurosci 2019; 12:271. [PMID: 31780895 PMCID: PMC6861308 DOI: 10.3389/fnmol.2019.00271] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 10/23/2019] [Indexed: 12/13/2022] Open
Abstract
There is a growing body of evidence that prionoid protein behaviors are a core element of neurodegenerative diseases (NDs) that afflict humans. Common elements in pathogenesis, pathological effects and protein-level behaviors exist between Alzheimer's Disease (AD), Parkinson's Disease (PD), Huntington's Disease (HD) and Amyotrophic Lateral Sclerosis (ALS). These extend beyond the affected neurons to glial cells and processes. This results in a complicated system of disease progression, which often takes advantage of protective processes to promote the propagation of pathological protein aggregates. This review article provides a current snapshot of knowledge on these proteins and their intrinsic role in the pathogenesis and disease progression seen across NDs.
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Lethbridge M, Stead M, Wells C. Estimating kangaroo density by aerial survey: a comparison of thermal cameras with human observers. Wildl Res 2019. [DOI: 10.1071/wr18122] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract
ContextAerial surveys provide valuable information about the population status and distribution of many native and pest vertebrate species. They are vital for evidence-based monitoring, budget planning and setting management targets. Despite aircraft running costs, they remain one of the most cost-effective ways to capture distribution and abundance data over a broad area. In Australia, annual surveys of large macropods are undertaken in several states to inform management, and in some jurisdictions, to help set commercial kangaroo harvest quotas. Improvements in the cost efficiencies of these surveys are continually sought. Aerial thermal imaging techniques are increasingly being tested for wildlife surveys, but to date no studies have directly compared population data derived from thermal imaging with data collected by human observers during the same flight.
AimsDuring an aerial survey of western grey kangaroos (Macropus fuliginosus), eastern grey kangaroos (M. giganteus) and red kangaroos (Osphranter rufus) across the state of Victoria, Australia, the objective was to conduct a direct comparison of the effectiveness of thermal camera technology and human observers for estimating kangaroo populations from aerial surveys.
MethodsA thermal camera was mounted alongside an aerial observer on one side of the aircraft for a total of 1360km of transect lines. All thermal footage was reviewed manually. Population density estimates and distance sampling models were compared with human observer counts.
Key resultsOverall, the kangaroo density estimates obtained from the thermal camera data were around 30% higher than estimates derived from aerial observer counts. This difference was greater in wooded habitats. Conversely, human-derived counts were greater in open habitats, possibly due to interference from sunlight and flushing. It was not possible to distinguish between species of macropod in the thermal imagery.
ConclusionsThermal survey techniques require refining, but the results of the present study suggest that with careful selection of time of day for surveys, more accurate population estimates may be possible than with conventional aerial surveys.
ImplicationsConventional aerial surveys may be underestimating animal populations in some habitats. Further studies that directly compare the performance of aerial observers and thermal imaging are required across a range of species and habitats.
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Fesenko S, Isamov N, Howard BJ, Sanzharova N, Wells C. Review of Russian language studies on radionuclide behaviour in agricultural animals: Transfer to animal tissues. J Environ Radioact 2018; 192:233-249. [PMID: 29986315 DOI: 10.1016/j.jenvrad.2018.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/18/2018] [Indexed: 06/08/2023]
Abstract
Data on radionuclide transfer to animals from research performed in the former Soviet Union were reviewed to collate transfer coefficient values (Ff) to animal tissues such as liver, kidney and bone, but not muscle which has previously been reported. The derived values were compared with selected data published in the English language literature. The new data are mainly for 90Sr and 137Cs, although some data were also provided for 3H, 54Mn, 59Fe, 60Co, 22Na 65Zn, 131I and U. The Russian language data may provide a basis for better informed evaluation of radiation dose from the consumption of such animal products, which can form important components of the diet in some countries.
