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Lee JH, Shi DD, Shin KY, Buckley E, Gunasti L, Roldan CS, Hall E, Mann E, Spicer B, Brennan VS, Huynh MA, Spektor A, Chen YH, Krishnan MS, Balboni TA, Hertan LM. A Prospective Study Assessing the Efficacy and Toxicity of Stereotactic Body Radiation Therapy for Oligometastatic Bone Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e126. [PMID: 37784681 DOI: 10.1016/j.ijrobp.2023.06.920] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiation therapy (SBRT) is a promising treatment for oligometastatic disease in bone due to its delivery of high dose to target tissue and minimal dose to surrounding tissue. The purpose of this study is to assess efficacy and toxicity of this treatment in patients with previously unirradiated oligometastatic bony disease. MATERIALS/METHODS In this prospective phase II trial, patients with oligometastatic bone disease, defined as ≤3 active sites of disease, were treated with SBRT at one of two academic institutions between December 2016 and May 2019. Local progression-free survival (LPFS), progression-free survival (PFS), prostatic specific antigen (PSA) progression, and overall survival (OS) were reported. Treatment-related toxicity was also reported. RESULTS A total of 98 patients and 131 lesions arising from various tumor histologies were included in this study. The median age of patients enrolled in the study was 72.8 years (80.6% male, 19.4% female). Median follow-up was 26.7 months. The most common histology was prostate cancer (68.4%, 67/98). The most common dose prescriptions were 27/30 Gy in 3 fractions (26.0%, 34/131), 30 Gy in 5 fractions (19.1%, 25/131), or 30/35 Gy in 5 fractions (16.0%, 21/131). Multiple doses per treatment regimen reflect dose painting employing the lower dose to the clinical target volume (CTV) and higher dose to the gross tumor volume (GTV). Four patients (4.1%, 4/98) experienced local progression at one site for each patient (3.1%, 4/131). Among patients who progressed locally, the median time to local recurrence was 25.8 months (31.0 months among prostate cancer patients, N = 2, and 14.5 months among non-prostate cancer patients, N = 2). Among the entire cohort, 2-year LPFS (including death without local progression) was 85.0%, 2-year PFS (including deaths as well as local, distant, and PSA-based progression) was 47.0%, and 2-year OS was 87.5%. Twenty-seven patients (27.6%, 27/98) developed treatment-related toxicities, and most were Grade 1 (19.4%, 19/98) and 2 (4.1%, 4/98). Four patients (4.1%, 4/98) developed Grade 3 toxicities; there were no Grade 4 toxicities. The most common toxicity was fatigue (10.2%, 10/98). Of 68 treated spine metastases, there were four (5.9%, 4/68) vertebral fractures. Among these four patients, median time to fracture was 23.5 months (range 14.2-39.2 months). CONCLUSION Our study supports existing literature in showing that SBRT is effective and tolerable in patients with oligometastatic bone disease. