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Simmonds WM, Awuku Y, Barrett C, Brand M, Davidson K, Epstein D, Fredericks E, Gabriel S, Grobler S, Gounden C, Katsidzira L, Louw VJ, Naidoo V, Noel C, Ogutu E, Ramonate N, Seabi N, Setshedi M, Van Zyl J, Watermeyer G, Kassianides C. Guidance for the gastrointestinal evaluation and management of iron deficiency in Sub-Saharan Africa. S Afr Med J 2024; 114:e711. [PMID: 38525666 DOI: 10.7196/samj.2024.v114i1b.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Over 30% of the world's population is anaemic, with a significant proportion of these being iron deficient. As iron deficiency (ID) anaemia in men and post-menopausal women is mostly caused by gastrointestinal blood loss or malabsorption, the initial evaluation of a patient with ID anaemia involves referral to a gastroenterologist. The current drive towards patient blood management in sub-Saharan Africa (SSA)prescribes that we regulate not only the use of blood transfusion but also the management of patients in whom the cause of iron loss or inadequate iron absorption is sought. Recommendations have been developed to: (i) aid clinicians in the evaluation of suspected gastrointestinal iron loss and iron malabsorption, and often a combination of these; (ii) improve clinical outcomes for patients with gastrointestinal causes of ID; (iii) provide current, evidence-based, context-specific recommendations for use in the management of ID; and (iv) conserve resources by ensuring rational utilisation of blood and blood products. METHOD Development of the guidance document was facilitated by the Gastroenterology Foundation of Sub-Saharan Africa and the South African Gastroenterology Society. The consensus recommendations are based on a rigorous process involving 21 experts in gastroenterology and haematology in SSA. Following discussion of the scope and purpose of the guidance document among the experts, an initial review of the literature and existing guidelines was undertaken. Thereafter, draft recommendation statements were produced to fulfil the outlined purpose of the guidance document. These were reviewed in a round-table discussion and were subjected to two rounds of anonymised consensus voting by the full committee in an electronic Delphi exercise during 2022 using the online platform, Research Electronic Data Capture. Recommendations were modified by considering feedback from the previous round, and those reaching a consensus of over 80% were incorporated into the final document. Finally, 44 statements in the document were read and approved by all members of the working group. CONCLUSION The recommendations incorporate six areas, namely: general recommendations and practice, Helicobacter pylori, coeliac disease, suspected small bowel bleeding, inflammatory bowel disease, and preoperative care. Implementation of the recommendations is aimed at various levels from individual practitioners to healthcare institutions, departments and regional, district, provincial and national platforms. It is intended that the recommendations spur the development of centre-specific guidelines and that they are integrated with the relevant patient blood management protocols. Integration of the recommendations is intended to promote optimal evaluation and management of patients with ID, regardless of the presence of anaemia.
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Affiliation(s)
- W M Simmonds
- Gastroenterology Division, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - Y Awuku
- Department of Medicine, University of Health and Allied Sciences, Ho, Ghana.
| | - C Barrett
- School of Clinical Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - M Brand
- Department of General Surgery, School of Medicine, University of Pretoria, South Africa.
| | - K Davidson
- Private practice, IBD nurse specialist, Cape Town, South Africa.
| | - D Epstein
- Division of Gastroenterology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - E Fredericks
- Department of Medicine, Stellenbosch University, South Africa.
| | - S Gabriel
- Gastroenterology Unit, Tygerberg Hospital and Stellenbosch University, South Africa.
| | - S Grobler
- niversitas Netcare Private Hospital, Bloemfontein, South Africa.
| | - C Gounden
- Department of Gastroenterology, School of Clinical Medicine, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
| | - L Katsidzira
- Internal Medicine Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
| | - V J Louw
- Division of Clinical Haematology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - V Naidoo
- Department of Gastroenterology, School of Clinical Medicine, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
| | - C Noel
- Division of Gastrointestinal Surgery, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - E Ogutu
- Department of Internal Medicine, University of Nairobi and Kenyatta National Hospital, Kenya.
| | - N Ramonate
- Gastroenterology Division, Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - N Seabi
- Gastroenterology Division, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
| | - M Setshedi
- Division of Gastroenterology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - J Van Zyl
- Department of Internal Medicine, Faculty of Health Sciences, University of the Free State and Netcare Universitas Private Hospital, Bloemfontein, South Africa.
| | - G Watermeyer
- Division of Gastroenterology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
| | - C Kassianides
- Department of Medicine, Faculty of Health Sciences, University of Cape Town and Morningside Mediclinic, Johannesburg, South Africa.
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Curzen N, Nicholas Z, Stuart B, Wilding S, Hill K, Shambrook J, Eminton Z, Ball D, Barrett C, Johnson L, Nuttall J, Fox K, Connolly D, O'Kane P, Hobson A, Chauhan A, Uren N, Mccann GP, Berry C, Carter J, Roobottom C, Mamas M, Rajani R, Ford I, Douglas P, Hlatky MA. Fractional flow reserve derived from computed tomography coronary angiography in the assessment and management of stable chest pain: the FORECAST randomized trial. Eur Heart J 2021; 42:3844-3852. [PMID: 34269376 PMCID: PMC8648068 DOI: 10.1093/eurheartj/ehab444] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/10/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022] Open
Abstract
Aims Fractional flow reserve (FFRCT) using computed tomography coronary angiography (CTCA) determines both the presence of coronary artery disease and vessel-specific ischaemia. We tested whether an evaluation strategy based on FFRCT would improve economic and clinical outcomes compared with standard care. Methods and results Overall, 1400 patients with stable chest pain in 11 centres were randomized to initial testing with CTCA with selective FFRCT (experimental group) or standard clinical care pathways (standard group). The primary endpoint was total cardiac costs at 9 months. Secondary endpoints were angina status, quality of life, major adverse cardiac and cerebrovascular events, and use of invasive coronary angiography. Randomized groups were similar at baseline. Most patients had an initial CTCA: 439 (63%) in the standard group vs. 674 (96%) in the experimental group, 254 of whom (38%) underwent FFRCT. Mean total cardiac costs were higher by £114 (+8%) in the experimental group, with a 95% confidence interval from −£112 (−8%) to +£337 (+23%), though the difference was not significant (P = 0.10). Major adverse cardiac and cerebrovascular events did not differ significantly (10.2% in the experimental group vs. 10.6% in the standard group) and angina and quality of life improved to a similar degree over follow-up in both randomized groups. Invasive angiography was reduced significantly in the experimental group (19% vs. 25%, P = 0.01). Conclusion A strategy of CTCA with selective FFRCT in patients with stable angina did not differ significantly from standard clinical care pathways in cost or clinical outcomes, but did reduce the use of invasive coronary angiography.