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Affiliation(s)
- S Fesenko
- Russian Institute of Radiology and Radioecology, 249020 Obninsk, Russia.
| | - N Isamov
- Russian Institute of Radiology and Radioecology, 249020 Obninsk, Russia
| | - B J Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LAI 4AP, UK
| | - N Sanzharova
- Russian Institute of Radiology and Radioecology, 249020 Obninsk, Russia
| | - C Wells
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LAI 4AP, UK
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Lee H, Stacey A, Klesert T, Wells C, Skalet A, Bloch C, Fung A, Bowen S, Wong T, Shibata D, Halasz L, Rengan R. A Contour-Based Approach for Predicting Corneal Toxicity in Patients with Uveal Melanoma Treated with Proton Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shell R, Al-Zaidy S, Arnold W, Rodino-Klapac L, Prior T, Kotha K, Paul G, Lowes L, Alfano L, Berry K, Church K, Kissel J, Nagendran S, Ogrinc F, Sproule D, Wells C, Meyer K, Likhite S, Kaspar B, Mendell J. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mendell J, Al-Zaidy S, Shell R, Arnold W, Rodino-Klapac L, Prior T, Lowes L, Alfano L, Berry K, Church K, Kissel J, Nagendran S, Italien J, Sproule D, Wells C, Burghes A, Foust K, Meyer K, Likhite S, Kaspar B. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Day J, Feltner D, Ogrinc F, Macek T, Wells C, Muehring L, Italien J, Sproule D, Nagendran S, Kaspar B, Mendell J. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Alfano L, Lowes L, Al-Zaidy S, Shell R, Arnold W, Rodino-Klapac L, Prior T, Berry K, Church K, Kissel J, Nagendran S, Italien J, Sproule D, Wells C, Burghes A, Foust K, Meyer K, Likhite S, Kaspar B, Mendell J. SMA THERAPIES I. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Scholten W, Simon O, Maremmani I, Wells C, Kelly J, Hämmig R, Radbruch L. Re: Letter to the editor of public health in response to ‘Access to treatment with controlled medicines rationale and recommendations for neutral, respectful, and precise language’. Public Health 2018; 160:157-158. [DOI: 10.1016/j.puhe.2018.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 02/05/2018] [Indexed: 12/01/2022]
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Lisberg A, Cummings A, Goldman JW, Bornazyan K, Reese N, Wang T, Coluzzi P, Ledezma B, Mendenhall M, Hunt J, Wolf B, Jones B, Madrigal J, Horton J, Spiegel M, Carroll J, Gukasyan J, Williams T, Sauer L, Wells C, Hardy A, Linares P, Lim C, Ma L, Adame C, Garon EB. A Phase II Study of Pembrolizumab in EGFR-Mutant, PD-L1+, Tyrosine Kinase Inhibitor Naïve Patients With Advanced NSCLC. J Thorac Oncol 2018; 13:1138-1145. [PMID: 29874546 DOI: 10.1016/j.jtho.2018.03.035] [Citation(s) in RCA: 369] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/25/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite the significant antitumor activity of pembrolizumab in NSCLC, clinical benefit has been less frequently observed in patients whose tumors harbor EGFR mutations compared to EGFR wild-type patients. Our single-center experience on the KEYNOTE-001 trial suggested that pembrolizumab-treated EGFR-mutant patients, who were tyrosine kinase inhibitor (TKI) naïve, had superior clinical outcomes to those previously treated with a TKI. As TKI naïve EGFR-mutants have generally been excluded from pembrolizumab studies, data to guide treatment decisions in this patient population is lacking, particularly in patients with programmed death ligand 1 (PD-L1) expression ≥50%. METHODS We conducted a phase II trial (NCT02879994) of pembrolizumab in TKI naive patients with EGFR mutation-positive, advanced NSCLC and PD-L1-positive (≥1%, 22C3 antibody) tumors. Pembrolizumab was administered 200 mg every 3 weeks. The primary endpoint was objective response rate. Secondary endpoints included safety of pembrolizumab, additional pembrolizumab efficacy endpoints, and efficacy and safety of an EGFR TKI after pembrolizumab. RESULTS Enrollment was ceased due to lack of efficacy after 11 of 25 planned patients were treated. Eighty-two percent of trial patients were treatment naïve, 64% had sensitizing EGFR mutations, and 73% had PD-L1 expression ≥50%. Only 1 patient had an objective response (9%), but repeat analysis of this patient's tumor definitively showed the original report of an EGFR mutation to be erroneous. Observed treatment-related adverse events were similar to prior experience with pembrolizumab, but two deaths within 6 months of enrollment, including one attributed to pneumonitis, were of concern. CONCLUSIONS Pembrolizumab's lack of efficacy in TKI naïve, PD-L1+, EGFR-mutant patients with advanced NSCLC, including those with PD-L1 expression ≥50%, suggests that it is not an appropriate therapeutic choice in this setting.
