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Shafat T, Grupel D, Porges T, Abuhasira R, Belkin A, Deri O, Oster Y, Zahran S, Horwitz E, Horowitz NA, Khatib H, Batista MV, Cortez AC, Brosh‐Nissimov T, Segman Y, Ishay L, Cohen R, Atamna A, Spallone A, Chemaly RF, Ramos‐Ramos JC, Chowers M, Rogozin E, Oren NC, Keske Ş, Barchad OW, Nesher L. An international multicenter study comparing COVID-19 omicron outcomes in patients with hematological malignancies treated with obinutuzumab versus rituximab. Cancer Med 2024; 13:e6997. [PMID: 38400683 PMCID: PMC10891459 DOI: 10.1002/cam4.6997] [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: 10/18/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES Hematological malignancy (HM) patients treated with anti-CD20 monoclonal antibodies are at higher risk for severe COVID-19. A previous single-center study showed worse outcomes in patients treated with obinutuzumab compared to rituximab. We examined this hypothesis in a large international multicenter cohort. METHODS We included HM patients from 15 centers, from five countries treated with anti-CD20, comparing those treated with obinutuzumab (O-G) to rituximab (R-G) between December 2021 and June 2022, when Omicron lineage was dominant. RESULTS We collected data on 1048 patients. Within the R-G (n = 762, 73%), 191 (25%) contracted COVID-19 compared to 103 (36%) in the O-G. COVID-19 patients in the O-G were younger (61 ± 11.7 vs. 64 ± 14.5, p = 0.039), had more indolent HM diagnosis (aggressive lymphoma: 3.9% vs. 67.0%, p < 0.001), and most were on maintenance therapy at COVID-19 diagnosis (63.0% vs. 16.8%, p < 0.001). Severe-critical COVID-19 occurred in 31.1% of patients in the O-G and 22.5% in the R-G. In multivariable analysis, O-G had a 2.08-fold increased risk for severe-critical COVID-19 compared to R-G (95% CI 1.13-3.84), adjusted for Charlson comorbidity index, sex, and tixagevimab/cilgavimab (T-C) prophylaxis. Further analysis comparing O-G to R-G demonstrated increased hospitalizations (51.5% vs. 35.6% p = 0.008), ICU admissions (12.6% vs. 5.8%, p = 0.042), but the nonsignificant difference in COVID-19-related mortality (n = 10, 9.7% vs. n = 12, 6.3%, p = 0.293). CONCLUSIONS Despite younger age and a more indolent HM diagnosis, patients receiving obinutuzumab had more severe COVID-19 outcomes than those receiving rituximab. Our findings underscore the need to evaluate the risk-benefit balance when considering obinutuzumab therapy for HM patients during respiratory viral outbreaks.
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Affiliation(s)
- Tali Shafat
- Infectious Diseases Institute, Soroka University Medical Center, and the Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
- Clinical Research Center, Soroka University Medical Center, and the Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
| | - Daniel Grupel
- Department of Clinical Microbiology and Infectious DiseasesHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Tzvika Porges
- Hematology Department, Soroka University Medical Center, and the Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
| | - Ran Abuhasira
- Clinical Research Center, Soroka University Medical Center, and the Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
| | - Ana Belkin
- Internal Medicine D and Infectious Diseases UnitSheba Medical CenterRamat‐GanIsrael
- Sackler Faculty of MedicineTel Aviv UniversityRamat‐AvivIsrael
| | - Ofir Deri
- Internal Medicine TSheba Medical CenterRamat‐GanIsrael
| | - Yonatan Oster
- Department of Clinical Microbiology and Infectious DiseasesHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Shadi Zahran
- Department of Clinical Microbiology and Infectious DiseasesHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Ehud Horwitz
- Department of Clinical Microbiology and Infectious DiseasesHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew UniversityJerusalemIsrael
| | - Netanel A. Horowitz
- Department of Hematology and Bone Marrow TransplantationRambam Health Care CampusHaifaIsrael
| | - Hazim Khatib
- Department of Hematology and Bone Marrow TransplantationRambam Health Care CampusHaifaIsrael
| | - Marjorie Vieira Batista
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
- Department of Infectious DiseasesAC Camargo Cancer CenterSão PauloSão PauloBrazil
| | - Anita Cassoli Cortez
- Department of Hematology and Cell TherapyAC Camargo Cancer CenterSão PauloSão PauloBrazil
| | - Tal Brosh‐Nissimov
- Infectious Diseases UnitSamson Assuta Ashdod University HospitalAshdodIsrael
- The Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
| | - Yafit Segman
- The Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
- Hematology InstituteSamson Assuta Ashdod University HospitalAshdodIsrael
| | - Linor Ishay
- Rappaport Faculty of MedicineTechnionHaifaIsrael
- Hillel Yaffe Medical CenterHaderaIsrael
| | - Regev Cohen
- Rappaport Faculty of MedicineTechnionHaifaIsrael
- Hillel Yaffe Medical CenterHaderaIsrael
| | - Alaa Atamna
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
- Infectious Diseases Unit, Rabin Medical CenterBeilinson HospitalPetah TikvaIsrael
| | - Amy Spallone
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
| | - Roy F. Chemaly
- Department of Infectious Diseases, Infection Control and Employee HealthThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
| | - Juan Carlos Ramos‐Ramos
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
- Infectious Disease UnitInternal Medicine Service. CIBERINFEC. Hospital Universitario La PazMadridSpain
| | - Michal Chowers
- Meir Medical CentreKfar SabaIsrael
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Evgeny Rogozin
- Infectious Diseases unitShamir (Assaf Harofeh) Medical CenterBe'er Ya'akovIsrael
| | - Noga Carmi Oren
- Infectious Diseases unitShamir (Assaf Harofeh) Medical CenterBe'er Ya'akovIsrael
| | - Şiran Keske
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
- Department of Infectious DiseasesVKV American HospitalIstanbulTurkey
| | | | - Lior Nesher
- Infectious Diseases Institute, Soroka University Medical Center, and the Faculty of Health SciencesBen‐Gurion University of the NegevBeer‐ShevaIsrael
- European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Respiratory Viruses (ESGREV)BaselSwitzerland
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2
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Kalra S, Peyser R, Ho J, Babbin C, Bohan N, Cortes A, Erley J, Fatima M, Flinn J, Horwitz E, Hsu R, Lee W, Lu V, Narch A, Navas D, Okoroafor K, Ouanemalay E, Ross S, Sowole F, Specht E, Woo J, Yu K, Coolon JD. Genome-wide gene expression responses to experimental manipulation of Saccharomyces cerevisiae repressor activator protein 1 (Rap1) expression level. Genomics 2023; 115:110625. [PMID: 37068644 DOI: 10.1016/j.ygeno.2023.110625] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/24/2023] [Accepted: 04/13/2023] [Indexed: 04/19/2023]