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Affiliation(s)
- N Curzen
- Faculty of Medicine, University of Southampton.,Coronary Research Group, University Hospital Southampton
| | - Z Nicholas
- Coronary Research Group, University Hospital Southampton
| | - B Stuart
- Clinical Trials Unit, University of Southampton
| | - S Wilding
- Clinical Trials Unit, University of Southampton
| | - K Hill
- Clinical Trials Unit, University of Southampton
| | - J Shambrook
- Cardiothoracic Radiology, University Hospital Southampton
| | - Z Eminton
- Clinical Trials Unit, University of Southampton
| | - D Ball
- Clinical Trials Unit, University of Southampton
| | - C Barrett
- Clinical Trials Unit, University of Southampton
| | - L Johnson
- Clinical Trials Unit, University of Southampton
| | - J Nuttall
- Clinical Trials Unit, University of Southampton
| | - K Fox
- Imperial College, London, UK
| | | | - P O'Kane
- Dorset Heart Centre, University Hospitals Dorset, Bournemouth
| | - A Hobson
- Queen Alexandra Hospital, Portsmouth
| | | | - N Uren
- Royal Infirmary, Edinburgh
| | - G P Mccann
- Department of Cardiovascular Sciences, University of Leicester & NIHR Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - C Berry
- British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow
| | - J Carter
- University Hospital of North Tees, Stockton on Tees
| | | | - M Mamas
- Royal Stoke University Hospital, Stoke-on-Trent
| | - R Rajani
- Guy's & St Thomas' Hospital, London
| | - I Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow
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Kafadar AH, Barrett C, Cheung KL. Knowledge and perceptions of Alzheimer's disease in three ethnic groups of younger adults in the United Kingdom. BMC Public Health 2021; 21:1124. [PMID: 34118921 PMCID: PMC8196265 DOI: 10.1186/s12889-021-11231-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a global public health problem with an ageing population. Knowledge is essential to promote early awareness, diagnosis and treatment of AD symptoms. AD knowledge is influenced by many cultural factors including cultural beliefs, attitudes and language barriers. This study aims: (1) to define AD knowledge level and perceptions amongst adults between 18 and 49 years of age in the UK; (2) to compare knowledge and perceptions of AD among three main ethnic groups (Asian, Blacks, and Whites); and (3) to assess potential associations of age, gender, education level, affinity with older people (65 or over), family history and caregiving history with AD knowledge. METHODS Data was collected from 186 participants as a convenience sample of younger adults of three different ethnicities (16.1% Asian, 16.7% Black, 67.2% White), living in the UK, recruited via an online research platform. The majority of the participants were in the 18-34 years age group (87.6%). Demographic characteristics of participants and AD knowledge correlation were assessed by the 30-item Alzheimer's Disease Knowledge Scale (ADKS), comprising 7 content domains. ANOVA/ANCOVA were used to assess differences in AD knowledge by ethnicity, gender, education level, age and affinity with dementia and Alzheimer's patients. RESULTS For AD general knowledge across all respondents only 45.0% answers were correct. No significant differences were found for the total ADKS score between ethnicities in this younger age group, who did not differ in education level. However, there were significant knowledge differences for the ADKS symptom domain score even after controlling for other demographics variables such as gender, education level (p = 0.005). White respondents were more likely to know about AD symptoms than their Black counterparts (p = 0.026). CONCLUSION The study's findings suggest that the AD knowledge level is not adequate for all ethnic groups. Meanwhile, significant differences were observed in symptoms, between ethnic groups, and therefore, differ in their needs regards health communication. The study contributes to an understanding of ethnicity differences in AD knowledge amongst adults from 18 to 49 years of age in the UK and may also provide input into an intervention plan for different ethnicities' information needs.
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Affiliation(s)
| | - Christine Barrett
- Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Kei Long Cheung
- Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
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Oh Y, Hennessey A, Young L, Yates D, Barrett C. OP0274-PARE EVALUATION OF PATIENT SATISFACTION FOR TELEHEALTH (PHONE AND VIDEO) IN RHEUMATOLOGY OUTPATIENTS DURING COVID-19 PANDEMIC. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Telehealth via phone (TPhone) or video conference (TVideo) in rheumatology has been a topic of interest for many years. Its use was rapidly expanded due to the international public health emergency of coronavirus disease-19 (COVID-19) outbreak in 2020. Australian Medicare Benefits Schedule (MBS) swiftly enabled temporary MBS telehealth items on 13 March 2020, currently extended until 31 March 20211. In the early phase of the COVID-19 pandemic, Antony et al. conducted a single-centre public survey to assess patient perception of rheumatology telehealth. Their results showed that 98.4% of patients consider telehealth acceptable during the pandemic2. It is unclear, however, whether this positive perception persists after patients experience a telehealth. In addition, a survey data in 2019 suggested more than half of Australian rheumatologists work in private practice3. Therefore, inclusion of private patients will better represent patient perception of telehealth.Objectives:The aim of this study was to evaluate patient satisfaction with telehealth during the COVID-19 pandemic. This would determine its feasibility to be integrated in future rheumatology outpatient model.Methods:A questionnaire containing 30 questions was sent to rheumatology patients who attended telehealth appointments at a level 2 public hospital and a local private clinic between April and May 2020. The questionnaires aimed to obtain information on baseline demographics (sex, age, public or private patient, employment status, visual or auditory impairment), appointment details (TPhone or TVideo, usual arrangement for face-to-face (F2F) appointment, cost effectiveness) and appointment satisfaction using a 5-point Likert scale. Descriptive statistical analysis was conducted.Results:The questionnaire was sent to 1452 patients, of which 494 patients responded (34%). Female predominance (77.1%) and a higher proportion of TPhone (79.1%) was seen in the respondents. A majority of patients were existing patients known to the services (90.9%). More than 70% of responses indicated overall satisfaction in specialist care via telehealth, and 88.7% perceived this suitable during a pandemic. Of all respondents, 21.7% were prescribed new medication, and the majority of these patients were confident in taking the new medication after the telehealth appointment. Future acceptability for TPhone was significantly lower in private patients compared to public patients (p= 0.01). Subgroup analysis revealed that higher telehealth satisfaction was associated with needing to take time off work to attend face-to-face appointment (p= 0.02), perception of cost effectiveness (p<0.001) and TVideo (p=0.03).Conclusion:This is the first study which included both public and private rheumatology patients to evaluate patient satisfaction for telehealth during the COVID-19 pandemic. Overall high level of satisfaction was seen in telehealth most notably associated with its cost effectiveness. A higher percentage of patients who had TVideo compared to TPhone were receptive to future telehealth via TVideo, supportive of the importance of visual cues. This in turn will have significant administrative and technological burdens to coordinate in comparison to a F2F or TPhone review. This qualitative study provides valuable insight of patient perception of telehealth, which has the potential to compliment the traditional rheumatology outpatient model of care following the pandemic.References:[1]COVID-19 Temporary MBS Telehealth Services 2020 [Available from: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-TempBB.[2]Antony A, Connelly K, De Silva T, Eades L, Tillett W, Ayoub S, et al. Perspectives of Patients With Rheumatic Diseases in the Early Phase of COVID-19. Arthritis Care & Research. 2020;72(9):1189-95.[3]Association AR. Workforce Survey Exective Summary 2019 2019 [Available from: https://rheumatology.org.au/members/documents/WorkforceSurveyExecutiveSummary-websiteMay2019.pdf.Acknowledgements:University of QueenslandNursing staff at Redcliffe Hospital and Administration officers at Redcliffe & Northside RheumatologyDisclosure of Interests:None declared
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Barrett C, Park SJ, Edmondson L, Monga D. Incidence of hypersensitivity reactions in patients on H1-receptor antagonists receiving oxaliplatin-based chemotherapy. J Oncol Pharm Pract 2021; 28:577-581. [PMID: 33789524 DOI: 10.1177/10781552211003958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study determined the incidence of hypersensitivity reactions in patients receiving oxaliplatin-based chemotherapy while on H1-receptor antagonists (H1RAs). Prophylaxis for patients receiving oxaliplatin is not currently recommended. H1RAs are used for the treatment of reactions; however, prophylactic H1RAs have not been well-studied. METHODS This retrospective chart review included patients with solid tumor malignancies who received H1RAs while on oxaliplatin-based chemotherapy between August 1, 2016 and October 31, 2019. RESULTS Of fifty-one patients, there were four hypersensitivity reactions (8%), most of which were mild, occurred within 60 minutes of the start of the infusion, and did not result in an interruption in treatment. One severe reaction occurred, which required discontinuation of therapy. Forty-two patients (82%) were able to receive at least 9 cycles of oxaliplatin without a reported reaction. CONCLUSION In this observational study, the incidence rate of hypersensitivity reactions in patients receiving oxaliplatin while on H1RAs was lower than reported in previous literature. Most reactions were mild, and patients were able to continue oxaliplatin-based therapy. With future, randomized controlled trials, H1RAs may prove to be effective in preventing or delaying the onset of hypersensitivity reactions related to oxaliplatin.
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Barrett C, Cheung KL. Knowledge, socio-cognitive perceptions and the practice of hand hygiene and social distancing during the COVID-19 pandemic: a cross-sectional study of UK university students. BMC Public Health 2021; 21:426. [PMID: 33648486 PMCID: PMC7919985 DOI: 10.1186/s12889-021-10461-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND During the first wave of the COVID-19 pandemic, social distancing and hand hygiene have been the primary means of reducing transmission in the absence of effective treatments or vaccines, but understanding of their determinants is limited. This study aimed to investigate knowledge and socio-cognitive perceptions, and their associations with such protective behaviours, in UK university students. METHODS A cross-sectional online survey of 293 students was undertaken on 13 May 2020. Survey questions addressed demographics, knowledge of the disease and effectiveness of the protective measures, risk perception, socio-cognitive perceptions (e.g. attitude, social support, and self-efficacy), habit, time factors and trust, as well as the hand hygiene and social distancing behaviours. Multiple linear regression was used to identify the strongest associations of potential determinants with behaviour. RESULTS Participants reported high levels of social distancing with 88.9% answering "Mostly" or "Always" for every activity, but only 42.0% reporting the same for all hand hygiene activities. Knowledge of the effectiveness of each activity in preventing transmission was high, with 90.7% and 93.5% respectively identifying at least 7 of 8 hand hygiene or 9 of 10 social distancing activities correctly. Habit (β = 0.39, p = 0.001) and time factors (β = 0.28, p = 0.001) were the greatest contributors to unique variance in hand hygiene behaviour, followed by ethnicity (β = - 0.13, p = 0.014) and risk perception (β = 0.13, p = 0.016). For social distancing behaviour, the determinants were self-efficacy (β = 0.25, p < 0.001), perceived advantages (β = 0.15, p = 0.022), trust in policy (β = 0.14, p = 0.026) and gender (β = - 0.14, p = 0.016). Regression models explained 40% hand hygiene and 25% social distancing variance. CONCLUSIONS This study indicated that communications about effectiveness of hand hygiene and social distancing behaviours had been effective in terms of knowledge acquisition. However, in the light of likely second waves of COVID-19, attention to maintaining social distancing behaviour and improving hand hygiene behaviour may need to address more difficult areas of changing habits, overcoming time factors and building trust, as well as interventions to increase self-efficacy and address risk perception concerns.