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Affiliation(s)
- A Lisberg
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - A Cummings
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J W Goldman
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - K Bornazyan
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - N Reese
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - T Wang
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - P Coluzzi
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - B Ledezma
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - M Mendenhall
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Hunt
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - B Wolf
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - B Jones
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Madrigal
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Horton
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - M Spiegel
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Carroll
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - J Gukasyan
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - T Williams
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - L Sauer
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - C Wells
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - A Hardy
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - P Linares
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - C Lim
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - L Ma
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - C Adame
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California
| | - Edward B Garon
- David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California.
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Wells C, Dellheim V, Goverman J, Ryan CM, Schneider JC. 492 Development of a Decision Tree to Assist with Treatment of Burn-Related Ankle Contractures. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- C Wells
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - V Dellheim
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - J Goverman
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - C M Ryan
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
| | - J C Schneider
- Spaulding Rehabilitation Hospital, Charlestown, MA; Massachusetts General Hospital, Boston, MA; Massachusetts General Hospital Harvard Medical School and Shriners Hospitals for Children, Boston, MA
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Matossian M, Burks H, Bowles A, Sabol R, Hoang V, Elliott S, Bunnell B, Zuercher W, Drewry D, Wells C, Alfortish A, Lee S, Hartono A, Jones S, Moroz K, Zea A, Burow M, Collins-Burow B. Abstract P5-05-05: Patient-derived triple negative breast cancer xenografts as a translational model to screen for novel kinase pathways. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-05-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Overall, triple negative breast cancers (TNBCs) constitute 12% of all breast cancers, and is approximately twice more prevalent in African-American populations. Louisiana has a high proportion of African-American residents (32.5% in 2015), and thus hosts a higher population of TNBC patients. TNBCs have an aggressive phenotype that is elusive to the targeted therapeutics used to treat other breast cancer subtypes. Certain kinase families have been extensively studied as regulators of epithelial-mesenchymal transition (EMT), a process involved in the initiation of cancer metastasis. Discovery of novel kinase targets within the subset of uncharacterized kinases could provide important insight into future targeted therapies. However, current models utilized in target discovery research are limited by the inability to accurately recapitulate the complex stromal architecture and heterogenous genetic and molecular composition of breast cancer. Furthermore, immortalized cell lines are limited to a 2D environment and over time acquire mutations that may not reflect the primary tumor. Recently, our laboratory has successfully established two TNBC patient-derived xenograft (PDX) models derived from African-American patients, and generated cell lines (TU-BCx-2K1, TU-BCx-2O0) and mammospheres. One of these models, 2O0, presents tumor architecture, cellular composition, genomic (qRT-PCR) and protein (western blot) expressions that are concordant with a claudin-low subtype, which has higher rates of metastasis and recurrence. Furthermore, we show that both TNBC models metastasize to the lungs, and exhibit molecular characteristics consistent with mesenchymal phenotypes. We utilized these translational PDX models to screen a library of small molecule inhibitors that represent a variety of kinase pathways to identify novel therapeutic targets and/or pathways that are specific to TNBC subtypes. We found in a preliminary cell morphology screen using three TNBC cell lines (MDA-MB-231, BT549, MDA-MB-157), two small molecule inhibitors that increased epithelial marker (CDH1) gene expression, suppressed mesenchymal (VIM, c-FOS, SNAI1, ZEB1) expression and/or suppressed cellular motility in transwell migration assays. We observed after ex vivo treatments with our PDX tumors the two compounds increase the epithelial marker CDH1 expression, and suppress mesenchymal markers (VIM, MMP2, c-FOS, SNAI1, ZEB1) expressions. We confirm these findings in the TU-BCx-2K1 cell line. Kinase array data revealed candidate kinases responsible for the observed EMT changes in the two compounds of interest (NEK5, NEK9, NEK1 potentially affect cell motility; SRC-family kinases, TAOK2, STK10 potentially affect EMT gene changes); we plan to utilize the PDX cell lines to characterize these kinases in EMT. We aim to ultimately discover novel therapeutic targets specific to different TNBC molecular subtypes.
Citation Format: Matossian M, Burks H, Bowles A, Sabol R, Hoang V, Elliott S, Bunnell B, Zuercher W, Drewry D, Wells C, Alfortish A, Lee S, Hartono A, Jones S, Moroz K, Zea A, Burow M, Collins-Burow B. Patient-derived triple negative breast cancer xenografts as a translational model to screen for novel kinase pathways [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-05-05.
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Affiliation(s)
- M Matossian
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - H Burks
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Bowles
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - R Sabol
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - V Hoang
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - S Elliott
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - B Bunnell
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - W Zuercher
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - D Drewry
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - C Wells
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Alfortish
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - S Lee
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Hartono
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - S Jones
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - K Moroz
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - A Zea
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - M Burow
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
| | - B Collins-Burow
- Tulane University School of Medicine, New Orleans, LA; Eshelman School of Pharmacy, University of Chapel Hill, Chapel Hill, NC; Louisiana Cancer Research Center, New Orleans, LA
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Arendt‐Nielsen L, Morlion B, Perrot S, Dahan A, Dickenson A, Kress H, Wells C, Bouhassira D, Drewes AM. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain 2018; 22:216-241. [DOI: 10.1002/ejp.1140] [Citation(s) in RCA: 360] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
AbstractDifferent neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation.SignificanceCentral sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.
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Affiliation(s)
| | - B. Morlion
- The Leuven Centre for Algology University Hospitals Leuven University of Leuven Belgium
| | - S. Perrot
- INSERM U987 Pain Center Cochin Hospital Paris Descartes University Paris France
| | - A. Dahan
- Department of Anesthesiology Leiden University Medical Center Leiden The Netherlands
| | - A. Dickenson
- Neuroscience Physiology & Pharmacology University College London UK
| | - H.G. Kress
- Department of Special Anaesthesia and Pain Therapy Medizinische Universität/AKH Wien Vienna Austria
| | | | - D. Bouhassira
- INSERM U987 Centre d'Evaluation et de Traitement de la Douleur Hôpital Ambroise Paré Boulogne Billancourt France
| | - A. Mohr Drewes
- Mech‐Sense Department of Gastroenterology and Hepatology Clinical Institute Aalborg University Hospital Aalborg Denmark
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Scholten W, Simon O, Maremmani I, Wells C, Kelly J, Hämmig R, Radbruch L. Access to treatment with controlled medicines rationale and recommendations for neutral, precise, and respectful language. Public Health 2017; 153:147-153. [DOI: 10.1016/j.puhe.2017.08.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 08/24/2017] [Accepted: 08/30/2017] [Indexed: 10/18/2022]
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Krcevski-Skvarc N, Wells C, Häuser W. Availability and approval of cannabis-based medicines for chronic pain management and palliative/supportive care in Europe: A survey of the status in the chapters of the European Pain Federation. Eur J Pain 2017; 22:440-454. [PMID: 29134767 DOI: 10.1002/ejp.1147] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is considerable public and political interest in the use of cannabis products for medical purposes. METHODS The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care. RESULTS Thirty-one out of 37 contacted councillors responded. Plant-derived tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray is approved for spasticity in multiple sclerosis refractory to conventional treatment in 21 EFIC chapters. Plant-derived THC (dronabinol) is approved for some palliative care conditions in four EFIC chapters. Synthetic THC analogue (nabilone) is approved for chemotherapy-associated nausea and vomiting refractory to conventional treatment in four EFIC chapters'. Eight EFIC chapters' countries have an exceptional and six chapters an expanded access programme for medical cannabis. German and Israeli pain societies recommend the use of cannabis-based medicines as third-line drug therapies for chronic pain within a multicomponent approach. Conversely, the German medical association and a team of finish experts and officials do not recommend the prescription of medical cannabis due to the lack of high-quality evidence of efficacy and the potential harms. CONCLUSIONS There are marked differences between the countries represented in EFIC in the approval and availability of cannabis-based products for medical use. EFIC countries are encouraged to collaborate with the European Medicines Agency to publish a common document on cannabis-based medicines. SIGNIFICANCE There are striking differences between European countries in the availability of plant-derived and synthetic cannabinoids and of medical cannabis for pain management and for symptom control in palliative care and in the covering of costs by health insurance companies or state social security systems.
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Affiliation(s)
- N Krcevski-Skvarc
- Department of Anesthesiology, Intensive Care and Pain Treatment, University Medical Center Maribor, Slovenia.,Faculty of Medicine of University Maribor, Institute for Palliative Medicine and Care, Slovenia
| | - C Wells
- Pain Medicine, Pain Matters Ltd, Liverpool, UK
| | - W Häuser
- Department Internal Medicine 1, Klinikum Saarbrücken gGmbH, Germany.,Department Psychosomatic Medicine and Psychotherapy, Technische Universität München, Germany
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Shell R, Al-Zaidy S, Arnold W, Rodino-Klapac L, Prior T, Lowes L, Alfano L, Berry K, Church K, Kissel J, Nagendran S, L'Italien J, Sproule D, Wells C, Burghes A, Foust K, Meyer K, Likhite S, Kaspar B, Mendell J. AVXS-101 phase 1 gene therapy clinical trial in SMA Type 1: decreased need of ventilatory and nutritional support at End-of-Study. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Braso Maristany F, Quist J, Wells C, Grigoriadis A, Marra P, Tutt A. PIM1 kinase promotes cell migration via SHP2 in triple-negative breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx361.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Keane C, Wells C, O'Grady G, Bissett IP. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis 2017; 19:713-722. [PMID: 28612460 DOI: 10.1111/codi.13767] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/29/2017] [Indexed: 12/13/2022]
Abstract
AIM There is increasing awareness of the poor functional outcome suffered by many patients after sphincter-preserving rectal resection, termed 'low anterior resection syndrome' (LARS). There is no consensus definition of LARS and varying instruments have been employed to measure functional outcome, complicating research into prevalence, contributing factors and potential therapies. We therefore aimed to describe the instruments and outcome measures used in studies of bowel dysfunction after low anterior resection and identify major themes used in the assessment of LARS. METHOD A systematic review of the literature was performed for studies published between 1986 and 2016. The instruments and outcome measures used to report bowel function after low anterior resection were extracted and their frequency of use calculated. RESULTS The search revealed 128 eligible studies. These employed 18 instruments, over 30 symptoms, and follow-up time periods from 4 weeks to 14.6 years. The most frequent follow-up period was 12 months (48%). The most frequently reported outcomes were incontinence (97%), stool frequency (80%), urgency (67%), evacuatory dysfunction (47%), gas-stool discrimination (34%) and a measure of quality of life (80%). Faecal incontinence scoring systems were used frequently. The LARS score and the Bowel Function Instrument (BFI) were used in only nine studies. CONCLUSION LARS is common, but there is substantial variation in the reporting of functional outcomes after low anterior resection. Most studies have focused on incontinence, omitting other symptoms that correlate with patients' quality of life. To improve and standardize research into LARS, a consensus definition should be developed, and these findings should inform this goal.
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Affiliation(s)
- C Keane
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - C Wells
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - G O'Grady
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - I P Bissett
- Department of Surgery, University of Auckland, Auckland, New Zealand.,Department of Surgery, Auckland City Hospital, Auckland, New Zealand
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Verceles A, Serra M, Wells C, Davis D, Sorkin J, Terrin M, Alon G, Goldberg A. EXERCISE, PROTEIN, AND ELECTRIC STIMULATION REDUCES ICU ASSOCIATED SARCOPENIA IN OLDER PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A.C. Verceles
- University of Maryland School of Medicine, Baltimore, Maryland,
- University of Maryland Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland
| | - M.C. Serra
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - C. Wells
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - D. Davis
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - J. Sorkin
- University of Maryland School of Medicine, Baltimore, Maryland,
- University of Maryland Claude D. Pepper Older Americans Independence Center, Baltimore, Maryland
| | - M.L. Terrin
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - G. Alon
- University of Maryland School of Medicine, Baltimore, Maryland,
| | - A.P. Goldberg
- University of Maryland School of Medicine, Baltimore, Maryland,
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Howard BJ, Wells C, Barnett CL, Howard DC. Improving the quantity, quality and transparency of data used to derive radionuclide transfer parameters for animal products. 2. Cow milk. J Environ Radioact 2017; 167:254-268. [PMID: 28011111 DOI: 10.1016/j.jenvrad.2016.10.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 06/06/2023]
Abstract
Under the International Atomic Energy Agency (IAEA) MODARIA (Modelling and Data for Radiological Impact Assessments) Programme, there has been an initiative to improve the derivation, provenance and transparency of transfer parameter values for radionuclides from feed to animal products that are for human consumption. A description of the revised MODARIA 2016 cow milk dataset is described in this paper. As previously reported for the MODARIA goat milk dataset, quality control has led to the discounting of some references used in IAEA's Technical Report Series (TRS) report 472 (IAEA, 2010). The number of Concentration Ratio (CR) values has been considerably increased by (i) the inclusion of more literature from agricultural studies which particularly enhanced the stable isotope data of both CR and Fm and (ii) by estimating dry matter intake from assumed liveweight. In TRS 472, the data for cow milk were 714 transfer coefficient (Fm) values and 254 CR values describing 31 elements and 26 elements respectively. In the MODARIA 2016 cow milk dataset, Fm and CR values are now reported for 43 elements based upon 825 data values for Fm and 824 for CR. The MODARIA 2016 cow milk dataset Fm values are within an order of magnitude of those reported in TRS 472. Slightly bigger changes are seen in the CR values, but the increase in size of the dataset creates greater confidence in them. Data gaps that still remain are identified for elements with isotopes relevant to radiation protection.
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Affiliation(s)
- B J Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK.
| | - C Wells
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK
| | - C L Barnett
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK
| | - D C Howard
- Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, LA1 4AP, UK
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Furin J, Alirol E, Allen E, Fielding K, Merle C, Abubakar I, Andersen J, Davies G, Dheda K, Diacon A, Dooley KE, Dravnice G, Eisenach K, Everitt D, Ferstenberg D, Goolam-Mahomed A, Grobusch MP, Gupta R, Harausz E, Harrington M, Horsburgh CR, Lienhardt C, McNeeley D, Mitnick CD, Nachman S, Nahid P, Nunn AJ, Phillips P, Rodriguez C, Shah S, Wells C, Thomas-Nyang'wa B, du Cros P. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults. Int J Tuberc Lung Dis 2017; 20:290-4. [PMID: 27046707 DOI: 10.5588/ijtld.15.0490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.