Abstract
Precise regulation of transcription in gene expression is critical for all aspects of normal organism form, fitness, and function and even minor alterations in the level, location, and timing of gene expression can result in phenotypic variation within and between species including evolutionary innovations and human disease states. Eukaryotic transcription is regulated by a complex interplay of multiple factors working both at a physical and molecular levels influencing this process. In Saccharomyces cerevisiae, the TF with the greatest number of putative regulatory targets is the essential gene Repressor Activator Protein 1 (RAP1). While much is known about the roles of Rap1 in gene regulation and numerous cellular processes, the response of Rap1 target genes to systematic titration of RAP1 expression level remains unknown. To fill this knowledge gap, we used a strain with a tetracycline-titratable promoter replacing wild-type regulatory sequences of RAP1 to systematically reduce the expression level of RAP1 and followed this with RNA sequencing (RNA-seq) to measure genome-wide gene expression responses. Previous research indicated that Rap1 plays a significant regulatory role in particular groups of genes including telomere-proximal genes, homothallic mating (HM) loci, glycolytic genes, DNA repair genes, and ribosomal protein genes; therefore, we focused our analyses on these groups and downstream targets to determine how they respond to reductions in RAP1 expression level. Overall, despite being known as both an activator and as a repressor of its target genes, we found that Rap1 acts as an activator for more target genes than as a repressor. Additionally, we found that Rap1 functions as an activator of ribosomal protein genes and a repressor of the silent mating locus genes consistent with predictions from the literature. Unexpectedly, we found that Rap1 functions as a repressor of glycolytic enzyme genes contrary to prior reports of it having the opposite effect. We also compared the expression of RAP1 to five different genes related to DNA repair pathway and found that decreasing RAP1 downregulated four of those five genes. Finally, we found no effect of RAP1 depletion on telomere-proximal genes despite its functioning to silence telomeric repeat-containing RNAs. Together our results enrich our understanding of this important transcriptional regulator. The graphical abstract is provided as a supplementary fig. (S-Fig 1).
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Affiliation(s)
- S Kalra
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - R Peyser
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - J Ho
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - C Babbin
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - N Bohan
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - A Cortes
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - J Erley
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - M Fatima
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - J Flinn
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - E Horwitz
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - R Hsu
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - W Lee
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - V Lu
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - A Narch
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - D Navas
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - K Okoroafor
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - E Ouanemalay
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - S Ross
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - F Sowole
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - E Specht
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - J Woo
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - K Yu
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America
| | - J D Coolon
- Department of Biology, Wesleyan University, Middletown, CT 06457, United States of America.
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3
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Jang-Milligan F, Goss K, Burnham A, Foppiani E, Medrano-Trochez C, Daley-Bauer L, Gibson G, Horwitz E. Critical differences in MSC gene expression induced by the proinflammatory cytokines interferon γ and TNFα: implications for biology and therapy. Cytotherapy 2021. [DOI: 10.1016/s1465324921003418] [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: 11/27/2022]
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4
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Chilmonczyk M, Kottke P, Horwitz E, Fedorov A. Probing MSC and Tumor Cell Secretome Locally via Dynamic Sampling Platform (DSP). Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.478] [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: 10/24/2022]
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5
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Sagy YW, Krieger M, Horwitz E, Paltiel O, Ravel-Vilk S, Ben-Yehuda A, Manor O, Calderon-Margalit R. Diabetes care in individuals with severe mental Illnesses in Israel. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.193] [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: 11/15/2022] Open
Abstract
Abstract
Background
Cardiovascular disease and risk factors are more common in people with severe mental illness (SMI; schizophrenia, schizoaffective disorders, and bi-polar disorders). For instance, diabetes mellitus (DM) prevalence was reported to be 2-3 times higher, with higher incidence and severity of complications. In 2015, following a reform in mental health services in Israel, services were transferred to the responsibility of the health plans, allowing a comprehensive healthcare. We aimed to compare quality of care indicators and intermediate DM outcomes in individuals with SMI compared to the general population.
Methods
The Israel national program for quality indicators in community healthcare obtains data from electronic medical records from the four health plans, covering the entire civilian population. In 2017, n = 74,226 individuals aged ≥18 years had a registered diagnosis of SMI (prevalence 1.37%). DM prevalence, hemoglobin A1c (HbA1c) testing yearly, and DM control in individuals with SMI were compared with the general population.