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Affiliation(s)
- Christine Barrett
- Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
| | - Kei Long Cheung
- Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
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Barrett C, Stein Z, Hernandez J, Naraparaju R, Schulz U, Tetard L, Raghavan S. Detrimental effects of sand ingression in jet engine ceramic coatings captured with Raman-based 3D rendering. Ann Ital Chir 2021. [DOI: 10.1016/j.jeurceramsoc.2020.09.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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Ellis J, J B Marks D, Srinivasan N, Barrett C, Hopkins TG, Richards A, Fuhr R, Albayaty M, Coenen M, Liefaard L, Leavens K, Nevin KL, Tang S, Hughes SA, Fortunato L, Edwards K, Cui Y, Anselm R, Delves CJ, Charles E, Feeney M, Webb TM, Brett SJ, Schmidt TS, Stone J, Savage COS, Wisniacki N, Tarzi RM. Depletion of LAG-3 + T Cells Translated to Pharmacology and Improvement in Psoriasis Disease Activity: A Phase I Randomized Study of mAb GSK2831781. Clin Pharmacol Ther 2020; 109:1293-1303. [PMID: 33113155 PMCID: PMC8246744 DOI: 10.1002/cpt.2091] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/11/2020] [Indexed: 12/18/2022]
Abstract
Activated T cells drive a range of immune‐mediated inflammatory diseases. LAG‐3 is transiently expressed on recently activated CD4+ and CD8+ T cells. We describe the engineering and first‐in‐human clinical study (NCT02195349) of GSK2831781 (an afucosylated humanized IgG1 monoclonal antibody enhanced with high affinity for Fc receptors and LAG‐3 and antibody‐dependent cellular cytotoxicity capabilities), which depletes LAG‐3 expressing cells. GSK2831781 was tested in a phase I/Ib, double‐blind, placebo‐controlled clinical study, which randomized 40 healthy participants (part A) and 27 patients with psoriasis (part B) to single doses of GSK2831781 (up to 0.15 and 5 mg/kg, respectively) or placebo. Adverse events were generally balanced across groups, with no safety or tolerability concern identified. LAG‐3+ cell depletion in peripheral blood was observed at doses ≥ 0.15 mg/kg and was dose‐dependent. In biopsies of psoriasis plaques, a reduction in mean group LAG‐3+ and CD3+ T‐cell counts was observed following treatment. Downregulation of proinflammatory genes (IL‐17A, IL‐17F, IFNγ, and S100A12) and upregulation of the epithelial barrier integrity gene, CDHR1, was observed with the 5 mg/kg dose of GSK2831781. Psoriasis disease activity improved up to day 43 at all GSK2831781 doses (0.5, 1.5, and 5 mg/kg) compared with placebo. Depletion of LAG‐3‐expressing activated T cells is a novel approach, and this first clinical study shows that GSK2831781 is pharmacologically active and provides encouraging early evidence of clinical effects in psoriasis, which warrants further investigation in T‐cell‐mediated inflammatory diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Martin Coenen
- Study Center Bonn (SZB), Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | | | | | | | - Shuo Tang
- GlaxoSmithKline, Upper Providence, Pennsylvania, USA
| | | | | | - Ken Edwards
- GlaxoSmithKline, Stevenage, Hertfordshire, UK
| | - Yi Cui
- GlaxoSmithKline, Stevenage, Hertfordshire, UK
| | | | | | | | | | | | | | | | - John Stone
- GlaxoSmithKline, Stevenage, Hertfordshire, UK
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Barrett C, Willcocks LC, Jones RB, Tarzi RM, Henderson RB, Cai G, Gisbert SI, Belson AS, Savage CO. Effect of belimumab on proteinuria and anti-phospholipase A2 receptor autoantibody in primary membranous nephropathy. Nephrol Dial Transplant 2020; 35:599-606. [PMID: 31243451 PMCID: PMC7139214 DOI: 10.1093/ndt/gfz086] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 11/06/2018] [Accepted: 04/01/2019] [Indexed: 11/21/2022] Open
Abstract
Background Immunosuppressant drugs reduce proteinuria and anti-phospholipase A2 receptor autoantibodies (PLA2R-Ab) in primary membranous nephropathy (PMN) with varying success and associated toxicities. This study aimed to evaluate the effect of belimumab on proteinuria and PLA2R-Ab in participants with PMN. Methods In this prospective, open-label, experimental medicine study, 14 participants with PMN and persistent nephrotic-range proteinuria received up to 2 years belimumab monotherapy (10 mg/kg, every 4 weeks). Changes in proteinuria (urinary protein:creatinine ratio), PLA2R-Ab, albumin, cholesterol, B-cell subsets and pharmacokinetics were analysed during treatment and up to 6 months after treatment. Results Eleven participants completed to the primary endpoint (Week 28) and nine participants completed the study. In the intention-to-treat population population, baseline proteinuria of 724 mg/mmol [95% confidence interval (CI) 579–906] decreased to 498 mg/mmol (95% CI 383–649) and 130 mg/mmol (95% CI 54–312) at Weeks 28 and 104, respectively, with changes statistically significant from Week 36 (n = 11, P = 0.047). PLA2R-Ab decreased from 174 RU/mL (95% CI 79–384) at baseline to 46 RU/mL (95% CI 16–132) and 4 RU/mL (95% CI 2–6) at Weeks 28 and 104, respectively, becoming statistically significant by Week 12 (n = 13, P = 0.02). Nine participants achieved partial (n = 8) or complete (n = 1) remission. Participants with abnormal albumin and/or cholesterol at baseline gained normal/near normal levels by the last follow-up. Adverse events were consistent with those expected in this population. Conclusions Belimumab treatment in participants with PMN can reduce PLA2R-Ab and subsequently proteinuria, important preludes to remission induction.
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Affiliation(s)
| | | | | | - Ruth M Tarzi
- Experimental Medicine Unit, GlaxoSmithKline R&D, UK
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Reungwetwattana T, Gray J, Markovets A, Nogami N, Lee J, Cho B, Chewaskulyong B, Majem M, Peled N, Vishwanathan K, Todd A, Rukazenkov Y, Johnson M, Barrett C, Chmielecki J, Hartmaier R, Ramalingam S. Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gray J, Peled N, Markovets A, Nogami N, Lee JS, Cho B, Chewaskulyong B, Majem M, Reungwetwattana T, Vishwanathan K, Todd A, Rukazenkov Y, Johnson M, Barrett C, Chmielecki J, Hartmaier R, Ramalingam S. Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Barrett C, Park SJ, Gaertner K, Mao S. The financial impact of physician practice patterns: An analysis of as-needed filgrastim versus prophylactic pegfilgrastim in patients with prostate cancer receiving docetaxel. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.6506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6506 Background: Docetaxel improves survival in metastatic prostate cancer. Patients receiving docetaxel are at an intermediate risk of febrile neutropenia (FN). Granulocyte-colony stimulating factor (G-CSF) reduces the incidence of neutropenia and infection. There is no consensus among physicians on G-CSF use with docetaxel in prostate cancer, and physician preference may significantly impact healthcare costs. The purpose of this study is to assess physician practice patterns by comparing efficacy and cost of as-needed filgrastim (ANF) to prophylactic pegfilgrastim (PPF) for neutropenia in patients with prostate cancer receiving docetaxel. Methods: This retrospective cohort study included patients with prostate cancer that received standard docetaxel and G-CSF, either ANF or PPF, from February 2016 to October 2018 at our institution. In the ANF arm, patients with an ANC less than 1000 cells/µL on day 8 of the cycle received filgrastim. In the PPF arm, patients received pegfilgrastim on day 2 for primary prophylaxis. Patient characteristics, chemotherapy dose intensity, delays, and reductions, and incidence of FN were collected. Results: Of the 65 patients included in this study, 32 received ANF and 33 received PPF. Patients in the ANF arm received an average of 6.0 cycles versus 4.8 cycles in the PPF arm (p = 0.013). The completion rate of planned cycles differed, with 93.8% completion in the ANF arm versus 66.7% in the PPF arm (p = 0.001). Average total drug exposure per patient was greater in the ANF arm than the PPF arm (437.5 mg/m2 versus 343.4 mg/m2; p = 0.007). In both groups, there was no significant difference in dose delays or reductions, or incidence of FN. However, there was a significant difference in cost, with an average of $740.26 per cycle per patient for filgrastim, versus $7327.72 per cycle per patient for pegfilgrastim, based on current average wholesale price. Conclusions: In our study, use of ANF was safe, and did not impact planned dose, intensity, or duration when compared to PPF. In addition, the administration of ANF was associated with significant cost savings. Analysis of G-CSF use in patients with prostate cancer receiving docetaxel at our institution has identified an opportunity for substantial healthcare cost savings.
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Affiliation(s)
| | - Seon Jo Park
- Allegheny Health Network Cancer Institute, Pittsburgh, PA
| | - Kelly Gaertner
- Allegheny Health Network Cancer Institute, Pittsburgh, PA
| | - Shifeng Mao
- Allegheny Health Network Cancer Institute, Pittsburgh, PA
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Alexander K, Barrett C, Dobos K, Cheng P, Liao R, Wheeler M, Liedtke M, Weisshaar D, Witteles R. Contemporary Outcomes in Patients with Cardiac Amyloidosis Undergoing Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Cho B, Cheng Y, Zhou C, Ohe Y, Imamura F, Lin MC, Majem M, Shah R, Rukazenkov Y, Todd A, Markovets A, Barrett C, Chmielecki J, Gray J, Ramalingam S. Mechanisms of acquired resistance to first-line osimertinib: Preliminary data from the phase III FLAURA study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy483.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Friedlander M, Rau J, Lee C, Meier W, Lesoin A, Kim JW, Poveda A, Buck M, Scambia G, Shimada M, Hilpert F, King M, Debruyne P, Bologna A, Malander S, Monk B, Petru E, Calvert P, Herzog T, Barrett C, du Bois A. Quality of life in patients with advanced epithelial ovarian cancer (EOC) randomized to maintenance pazopanib or placebo after first-line chemotherapy in the AGO-OVAR 16 trial. Measuring what matters—patient-centered end points in trials of maintenance therapy. Ann Oncol 2018; 29:737-743. [DOI: 10.1093/annonc/mdx796] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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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16
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Sun J, Li Y, Milbury C, Skoletsky J, Burns C, Yip W, Luo J, Dewal N, Johnson A, Gowen K, Tong J, He Y, He J, White J, Roels S, Tsuji A, Truesdell J, Peters E, Gilbert H, Wu C, Schleifman E, Barrett C, Thress K, Jenkins S, Elvin J, Otto G, Lipson D, Ross J, Miller V, Stephens P, Doherty M, Vietz C. P2.02-052 A Clinically-Validated Universal Companion Diagnostic Platform for Cancer Patient Care. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1230] [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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17
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Keane F, Greally M, Harrold E, Barrett C, McCaffrey J. Epithelioid Angiomyolipoma - a case report and review of the literature. Ir Med J 2017; 110:604. [PMID: 29341516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Herein we present the case of a 43-year-old female in whom a left renal mass was identified incidentally on imaging performed for staging of a newly diagnosed breast carcinoma. The mass was resected and histologic examination and immunohistochemistry confirmed a diagnosis of epithelioid angiomyolipoma.
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Affiliation(s)
- F Keane
- Department of Medical Oncology, Mater Misericordiae Hospital, Dublin
| | - M Greally
- Department of Medical Oncology, Mater Misericordiae Hospital, Dublin
| | - E Harrold
- Department of Medical Oncology, Mater Misericordiae Hospital, Dublin
| | - C Barrett
- Department of Pathology, Mater Misericordiae Hospital, Dublin
| | - J McCaffrey
- Department of Medical Oncology, Mater Misericordiae Hospital, Dublin
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Comiskey D, Api A, Barrett C, Ellis G, McNamara C, O'Mahony C, Robison S, Rose J, Safford B, Smith B, Tozer S. Integrating habits and practices data for soaps, cosmetics and air care products into an existing aggregate exposure model. Regul Toxicol Pharmacol 2017; 88:144-156. [DOI: 10.1016/j.yrtph.2017.05.017] [Citation(s) in RCA: 1034] [Impact Index Per Article: 147.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/08/2017] [Accepted: 05/23/2017] [Indexed: 12/11/2022]
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19
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Ng C, Rozen G, Biton Y, Leyton-Mange J, Barrett C. P389Direct ultrasound visualization in combination with micropuncture needle reduces vascular access complications in cardiac electrophysiological procedures. Europace 2017. [DOI: 10.1093/ehjci/eux141.114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Barrett C, Henderson R, Galwey N, Flint S, Gibson A, Savage C. THU0006 Novel Changes in B and T-Cell Phenotypes with Belimumab in An Autoantibody Mediated Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1508] [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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21
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Oxnard G, Thress K, Alden R, Lawrance R, Paweletz C, Cantarini M, Barrett C, Yang J, Jänne P. 135O_PR: Plasma genotyping for predicting benefit from osimertinib in patients (pts) with advanced NSCLC. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30328-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Yeh T, Jacobs V, Angell H, Geradts J, Hou J, Karakunnel J, Barrett C. 60PD Inhibition of pEGFR in paired tumour biopsies from TKI treatment-naïve EGFR mutant NSCLC patients treated with gefitinib (EGFR inhibitor) or gefitinib in combination with durvalumab (anti-PD-L1). J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30173-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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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23
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Reddy V, Short S, Barrett C, Washington M, Williams C. BVES is Regulated in Response to Radiation and Influences Intestinal Stem Cell Programs and Recovery After Radiation. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Timms K, Neff C, Morris B, Hodgson D, Orr M, Zhongwu L, Fielding A, Dougherty B, Spencer S, Robertson J, Barrett C, Gutin A, Lanchbury J. 466 Next generation sequencing of BRCA1 and BRCA2 genes in ovarian tumors captures all germline mutations and expands the potential treatment group for the PARP inhibitor olaparib. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30300-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Jarmuz P, Ocali O, Baldwin M, Sakkas D, Barrett C. Success rates of rescue ICSI and analysis of embryo cleavage rates by real time video imaging. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Helsby N, Yang J, Goldthorpe M, Barrett C, Wilson G, Broom R, Findlay M, Porter D. CYP2C19 Phenoconversion in patients with Breast Cancer and alterations in Bioactivation of Cyclophosphamide. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Willcocks L, Barrett C, Brenchley P, Schmidt T, Gisbert S, Cai G, Savage C, Jones R. SaO022EFFECT OF BELIMUMAB ON PROTEINURIA AND ANTI-PLA2R AUTOANTIBODY IN IDIOPATHIC MEMBRANOUS NEPHROPATHY - 6 MONTHS DATA. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv149.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Rooney C, Geh C, Williams V, Cresswell C, Al-Kadhimi K, Dymond M, French T, Smith P, Barrett C, Harrington E, Kilgour E. 520 Validation of Nanostring for FGFR1 gene expression analysis in squamous non-small cell lung cancer (sqNSCLC) tissue. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70646-x] [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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29
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Nomura H, Hanker L, Fabbro M, Rau J, Kim Y, Arija JA, Friedlander M, Ferrandina G, Vuylsteke P, Colombo N, Malander S, Monk B, Petru E, Calvert P, Herzog T, Barrett C, Jobanputra M, Wang Q, Elser G, Du Bois A. Pazopanib Versus Placebo in Women Without Progression After First-Line Chemotherapy for Advanced Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer (Aeoc): Second Interim Overall Survival Analysis from the Ago-Ovar16 Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.6] [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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30
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Barrett C, van Uum S, Lenders JW. Risks of catecholaminergic crisis following steroid administration in patients with an adrenal mass: a literature review. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Australia is a vast country with one-third of the population living outside capital cities. Providing specialist rheumatologist services to regional, rural and remote Australians has generally required expensive and time-consuming travel for the patient and/or specialist. As a result, access to specialist care for remote Australians is poor. Rheumatoid arthritis is a common disease, but like many rheumatic diseases, it is complex to treat. Time-dependent joint damage and disability occur unless best evidence care is implemented. The relatively poor access to rheumatologist care allotted to nonmetropolitan Australians therefore represents a significant cause of potentially preventable disability in Australia. Telehealth has the potential to improve access to specialist rheumatologists for patients with rheumatoid arthritis and other rheumatic diseases, thereby decreasing the burden of disability caused by these diseases. Advances in videoconferencing technology, the national broadband rollout and recent Federal government financial incentives have led to a heightened interest in exploring the use of this technology in Australian rheumatology practice. This review summarises the current evidence base, outlines telehealth's strengths and weaknesses in managing rheumatic disease, and discusses the technological, medicolegal and financial aspects of this model of care. A mixed model offering both face-to-face and virtual consultations appears to be the best option, as it can overcome the barriers to accessing care posed by distance while also mitigating the risks of virtual consultation.
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Affiliation(s)
- L J Roberts
- School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
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32
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Affiliation(s)
- L. J. Roberts
- Department of Rheumatology; Townsville Hospital; Townsville
| | - E. G. LaMont
- School of Medicine and Dentistry; James Cook University; Townsville
| | - I. Lim
- BJC Health; Sydney; New South Wales; Australia
| | | | - C. Barrett
- Department of Rheumatology; Redcliffe Hospital; Brisbane; Queensland
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33
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Guild S, Stehlin E, Malpas S, Barrett C. Left Ventricular Pressure (LVP) Measurement in Conscious Small Animals via Telemetry. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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34
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Pinkham M, Barrett C. Sympathetic Activation after Myocardial Infarction in the Rat: Role of the Arterial Baroreflex, Cardiac Afferent Reflexes and Sex. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Bowes MJ, Ings NL, McCall SJ, Warwick A, Barrett C, Wickham HD, Harman SA, Armstrong LK, Scarlett PM, Roberts C, Lehmann K, Singer AC. Nutrient and light limitation of periphyton in the River Thames: implications for catchment management. Sci Total Environ 2012; 434:201-12. [PMID: 22035560 DOI: 10.1016/j.scitotenv.2011.09.082] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 09/01/2011] [Accepted: 09/07/2011] [Indexed: 05/07/2023]
Abstract
Soluble reactive phosphorus (SRP) concentrations in the River Thames, south east England, have significantly decreased from an annual maximum of 2100 μg l(-1) in 1997 to 344 in 2010, primarily due to the introduction of phosphorus (P) removal at sewage treatment works within the catchment. However, despite this improvement in water quality, phytoplankton biomass in the River Thames has greatly increased in recent years, with peak chlorophyll concentrations increasing from 87 μg l(-1) in the period 1997 to 2002, to 328 μg l(-1) in 2009. A series of within-river flume mesocosm experiments were performed to determine the effect of changing nutrient concentrations and light levels on periphyton biomass accrual. Nutrient enrichment experiments showed that phosphorus, nitrogen and silicon were not limiting or co-limiting periphyton growth in the Thames at the time of the experiment (August-September 2010). Decreasing ambient SRP concentration from 225 μg l(-1) to 173 μg l(-1) had no effect on periphyton biomass accrual rate or diatom assemblage. Phosphorus limitation became apparent at 83 μg SRP l(-1), at which point a 25% reduction in periphyton biomass was observed. Diatom assemblage significantly changed when the SRP concentration was reduced to 30 μg l(-1). Such stringent phosphorus targets are costly and difficult to achieve for the River Thames, due to the high population density and intensive agriculture within the Thames basin. Reducing light levels by shading reduced the periphyton accrual rate by 50%. Providing shading along the River Thames by planting riparian tree cover could be an effective measure to reduce the risk of excessive algal growth. If the ecology of the Thames is to reach the WFD's "good ecological status", then both SRP concentration reductions (probably to below 100 μg l(-1)) and increased shading will be required.
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Affiliation(s)
- M J Bowes
- Centre for Ecology and Hydrology, Crowmarsh Gifford, Wallingford, Oxfordshire, UK.
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36
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Eadsforth T, Grewal I, Barrett C, Pillay R. Management and Outcomes of Intentional Durotomies. J Neurol Surg A Cent Eur Neurosurg 2012. [DOI: 10.1055/s-0032-1316241] [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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37
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Dahab R, Barrett C, Pillay R, De Matas M. Anterior thigh compartment syndrome after prone positioning for lumbosacral fixation. Eur Spine J 2012; 21 Suppl 4:S554-6. [PMID: 22481550 DOI: 10.1007/s00586-012-2282-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 02/23/2012] [Accepted: 03/14/2012] [Indexed: 12/28/2022]
Abstract
We report a case of a patient who developed anterior thigh compartment syndrome after being positioned prone for instrumented lumbar spine surgery. Although rare, clinicians should be aware that compartment syndrome is a possible complication of spinal surgery.
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Affiliation(s)
- R Dahab
- The Royal Liverpool University Hospital, Liverpool, UK.
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Beinart R, Danik S, Palacios I, Barrett C, Inglessis I, Agnihotri A, Passeri J. Ventricular tachycardia following trans-apical aortic valve replacement. Europace 2011; 14:450-2. [DOI: 10.1093/europace/eur324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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40
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Grimminger PP, Shi M, Barrett C, Lebwohl D, Danenberg KD, Brabender J, Vigen CLP, Danenberg PV, Winder T, Lenz HJ. TS and ERCC-1 mRNA expressions and clinical outcome in patients with metastatic colon cancer in CONFIRM-1 and -2 clinical trials. Pharmacogenomics J 2011; 12:404-11. [PMID: 21788964 DOI: 10.1038/tpj.2011.29] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To validate established cutoff levels of thymidylate synthase (TS) and excision repair cross-complementing (ERCC-1) intratumoral mRNA expressions in tumor samples from metastatic colorectal cancer (mCRC) patients treated with PTK787/ZK222584 (PTK/ZK). From 122 samples of patients with mCRC enrolled in CONFIRM-1 (Colorectal Oral Novel Therapy for the Inhibition of Angiogenesis and Retarding of Metastases) or CONFIRM-2, mRNA was isolated of microdissected formalin-fixed paraffin-embedded samples and quantitated using TaqMan-based technology. Existing TS and ERCC-1 cutoff levels were tested for their prognostic value in first-line and second-line therapy. TS expression was associated with overall survival (OS) in first-line, but not second-line therapy. ERCC-1 was associated with OS in patients treated with first-line and second-line FOLFOX4. In first-line FOLFOX4, combination of high TS and/or high ERCC-1 was associated with shorter OS. A correlation was observed between ERCC-1 expression and benefit from PTK/ZK+FOLFOX4 treatment. TS and ERCC-1 expression is associated with clinical outcome in mCRC. Baseline TS and ERCC-1 levels may allow the selection of patients who benefit from FOLFOX4 chemotherapy.
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Affiliation(s)
- P P Grimminger
- Department of Molecular Biology and Biochemistry, University of Southern California/Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA, USA
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Coss C, Barrett C, Kim J, Li C, Dalton JT, Veverka KA. Importance of CYP2D6 metabolism in the in vitro antiestrogenic activity of toremifene and tamoxifen. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13067] [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: 11/20/2022] Open
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42
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Nuciforo P, Burzykowski T, Lambertini C, Gardner H, Liu WH, Lee B, Barzaghi-Rinaudo P, Rheinhardt J, Barrett C, Linnartz R, Dugan M, Hackl W, Eiermann W, Pienkowski T, Crown J, Robert N, Pawlicki M, Martin M, Finn R, Lindsay MA, Slamon D, Press M. Abstract P3-10-24: Fibroblast Growth Factor Receptor 1 Amplification and Overexpression in Breast Cancer Tissue Microarrays Using Chromogenic In Situ Hybridization and Immunohistochemistry. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-10-24] [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
Fibroblast growth factor receptors 1 (FGFR1) belongs to a subfamily of receptor tyrosine kinases (RTKs), which are involved in proliferation and apoptosis. FGFR1 amplification and mRNA overexpression occurs in ∼10% of breast cancers and has been associated with poor outcome. However, studies assessing FGFR1 amplification and protein overexpression in a large collection of breast tumors are lacking. In this prospective, we examined a series of primary breast cancers samples derived from the BCIRG trials assembled into 15 tissue microarrays. FGFR1 gene amplification was studied using chromogenic in situ hybridization (CISH) and evaluated with respect to association with level of protein expression and clinicopathological parameters. FGFR1 gene amplification was significantly associated with high protein levels as determined by immunohistochemistry (P<0.0001, 3294 pts with available matched CISH and IHC records). Overall, the incidence of FGFR1 amplification found was 9.7% (160 out of 1646 pts. with available clinicopathological records) without a statistically significant difference between Her2- (78 out 720 pts., 11%) and Her2+ (82 out of 926 pts., 9%) cancers. In both cohorts, the hormone receptor-positive (ER+/PR+) cancers showed statistically significant higher levels of FGFR1 amplification compared to hormone receptor-negative tumors. In the analysis of the association of FGFR1 and the presence of PIK3CA mutations, the incidence of FGFR1 amplificationwas greatly reduced in mutant vs. wt PI3KCA tumors. In these cohorts, a clear relationship between FGFR1 amplification status and clinical outcome was not detected. Data from this large study confirms recently reported incidences of FGFR1 amplification in breast cancer and shows for the first time an association between FGFR1 gene amplification and protein overexpression. Moreover, the lower incidence of FGFR1 amplification in PIK3CA mutated cancers suggests that these are largely exclusive molecular events that could benefit from different targeted therapies.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-24.
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Affiliation(s)
- P Nuciforo
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - T Burzykowski
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - C Lambertini
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - H Gardner
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - WH Liu
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - B Lee
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - P Barzaghi-Rinaudo
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - J Rheinhardt
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - C Barrett
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - R Linnartz
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Dugan
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - W Hackl
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - W Eiermann
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - T Pienkowski
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - J Crown
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - N Robert
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Pawlicki
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Martin
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - R Finn
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M-A Lindsay
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - D Slamon
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
| | - M Press
- Novartis Pharma AG, Basel, Switzerland; International Drug Development Institute, Louvain-la-Neuve, Belgium; Novartis Institutes for Biomedical Research, Cambridge, MA; Norvartis Pharmaceuticals, Florham Park, NJ; GBG, Munchen, Germany; Oncology Center, Warsaw, Poland; ICORG, Dublin, Ireland; US Oncology, Houston, TX; Maria Sklodowska-Curie Centre, Warsaw, Poland; GEICAM, Madrid, Spain; UCLA, Los Angeles, CA; CIRG, Edmonton, Canada; USC, Los Angeles, CA
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Abstract
We describe the cases of female monozygotic twins who presented almost synchronously with symptomatic Chiari malformation type I. Both were successfully treated with foramen magnum decompression. We analyse these findings in the context of previously reported cases and discuss the genetic implications.