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Affiliation(s)
- J Furin
- TB Research Unit, Case Western Reserve University School of Medicine, Room E-202, 2210 Circle Dr, Cleveland, OH 44149, USA.
| | - E Alirol
- Manson Unit Médicins Sans Frontières, London, UK
| | - E Allen
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - K Fielding
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - C Merle
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - I Abubakar
- Department of Infection and Population Health, University College of London, London, UK
| | - J Andersen
- Statistical and Data Analysis Center, Harvard School of Public Health, Boston, Massachusetts, USA
| | - G Davies
- Institutes of Infection and Global Health and of Translational Medicine, University of Liverpool, Liverpool, UK
| | - K Dheda
- Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - A Diacon
- Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | - K E Dooley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - G Dravnice
- Tuberculosis Foundation, KNCV, Amsterdam, The Netherlands
| | - K Eisenach
- Pathology and Microbiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - D Everitt
- Global Alliance for TB Drug Development, New York, New York, USA
| | | | | | - M P Grobusch
- Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Gupta
- Otsuka USA, Rockville, Maryland, USA
| | - E Harausz
- TB Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - M Harrington
- Treatment Action Group, New York City, New York, USA
| | - C R Horsburgh
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - C Lienhardt
- Stop TB Partnership & Stop TB Department, World Health Organization, Geneva, Switzerland
| | - D McNeeley
- Medical Service Corp International, Arlington, Virginia, USA
| | - C D Mitnick
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - S Nachman
- Department of Pediatrics, Stony Brook School of Medicine, Stony Brook, New York, USA
| | - P Nahid
- Curry International Tuberculosis Center, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - A J Nunn
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - P Phillips
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - C Rodriguez
- Department of Respiratory Medicine, P D Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - S Shah
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - C Wells
- Otsuka USA, Rockville, Maryland, USA
| | | | - P du Cros
- Manson Unit Médicins Sans Frontières, London, UK
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45
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Wanaski S, Shieh P, Kuntz N, Ciafaloni E, Butterfield R, Brantley S, Grasfeder L, Dubow J, Beers B, Kernbauer E, Wells C, Cunniff T, Griggs R. Pharmacokinetics of 21-desacetyldeflazacort and the safety of deflazacort after oral administration to children and adolescents with Duchenne muscular dystrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Huque S, Hepgul N, Verne J, Wells C, Higginson IJ, Gao W. OP94 Causes of death in long-term neurological conditions: a population-based study in England, 2012–2014. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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47
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Howard BJ, Wells C, Barnett CL. Improving the quantity, quality and transparency of data used to derive radionuclide transfer parameters for animal products. 1. Goat milk. J Environ Radioact 2016; 154:34-42. [PMID: 26845198 DOI: 10.1016/j.jenvrad.2016.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/14/2016] [Accepted: 01/16/2016] [Indexed: 06/05/2023]
Abstract
Under the MODARIA (Modelling and Data for Radiological Impact Assessments Programme of the International Atomic Energy Agency), there has been an initiative to improve the derivation, provenance and transparency of transfer parameter values for radionuclides. The approach taken for animal products is outlined here and the first revised table for goat milk is provided. Data from some references used in TRS 472 were removed and reasons given for removal. Particular efforts were made to improve the number of CR (concentration ratio) values which have some advantages over transfer coefficients. There is little difference in most of the new CR and Fm (transfer coefficient) values for goat milk compared with those in TRS 472. In TRS 472, 21 CR values were reported for goat milk. In the 2015 dataset for goat milk CR values for a further 14 elements are now included. The CR and Fm values for only one element (Co) were removed.