Results
DM prevalence in adults with SMI in 2017 was 14.3%, compared with 9.7% among all Israeli adults (RR of 1.5). rates of HbA1c testing and control (HbA1c<7-8%, depending on age and duration of disease) were similar among DM patients with SMI and the general population (testing: 90.1% and 90.9%; Control: 70.8% and 69.7%, SMI and general population, respectively); Similarly, uncontrolled DM (HbA1c>9%) was observed in 10.8% of individuals with SMI and in 10.0% of the general population.
Conclusions
Along with the expected excess of DM prevalence in individuals with SMI, quality of care DM indicators rates were alike among those with SMI as in the general population, suggesting non-inferior quality of care. This is consistent with results reported by the British national diabetes audit for England and Wales. However, our results are limited by a possible under-registration or diagnosis of SMI in the Israeli population.
Key messages
Higher diabetes mellitus prevalence is observed in individuals with severe mental illness. Hemoglobin A1c testing and diabetes mellitus control rates are alike in individuals with severe mental illness compared with the general population, suggesting non-inferior quality of care.
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Affiliation(s)
- Y Wolff Sagy
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
| | - M Krieger
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
| | - E Horwitz
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Pharmacy Division, Hadassah Medical Center, Jerusalem, Israel
| | - O Paltiel
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Hematology, Hadassah Medical Center, Jerusalem, Israel
| | - S Ravel-Vilk
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Pediatric Hemato-Oncology, Shaare-Zedek, Jerusalem, Israel
| | - A Ben-Yehuda
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Internal Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - O Manor
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
| | - R Calderon-Margalit
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
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6
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Wolff Sagy Y, Krieger M, Horwitz E, Ben-Yehuda A, Paltiel O, Ravel-Vilk S, Manor O, Calderon-Margalit R. Diabetes in Israel- do all patients receive equal care? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.223] [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] Open
Abstract
Abstract
Background
Diabetes Mellitus (DM) is associated with micro- and macro-vascular complications, leading to high burden of morbidity and mortality. Populations of low socioeconomic position (SEP) in various countries were found to have increased prevalence of the disease, worse glycemic control, and increased complications. We aimed to examine whether there are social disparities in diabetes care in Israel, as reflected in a national program for quality indicators.
Methods
The Israel National Program for Quality Indicators in Community Healthcare obtains data from electronic medical records from all health plans, covering the entire Israeli population. In 2017, 497,397 individuals aged >18 years were identified with DM. DM prevalence, quality of care indicators, including process and intermediate outcomes were explored by SEP categories (1-10), determined according to residential addresses.
Results
DM prevalence in Israeli adults in 2017 was 9.7%, showing a strong SEP gradient, with higher prevalence in individuals of lower SEP. No SEP disparities were observed in process indicators with overall rates of documentation of hemoglobin A1c (HbA1c) of 90.9%, ophthalmologic examinations of 72.5%, and kidney function examinations of 92.5%. However, strong SEP disparities were observed in the prevalence of uncontrolled diabetes (HbA1c≥9%), with an overall rate of 10.0%, and a 5.4-times higher rate in diabetics of the lowest SES level (23.5%) compared with the highest SEP level (4.3%). A somewhat weaker gradient was seen for the well-control of DM (HbA1c<7-8%, according to duration of disease and age), with an overall rate of 69.7%, and a 1.7 ratio, comparing diabetics of the highest vs the lowest SEP level.
Conclusions
These findings suggest that access to care does not explain SEP disparities in diabetes control in Israel. There is a need to explore the underlying social, cultural, and possibly the benefits-policy determinants of poor control among individuals of low SEP.
Key messages
Wide socioeconomic disparities are present among Israeli adults in diabetes mellitus prevalence and control rates, but not in care processes indicators. These findings call for a deeper understanding of the determinants and perhaps a revision of current social benefits policy, which may encourage lack of glycemic control.
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Affiliation(s)
- Y Wolff Sagy
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
| | - M Krieger
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
| | - E Horwitz
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Pharmacy Division, Hadassah Medical Center, Jerusalem, Israel
| | - A Ben-Yehuda
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Internal Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - O Paltiel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Hematology, Hadassah Medical Center, Jerusalem, Israel
| | - S Ravel-Vilk
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
- Pediatric Hemato-Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - O Manor
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
| | - R Calderon-Margalit
- Braun School of Public Health & Community Medicine, Hebrew University, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthc, Israel National Institute for Health Policy Research, Tel Hashomer, Israel
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7
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Weisband YL, Calderon-Margalit R, Wolff-Sagy Y, Krieger M, Abu-Ahmed W, Ben-Yehuda A, Horwitz E, Manor O. Socioeconomic disparities in diabetes prevalence and quality of care among Israeli children. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.035] [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: 11/12/2022] Open
Abstract
Abstract
Background
Despite Israel’s universal health coverage, disparities in health services provision may still exist. We aimed to assess socioeconomic disparities in diabetes prevalence and quality of care among Israeli children, and to assess trends in these over time.
Methods
Repeated cross-sectional analyses in the setting of the National Program for Quality Indicators in Community Healthcare that receives data based on electronic medical records from Israel’s four health maintenance organizations. The study population included all Israeli children aged 2-19 years in 2011-2017 (for 2017: N = 2,364,374, including 2,914 with diabetes). Socio-economic position (SEP) was measured using Central Bureau of Statistics data further updated by a private company (Points Business Mapping Ltd), and grouped into 4 categories, ranging from 1 (lowest) to 4 (highest). Using logistic regression, we assessed the association of SEP with diabetes prevalence, diabetes clinic visits, hemoglobin A1C (HbA1C) testing, and poor glycemic control (HbA1C> 9%), and assessed whether these changed over time. Models were adjusted for age, and sex.