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Affiliation(s)
- A Solth
- Department of Neurosurgery, Newcastle General Hospital, Newcastle Upon Tyne, UK
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Cao J, Gu Y, Fan W, Chen LQ, Ogletree DF, Chen K, Tamura N, Kunz M, Barrett C, Seidel J, Wu J. Extended mapping and exploration of the vanadium dioxide stress-temperature phase diagram. Nano Lett 2010; 10:2667-2673. [PMID: 20586406 DOI: 10.1021/nl101457k] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Single-crystal micro- and nanomaterials often exhibit higher yield strength than their bulk counterparts. This enhancement is widely recognized in structural materials but is rarely exploited to probe fundamental physics of electronic materials. Vanadium dioxide exhibits coupled electronic and structural phase transitions that involve different structures existing at different strain states. Full understanding of the driving mechanism of these coupled transitions necessitates concurrent structural and electrical measurements over a wide phase space. Taking advantages of the superior mechanical property of micro/nanocrystals of VO(2), we map and explore its stress-temperature phase diagram over a phase space that is more than an order of magnitude broader than previously attained. New structural and electronic aspects were observed crossing phase boundaries at high-strain states. Our work shows that the actively tuning strain in micro/nanoscale electronic materials provides an effective route to investigate their fundamental properties beyond what can be accessed in their bulk counterpart.
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Affiliation(s)
- J Cao
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
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Rahbar L, Moxley G, Carleton D, Barrett C, Brannen J, Thacker L, Waterhouse EJ, Roberts WN. Correlation of rheumatology subspecialty choice and identifiable strong motivations, including intellectual interest. Arthritis Care Res (Hoboken) 2010; 62:1796-804. [PMID: 20597115 DOI: 10.1002/acr.20284] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 06/24/2010] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To describe motivations correlating with subspecialty choices, particularly rheumatology. METHODS A total of 179 respondents answered queries about various aspects affecting specialty and subspecialty choice with ordinal ratings of importance. Likert scale response data were analyzed to determine independent predictors of being a rheumatology fellow. Multivariate logistic regression analyses were used to develop models predicting rheumatology fellowship. Factor analysis methods to condense the individual responses into fewer underlying variables or factors were employed. RESULTS While every group ranked intellectual interest as more important than all other responses, its score in the rheumatology fellow group was significantly higher than that in the medical student group. A model using 4 composite variables based on prior literature did not fit well. Exploratory factor analysis identified 5 underlying motivations, which were designated as time, money, external constraints, practice content, and academics. All motivations except money were statistically significant, with the rheumatology fellow group attributing greater importance than medical students to time, practice content, and academics, and lesser importance than medical students to external constraints. CONCLUSION Values and motivations leading toward rheumatology subspecialty choice can be traced to identifiable factors. Intellectual interest appears to be split between 2 distinct significant variables: practice content and academics. Time or controllable lifestyle, external constraints, practice content, and academic issues appear to be important influences on the choice of rheumatology fellowship. Such variables appear to reflect underlying values and motivations.
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Affiliation(s)
- L Rahbar
- Virginia Commonwealth University, Richmond, VA 23298, USA
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47
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Gardner H, Nuciforo P, Liu W, Lee B, Rheinhardt J, Barrett C, Linnartz R, Dugan M, Eiermann W, Pienkowski T, Martin M, Robert N, Forbes J, Buyse M, Finn R, Lindsay M, Slamon D, Press M. PI3 Kinase Pathway Analysis in Tissue Microarrays Using Laser Capture Microdissection and Immunohistochemistry. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-4043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. During the performance of the BCIRG trials primary patient tumor samples were obtained from paraffin blocks and assembled into 15 tissue microarrays, including 3000 samples from trial 005 (adjuvant taxol in Her2- node positive patients), 2200 in 006 (adjuvant herceptin in Her2+ high risk patients) and 300 in 007 (addition of platinum in Her2+ first line therapy). This array set was prepared prospectively, in anticipation of molecular epidemiologic studies of a variety of targets in relation to outcome. In order to address the potentially important role of the PIK3CA pathway in modulating outcome in different clinical situations we assessed components of the PIK3CA pathway by various methods.Methods. We analysed the expression of PTEN, Cyclin D1, p53 and Stathmin by immunohistochemistry using standard methods. All markers were scored by histoscore. Phospho S6 240 and phospho Akt 473 were assessed simultaneously by quantum dot immunofluorescence using automated image capture and segmentation. PIK3CA mutations were evaluated using SnaPshot analysis of laser captured TMA spots in a subset of approximately 2000 samples.Results. In the samples analyzed PIK3CA mutation had an incidence of 23%, with 9% being mutations in exon 9 and 13% in exon 20, with 0.5% being mutant in both exons. Initial analysis of the results prior to outcome analysis indicated that Stathmin expression, while being a robust marker with good dynamic range, did not appear to correlate with PTEN loss by IHC or with PIK3CA mutation.Conclusions. PIK3CA mutational analysis is feasible from TMA cores and gives mutation incidences similar to the published literature for archival material. Relationships of markers with outcome will be presented.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4043.
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Affiliation(s)
- H. Gardner
- 1Novartis Institutes for Biomedical Research, MA,
| | | | - W. Liu
- 1Novartis Institutes for Biomedical Research, MA,
| | - B. Lee
- 1Novartis Institutes for Biomedical Research, MA,
| | | | - C. Barrett
- 1Novartis Institutes for Biomedical Research, MA,
| | | | | | | | | | | | | | | | - M. Buyse
- 9International Drug Development Institute, Belgium
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Barrett C, Jayakrishnan V, Gholkar A, Todd NV. Coil embolisation of intercostal artery for operative localisation of spinal dural arterio-venous fistulae. Br J Neurosurg 2009; 23:332-4. [DOI: 10.1080/02688690802464704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Barrett C, Lowson D, Blades KJ. Limited benefit of combined use of tar‐based shampoo with 50 μg/ml calcipotriol solution in scalp psoriasis. J DERMATOL TREAT 2009; 16:175. [PMID: 16211775 DOI: 10.1080/09546630510011739] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Browne L, Murphy E, Margey R, Galvin J, Sugrue D, Barrett C, Keelan E. FP54 Survival to Discharge After out of Hospital Cardiac Arrest. Eur J Cardiovasc Nurs 2009. [DOI: 10.1016/s1474-5151(09)60093-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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