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Affiliation(s)
- B J Howard
- NERC Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, UK.
| | - C Wells
- NERC Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, UK
| | - C L Barnett
- NERC Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LA1 4AP, UK
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48
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Beresford NA, Beaugelin-Seiller K, Burgos J, Cujic M, Fesenko S, Kryshev A, Pachal N, Real A, Su BS, Tagami K, Vives i Batlle J, Vives-Lynch S, Wells C, Wood MD. Radionuclide biological half-life values for terrestrial and aquatic wildlife. J Environ Radioact 2015; 150:270-276. [PMID: 26378959 DOI: 10.1016/j.jenvrad.2015.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Abstract
The equilibrium concentration ratio is typically the parameter used to estimate organism activity concentrations within wildlife dose assessment tools. Whilst this is assumed to be fit for purpose, there are scenarios such as accidental or irregular, fluctuating, releases from licensed facilities when this might not be the case. In such circumstances, the concentration ratio approach may under- or over-estimate radiation exposure depending upon the time since the release. To carrying out assessments for such releases, a dynamic approach is needed. The simplest and most practical option is representing the uptake and turnover processes by first-order kinetics, for which organism- and element-specific biological half-life data are required. In this paper we describe the development of a freely available international database of radionuclide biological half-life values. The database includes 1907 entries for terrestrial, freshwater, riparian and marine organisms. Biological half-life values are reported for 52 elements across a range of wildlife groups (marine = 9, freshwater = 10, terrestrial = 7 and riparian = 3 groups). Potential applications and limitations of the database are discussed.
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Affiliation(s)
- N A Beresford
- NERC Centre for Ecology & Hydrology, Bailrigg, Lancaster LA1 4AP, UK; School of Environment & Life Sciences, University of Salford, Manchester M4 4WT, UK.
| | - K Beaugelin-Seiller
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-ENV, LM2E, Cadarache, France
| | | | - M Cujic
- Institute for the Application of Nuclear Energy, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - S Fesenko
- International Atomic Energy Agency, A-2444 Seibersdorf, Austria
| | | | - N Pachal
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, L8S 4K1, Canada
| | - A Real
- Centro de Investigaciones Energéticas Medio Ambientales y Tecnológicas, Av. Complutense 40, Madrid 28040, Spain
| | - B S Su
- Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, L8S 4K1, Canada
| | - K Tagami
- National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, 263-8555 Chiba, Japan
| | - J Vives i Batlle
- Belgian Nuclear Research Centre, Boeretang 200, 2400 Mol, Belgium
| | | | - C Wells
- NERC Centre for Ecology & Hydrology, Bailrigg, Lancaster LA1 4AP, UK
| | - M D Wood
- School of Environment & Life Sciences, University of Salford, Manchester M4 4WT, UK
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49
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Levin S, Wells C, Barnard N. Dietary Cholesterol and Blood Cholesterol Concentrations. JAMA 2015; 314:2083-4. [PMID: 26575069 DOI: 10.1001/jama.2015.12595] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Susan Levin
- Physicians Committee for Responsible Medicine, Washington, DC
| | - Cameron Wells
- Physicians Committee for Responsible Medicine, Washington, DC
| | - Neal Barnard
- George Washington University School of Medicine and Health Sciences, Washington, DC
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50
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De Benedetti F, Ruperto N, Brunner H, Keane C, Wells C, Wang J, Calvo I, Cuttica R, Ravelli A, Schneider R, Eleftheriou D, Wouters C, Xavier R, Zemel L, Baildam E, Burgos-Vargas R, Dolezalova P, Garay S, Joos R, Grom A, Wulffraat N, Zuber Z, Zulian F, Martini A, Lovell D. THU0508 Safety and Efficacy of Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis: 5-Year Data from Tender, A Phase 3 Clinical Trial. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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