Results
Diabetes prevalence increased with age and SEP. SEP was positively associated with visiting a specialized diabetes clinic (OR SEP 4 vs. 1 2.53, 95% CI 1.72 - 3.70). Odds of HbA1C testing and odds of poor glycemic control were negatively associated with SEP (OR SEP 4 vs. 1: 0.54, 95% CI 0.40 - 0.72 and OR SEP 4 vs. 1: 0.25, 95% CI 0.18 - 0.34 respectively). Disparities were especially apparent among children aged 2-9 (4.6% poor glycemic control in SEP 4 vs. 40.8% in SEP 1). Poor glycemic control decreased over time, from 44.0% in 2011 to 34.8% in 2017.
Conclusions
While poor glycemic control rates among children have improved, significant socioeconomic gaps remain. It is eminent to study the causes of these disparities and develop policies to improve care provided to children in the lower SEP levels, to promote health equity.
Key messages
Major socioeconomic inequalities in the control of diabetes among children in Israel remain despite universal health care coverage. The rate of uncontrolled diabetes among Israeli children has improved over time.
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Affiliation(s)
- Y Loewenberg Weisband
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - R Calderon-Margalit
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - Y Wolff-Sagy
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - M Krieger
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - W Abu-Ahmed
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - A Ben-Yehuda
- Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - E Horwitz
- Pharmacy Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
| | - O Manor
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Program Directorate, National Program for Quality Indicators in Community Healthcare in Israel, Jerusalem, Israel
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8
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Perlman A, Hochberg-Klein S, Choshen Cohen L, Dagan G, Hirsh-Raccah B, Horwitz E, Aldouby-Bier G, Negev T, Matok I, Azoulay L, Kalish Y, Muszkat M. Management strategies of the interaction between direct oral anticoagulant and drug-metabolizing enzyme inducers. J Thromb Thrombolysis 2019; 47:590-595. [PMID: 30617727 DOI: 10.1007/s11239-018-01804-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Little is known regarding the management of direct oral anticoagulants (DOACs) in patients with enzyme-inducing drugs (EID). The use of EID may lead to sub-therapeutic concentrations of DOACs and to treatment failure. Thus, many patients on EIDs cannot benefit from the advantages of DOACs. This was a retrospective study, evaluating the management of hospitalized patients with DOACs. Characteristics of hospitalized patients with a prescription for DOACs, with and without EIDs, were summarized and evaluated, and management strategies addressing the potential interaction were documented, including the use of DOAC concentration monitoring. During the period evaluated, 1596 hospitalized patients with prescriptions for DOACs were identified. Most patients received apixaban (n = 1227, 77%), followed by rivaroxaban (240, 15%), and dabigatran (129, 8%). Twenty-two patients (1.4%) had concomitant EIDs. Demographic and clinical characteristics of hospitalized patients with DOACs were similar in those receiving EID and those not. Management strategies included stopping DOAC or EID (41%), and DOAC dose increase (14%). During management of these interactions, DOAC concentrations were measured for 11 of 22 patients and were below the 5th percentile of expected concentration for six of these patients. The management of patients with DOAC concentration measurement differed significantly from those without (p = 0.005), as they were much less likely to have one of the medications stopped and more often had the DOACs' dose increased. Among hospitalized patients with DOACs, EIDs are not rare. DOAC concentrations are often low in the presence of EIDs. DOAC concentration monitoring may be useful in settings requiring both DOAC and EIDs.
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Affiliation(s)
- Amichai Perlman
- Pharmacy Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, 91540, Jerusalem, Israel.,Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sarit Hochberg-Klein
- Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, 91540, Jerusalem, Israel.,Department of Epidemiology, Biostatistics, and Occupational Health, Centre for Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute, Montreal, Canada
| | - Lotan Choshen Cohen
- Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, 91540, Jerusalem, Israel
| | - Gil Dagan
- Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, 91540, Jerusalem, Israel
| | - Bruria Hirsh-Raccah
- Pharmacy Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ehud Horwitz
- Pharmacy Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, 91540, Jerusalem, Israel
| | - Gefen Aldouby-Bier
- Pharmacy Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Negev
- Pharmacy Division, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Orthopedics, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ilan Matok
- Division of Clinical Pharmacy, Institute for Drug Research, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Laurent Azoulay
- Department of Epidemiology, Biostatistics, and Occupational Health, Centre for Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute, Montreal, Canada.,Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada
| | - Yosef Kalish
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Mordechai Muszkat
- Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, 91540, Jerusalem, Israel.
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Krieger M, Abu Ahmad W, Wolff-Sagy Y, Horwitz E, Ben-Yehuda A, Paltiel O, Manor O, Calderon-Margalit R. [ANTIBIOTIC USE IN COMMUNITY HEALTHCARE IN ISRAEL AS REFLECTED IN THE NATIONAL PROGRAM FOR QUALITY INDICATORS]. Harefuah 2019; 158:299-304. [PMID: 31104389] [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: 06/09/2023]
Abstract
AIMS We sought to evaluate the extent of overall and second-line systemic antibiotic use in the Israeli community, to compare them to international data and to monitor temporal trends. BACKGROUND Antibiotic overuse is prevalent and has grave implications, primarily the emergence of resistant pathogens - an urgent public health concern worldwide. METHODS The Israel National Program for Quality Indicators in Community Healthcare (QICH) obtains data from electronic medical records from the 4 health-plans, covering the entire civilian population. We assessed 2 quality indicators, compatible with those of the OECD: 1. Overall volume of antibiotics for systemic use dispensed. 2. Volume of second-line antibiotics as a proportion of all systemic antibiotics. Analysis was stratified by gender, age and socio-economic position (SEP). RESULTS The volume of systemic antibiotics dispensed in 2016 was 20.76 DDD/1000 person/day, with second-line antibiotics comprising 22.0% of the total. These values have been stable since 2014, and are higher compared with the OECD averages (20.61 DDD/1000 person/day, and 17.02% in 2015). Both overall volume and the proportion of second-line antibiotics rose with age and were higher among women especially in the 20-40 years age bracket (overall volume of 23.98 DDD/1000 person/day, proportion of second-line antibiotics of 23.98% VS 17.41 and 19.17% in men). Higher overall use was observed among patients of low SEP. CONCLUSIONS The observed volume of systemic antibiotics and the proportion of second-line antibiotics dispensed in the Israeli community were stable and high. Higher use was observed among older individuals, women and patients of low SEP. Our results call for the implementation of a national-level, community-based antibiotic stewardship program. QICH might serve to monitor such a program.
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Affiliation(s)
- Michal Krieger
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
| | - Wiessam Abu Ahmad
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
| | - Yael Wolff-Sagy
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
| | - Ehud Horwitz
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
- Pharmacy Division, Hadassah Medical Center, Hebrew University
| | - Arie Ben-Yehuda
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- Department of Internal Medicine, Hadassah Medical Center, Hebrew University
| | - Ora Paltiel
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
| | - Orly Manor
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
| | - Ronit Calderon-Margalit
- Braun School of Public Health and Community Medicine, The Hebrew University- Hadassah
- National Program for Quality Indicators in Community Healthcare
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10
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Perlman A, Horwitz E, Hirsh-Raccah B, Aldouby-Bier G, Fisher Negev T, Hochberg-Klein S, Kalish Y, Muszkat M. Clinical pharmacist led hospital-wide direct oral anticoagulant stewardship program. Isr J Health Policy Res 2019; 8:19. [PMID: 30709417 PMCID: PMC6357500 DOI: 10.1186/s13584-019-0285-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/05/2018] [Indexed: 12/20/2022] Open
Abstract
Introduction In the past decade, direct-acting oral anticoagulants (DOAC) have been introduced to medical practice for several indications, with a wide range of dosing regimens. As both over- and under-dosing might lead to life-threatening events, development of methods promoting safe and effective utilization of these agents is imperative. The Hadassah Clinical Pharmacy team initiated a hospital-wide program, for monitoring and promoting safe and effective prescription of DOAC during hospitalization. This study describes the types of drug related problems addressed and the program’s performance in terms of consultation rates and physician acceptance. Methods Electronic medical records throughout the hospital were screened for DOAC orders. All DOAC orders were assessed by a clinical pharmacist for potentially-inappropriate prescribing. When potentially-inappropriate prescribing or a drug-related problem was identified, the clinical pharmacist provided consultation on management options. In specific cases, additional guidance was provided by coagulation and pharmacology specialists. Data on patient characteristics, clinical pharmacist consultations, and physician response was retrospectively retrieved for the first six months of 2017. Characteristics of patients with and without consultations were compared, consultations were categorized by the recommended management of the drug related problem, and physician acceptance rates were evaluated by category. Results During the evaluated period, 585 patients with DOAC orders were identified. Patients were evenly distributed by gender, and age averaged 78 years. Most patients received apixaban (75%) followed by rivaroxaban (14%) and dabigatran (11%), and most (63%) received “reduced dose” regimens. Clinical pharmacists provided 258 consultations for 210 patients, regarding anticoagulation management, such that more than one in three patients on DOAC had potentially inappropriate prescribing or drug related problems. Consultations included alerts regarding potentially inappropriate DOAC doses and recommendations to increase (29%) or decrease (5%) the dose, potentially inappropriate concomitant antiplatelet agents (20%), need for DOAC level monitoring (23%), and alerts regarding other drug related problems (23%). More than 70% of recommendations were accepted by the attending physician. Conclusion Due to the complexity of DOAC management, potentially-inappropriate prescribing and drug related problems are common. Multidisciplinary collaborative projects including review and consultation by clinical pharmacists are an effective method of improving management of patients on DOAC. Trial registration Retrospectively registered at clinicaltrials.gov, NCT03527615.
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Affiliation(s)
- Amichai Perlman
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel.,Department of Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ehud Horwitz
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel
| | - Bruria Hirsh-Raccah
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Gefen Aldouby-Bier
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Orthopedics, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Tamar Fisher Negev
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Sarit Hochberg-Klein
- Department of Pharmacy, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yosef Kalish
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Mordechai Muszkat
- Department of Medicine, Hadassah Hebrew University Medical Center, Mt Scopus, Jerusalem, Israel.
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11
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Kaufman-Shriqui V, Calderon-Margalit R, Abu-Ahmed W, Krieger M, Horwitz E, Shmueli A, Ben-Yehuda A, Paltiel O, Manor O. Primary prevention of cardiometabolic disease – is everybody receiving quality care? Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw167] [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)
- V Kaufman-Shriqui
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
| | - R Calderon-Margalit
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
| | - W Abu-Ahmed
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
| | - M Krieger
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
| | - E Horwitz
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
- Hadassah Medical Center, Jerusalem, Israel
| | - A Shmueli
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
| | - A Ben-Yehuda
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
- Hadassah Medical Center, Jerusalem, Israel
| | - O Paltiel
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
- Hadassah Medical Center, Jerusalem, Israel
| | - O Manor
- The Hebrew University- Hadassah, Jerusalem, Israel
- National Program for Quality Indicators in Community Healthcare, Jerusalem, Israel
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12
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Veltchev I, Price R, Horwitz E, Ma C. SU-F-T-34: Transition Form CT-Based to Ultrasound-Based HDR Treatment Planning for Prostate Cancer. Med Phys 2016. [DOI: 10.1118/1.4956169] [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: 11/07/2022] Open
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13
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Naples JC, Skeens MA, Auletta J, Rangarajan H, Abu-Arja R, Horwitz E, Stanek J, Bajwa RS. Anicteric veno-occlusive disease after hematopoietic stem cell transplantation in children. Bone Marrow Transplant 2015; 51:135-7. [PMID: 26367232 DOI: 10.1038/bmt.2015.208] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- J C Naples
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - M A Skeens
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - J Auletta
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - H Rangarajan
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - R Abu-Arja
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - E Horwitz
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - J Stanek
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
| | - R S Bajwa
- Department Of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, USA
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14
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Price R, Meyer J, Horwitz E, Ma C. SU-E-T-747: The Use of the EQD2 Formalism and Repair Estimates in the Re-Irradiation Setting and Correlation with Patient Follow-Up Data. Med Phys 2015. [DOI: 10.1118/1.4925111] [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: 11/07/2022] Open
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15
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Fourkal E, Hossain M, Veltchev I, Ma C, Meyer J, Horwitz E, Nahum A. SU-E-T-385: 4D Radiobiology. Med Phys 2014. [DOI: 10.1118/1.4888718] [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: 11/07/2022] Open
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16
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Veltchev I, Fourkal E, Doss M, Ma C, Meyer J, Yu M, Horwitz E. SU-E-T-189: First Experimental Verification of the Accuracy of Absolute Dose Reconstruction From PET-CT Imaging of Yttrium 90 Microspheres. Med Phys 2014. [DOI: 10.1118/1.4888519] [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: 11/07/2022] Open
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17
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Grisendi G, Spano C, D'Souza N, Rasini V, Veronesi E, Piccinno S, De Santis G, Horwitz E, Conte P, Paolucci P, Dominici M. Modified adipose mesenchymal progenitors target Ewing's sarcoma. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.105] [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: 10/25/2022]
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18
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Otsuru S, Hofmann T, Raman P, Olson T, Horwitz E. Equivalent MSC preparations using two isolation methods. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.276] [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: 10/25/2022]
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19
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Samarin J, Stein I, Horwitz E, Ho C, Chen X, Pikarsky E, Calvisi D, Schirmacher P, Breuhahn K. Stabilization of protumorigenic FUSE binding proteins (FBPs) in hepatocarcinogenesis. Z Gastroenterol 2014. [DOI: 10.1055/s-0033-1360998] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Sizoo B, Horwitz E. EPA-0548 - Assessment of the psychometric properties of the raads-r and two abridged versions of the autism spectrum quotient (AQ-10 and AQ-28) in a dutch adult outpatient population. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77941-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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Chang L, Li T, Horwitz E, Chen D, Viterbo R, Kutikov A, Greenberg R, Buyyounouski M. Toxicity and Biochemical Failure Following Image-Guided Prostate Intensity Modulated Radiation Therapy: Fiducial Markers Versus Electromagnetic Transponders. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.967] [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: 11/17/2022]
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22
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Sandlund J, Shurtleff S, Onciu M, Horwitz E, Leung W, Howard V, Rencher R, Conley M. Frequent mutations in SH2D1A (XLP) in males presenting with high-grade mature B-cell neoplasms. Pediatr Blood Cancer 2013; 60:E85-7. [PMID: 23589280 PMCID: PMC4758190 DOI: 10.1002/pbc.24525] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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: 08/15/2012] [Accepted: 02/07/2013] [Indexed: 11/10/2022]
Abstract
X-linked lymphoproliferative syndrome (XLP) is caused by mutations in SH2D1A, and is associated with overwhelming infectious mononucleosis, aplastic anemia, hypogammaglobulinemia, and B-cell lymphomas. However, the frequency of SH2D1A mutations in males who present with B NHL is unknown. Five cases of XLP were diagnosed among 158 males presenting with B NHL (approximately 3.2%). Four of the patients had two episodes of B NHL and one had a single episode of B NHL followed by aggressive infectious mononucleosis. Prospective screening for XLP in males with B-cell lymphoma at the time of initial diagnosis should be considered.
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Affiliation(s)
- J.T. Sandlund
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee,The University of Tennessee College of Medicine, Memphis, Tennessee,Correspondence to: John T. Sandlund, 262 Danny Thomas Place, Memphis, TN 38105.
| | - S.A. Shurtleff
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - M. Onciu
- The University of Tennessee College of Medicine, Memphis, Tennessee,Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - E. Horwitz
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee,Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - W. Leung
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee,The University of Tennessee College of Medicine, Memphis, Tennessee
| | - V. Howard
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - R. Rencher
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - M.E. Conley
- The University of Tennessee College of Medicine, Memphis, Tennessee,Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee
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23
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Huang K, Walker G, Stoyanova R, Sandler K, Horwitz E, Buyyounouski M, Pollack A. Primary Prostate Radiation Therapy: Where Are We Failing? Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Stoyanova R, Walker G, Sandler K, Khor L, Horwitz E, Buyyounouski M, Pollack A. Determinants of Prostate Biopsy Positivity 2 Years After Radiation Therapy for Men With Prostate Cancer Treated on a Randomized Trial. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.362] [Citation(s) in RCA: 2] [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: 11/16/2022]
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25
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Li JS, Buyyounouski M, Horwitz E, Ma CM. WE-A-BRB-11: How Certain Can the Real-Time Plan Predict the Post Dosimetry for Prostate Seed Implant? Med Phys 2012. [DOI: 10.1118/1.4736052] [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: 11/07/2022] Open
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26
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Horwitz E, Tal-Gan Y, Temper V, Shapiro M, Gilon C, Hoffman A. Chemical trapping of vancomycin: a potential strategy for preventing selection of vancomycin-resistant Enterococci. Microb Drug Resist 2011; 18:109-15. [PMID: 22088148 DOI: 10.1089/mdr.2011.0057] [Citation(s) in RCA: 2] [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: 11/12/2022] Open
Abstract
Emergence of antimicrobial resistance is among the most worrisome issues in public health worldwide. Vancomycin resistance is rapidly spreading, resulting in increased morbidity, mortality, and healthcare-associated costs. Multiple strategies are required to preserve the effectiveness of this essential antibiotic. It has been recently shown that biliary excretion of vancomycin following parenteral administration results in significant fecal concentrations of vancomycin that may lead to selection of vancomycin-resistant strains within the colon. In this study we present a novel strategy for preventing this undesired effect and its consequences, using chemical trapping of vancomycin by a tripeptide analog that mimics the natural bacterial vancomycin binding-site. Initially, we demonstrated that a tripeptide analog can neutralize vancomycin activity against Enterococci at a molar excess of 28. In the second phase, two chemical modifications, designed to attach the tripeptide to vancomycin covalently, were explored. Attachment of a 4-flurosulfonyl-benzoic acid (FSBA) moiety to the parent tripeptide resulted in vancomycin neutralization at a molar ratio of less than 4:1. Finally it was shown that the FSBA-bound tripeptide analog can prevent in-vitro selection of vancomycin-resistant Enterococci (VRE) from a mixed vancomycin susceptible/resistant population following exposure to vancomycin. These findings demonstrate the ability of the proposed strategy to prevent selection of VRE. The present proof-of-concept study provides the basis for further development of the proposed strategy. Further, this strategy may be implemented for combating resistance to other antimicrobials.
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Affiliation(s)
- Ehud Horwitz
- Department of Pharmaceutics, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
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27
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Lubbe W, Price R, Ruth K, Cherian G, Kutikov A, Chen D, Uzzo R, Buyyounouski M, Ma C, Horwitz E. VMAT Reduces Moderate to High Integral Dose When Compared to Conventional IMRT for Treatment of Prostate Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.742] [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: 11/15/2022]
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28
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Pollack A, Walker G, Buyyounouski M, Horwitz E, Price R, Feigenberg S, Konski A, Stoyanova R, Ma C. Five Year Results of a Randomized External Beam Radiotherapy Hypofractionation Trial for Prostate Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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29
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Crook J, Malone S, Horwitz E, Dearnaley D, Duncan G, Warde P, Gospodarowicz M, Ding K, OCallaghan C, Klotz L. A Phase III Randomized Trial of Intermittent vs. Continuous Androgen Suppression for PSA Progression after Radical Therapy (NCIC CTG PR.7/SWOG JPR.7/CTSU JPR.7/ UK Intercontinental Trial CRUKE/01/013). Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.010] [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: 11/28/2022]
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30
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Horwitz E, Kagan L, Avni-Magen N, Daryi D, Gati I, Hoffman A, Friedman M, Lavy E. A novel subcutaneous controlled-release amoxicillin degradable implant for extended-interval administration in veterinary medicine. J Vet Pharmacol Ther 2011; 34:494-8. [PMID: 21198679 DOI: 10.1111/j.1365-2885.2010.01256.x] [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: 11/28/2022]
Abstract
Dosage forms of antimicrobials play a critical role in facilitating the attainment of pharmacokinetic-pharmacodynamic (PK-PD) targets as well as adherence in both veterinary and human medicine. The purpose of this study was to develop and evaluate a controlled-release subcutaneous amoxicillin implant for single-dose therapy of large ruminants such as goats, sheep, and deer. The degradable implant, designed to attain PK-PD targets following single administration, was evaluated for amoxicillin release rate and time-concentration profile. In vitro release studies demonstrated constant-rate release of approximately 40% of amoxicillin content within 96 h. In an in vivo study in goats, serving as a model for target animals, a serum concentration of approximately 0.4 mg/L was achieved within 8 h of implant insertion and maintained for >6 days. In comparison, in control goats given a standard single intramuscular amoxicillin dose of 15 mg/kg, amoxicillin peaked at 1.2 mg/L after 1 h, rapidly dropping to below detection level at 8 h. These results suggest that the proposed implant offers a unique modality for animal caregivers to conveniently administer a full antimicrobial course following a single dose of an efficient PK-PD-optimized dosage form. Furthermore, modifications of implant composition may allow for tailoring of its characteristics to various PK, PD, microbiological, and clinical requirements.
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Affiliation(s)
- E Horwitz
- Pharmaceutics Department, School of Pharmacy, Hebrew University of Jerusalem, Jerusalem, Israel
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31
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Price R, Tafo AG, Horwitz E, Ma C. SU-GG-T-566: VMAT Optimization on MVCT Dose and the Affects on Prostate IMRT Acceptance Criteria. Med Phys 2010. [DOI: 10.1118/1.3468964] [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: 11/07/2022] Open
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32
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Price R, Cherian G, Horwitz E, Wang L, Ma C. SU-GG-T-575: Comparison of RapidArc vs. Fixed Beam IMRT for Treatment of Prostate Cancer at Fox Chase Cancer Center. Med Phys 2010. [DOI: 10.1118/1.3468973] [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: 11/07/2022] Open
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Schäfer R, Dominici M, Müller I, Horwitz E, Asahara T, Bulte JWM, Bieback K, Le Blanc K, Bühring HJ, Capogrossi MC, Dazzi F, Gorodetsky R, Henschler R, Handgretinger R, Kajstura J, Kluger PJ, Lange C, Luettichau IV, Mertsching H, Schrezenmeier H, Sievert KD, Strunk D, Verfaillie C, Northoff H. Basic research and clinical applications of non-hematopoietic stem cells, 4-5 April 2008, Tubingen, Germany. Cytotherapy 2009; 11:245-55. [PMID: 19152153 DOI: 10.1080/14653240802582117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
From 4 to 5 April 2008, international experts met for the second time in Tubingen, Germany, to present and discuss the latest proceedings in research on non-hematopoietic stem cells (NHSC). This report presents issues of basic research including characterization, isolation, good manufacturing practice (GMP)-like production and imaging as well as clinical applications focusing on the regenerative and immunomodulatory capacities of NHSC.
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Affiliation(s)
- R Schäfer
- Institute of Clinical and Experimental Transfusion Medicine, University Hospital Tubingen, Germany.
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Buyyounouski M, Li T, Al-Saleem T, Horwitz E, Konski A, Feigenberg S, Uzzo R, Greenberg R, Pollack A. Predicting Local Persistence of Intermediate and High-risk Prostate Cancer using Percentage of Adenocarcinoma in Pretreatment Biopsy Tissue. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1103] [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: 10/21/2022]
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Pahlajani N, Egleston B, Buyyounouski M, Chen D, Horwitz E, Pollack A. Estimating Gains in Biochemical Outcome from Various Durations of Androgen Deprivation in Patients Treated with Dose Escalated Radiotherapy for Prostate Cancer using Two Nomograms. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.888] [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: 11/30/2022]
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36
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Ma C, Chi Z, Xu Q, Chen L, Paskalev K, Buyyounoski M, Horwitz E, Pollack A. Image Guided Adaptive Radiotherapy of Prostate Cancer: A Retrospective Study. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1070] [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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37
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Call S, Kasow K, Barfield R, Leung W, Madden R, Horwitz E, Woodard P, Yusuf U, Panetta J, Baker S, Handgretinger R, Rodman J, Hale G. 473: Rabbit ATG (thymoglobulin r) Pharmacokinetics in Pediatric Patients Receiving a Matched Unrelated Donor Bone Marrow Transplantation. Biol Blood Marrow Transplant 2008. [DOI: 10.1016/j.bbmt.2007.12.483] [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: 10/22/2022]
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38
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Li J, Pollack A, Horwitz E, Buyyounouski M, Price R, Ma C. Clinical Experience on Localization and Real-Time Tracking of the Prostate During External Radiotherapy using Calypso® 4D Localization System. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.342] [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: 10/22/2022]
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39
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Chen Y, Paskalev K, Horwitz E, Price R, Buyyounouski M, Ma C, Pollack A. Effect of Target Smoothness on Treatment Planning for Prostate IMRT. Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.1993] [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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Li J, Horwitz E, Buyyounouski M, McNeeley S, Crawford K, Ma C. SU-DD-A1-06: Do Stranded Seeds Improve the Quality of Permanent Prostate Seed Implant? Med Phys 2007. [DOI: 10.1118/1.2760344] [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: 11/07/2022] Open
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41
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Paskalev K, Horwitz E, Price R, Feigenberg S, Buyyounouski M, Chen Y, Konski A, Silverman J, Ma C, Pollack A. SU-FF-J-60: Daily Localization for Prostate Bed Patients Based On Surgical Clips. Med Phys 2007. [DOI: 10.1118/1.2760565] [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: 11/07/2022] Open
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Chen Y, Paskalev K, Horwitz E, Price R, Buyyounouski M, Ma C, Pollack A. TH-D-M100F-06: Surface Smoothing of a Tubular Structure Using a Non-Shrinking Algorithm. Med Phys 2007. [DOI: 10.1118/1.2761706] [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: 11/07/2022] Open
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Paskalev K, Feigenberg S, McNeeley S, Horwitz E, Price R, Wang L, Konski A, Ma C, Pollack A. SU-FF-J-37: Comparison Between CT-Based and Ultrasound-Based Localization for Prostate Patients. Med Phys 2006. [DOI: 10.1118/1.2240815] [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: 11/07/2022] Open
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Chen L, Paskalev K, Xu X, Zhu J, Wang L, Price R, Horwitz E, Feigenberg S, Pollack A, Ma C. TU-C-ValB-10: Rectal Dose Variation in Image Guided Radiation Therapy of Prostate Cancer. Med Phys 2006. [DOI: 10.1118/1.2241522] [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: 11/07/2022] Open
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46
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Pring K, Hale G, Barfield R, Horwitz E, Kasow K, Leung W, Woodard P, Yusuf U, Handgretinger R. A review of the use of topotecan for mobilization of peripheral blood stem cells in autologous hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.11.308] [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: 10/25/2022]
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47
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Hale G, Call S, Handgretinger R, Horwitz E, Kasow K, Barfield R, Yusuf U, Woodard P, Leung W, Rodman J. Rabbit anti-thymocyte globulin (rATG;thymoglobulin®) pharmacokinetics in pediatric patients receiving a hematopoietic stem cell transplant (HSCT). Biol Blood Marrow Transplant 2006. [DOI: 10.1016/j.bbmt.2005.12.019] [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: 11/26/2022]
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Chen L, Paskalev K, Zhu J, Xu X, Wang L, Price R, Horwitz E, Feigenberg S, Ma C, Pollack A. Image Guided Radiation Therapy for Prostate IMRT: Rectum Volume Changes and Dosimetric Considerations. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.925] [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]
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Alcantara P, Schultheiss T, Ruth K, Shammo G, McNeeley S, Horwitz E, Pollack A. Dose-Volume Determinants of Late Genitourinary Toxicity After External Beam Radiotherapy for Prostate Cancer. Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.502] [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: 11/15/2022]
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50
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Nguyen K, Horwitz E, Eisenberg D, Hanlon A, Feigenberg S, Pollack A. Does Hyperinsulinemia in Type-II Diabetes Mellitus Influence Disease Presentation and Long-Term Treatment Outcomes of Localized Prostate Cancer? Int J Radiat Oncol Biol Phys 2005. [DOI: 10.1016/j.ijrobp.2005.07.566] [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: 11/30/2022]
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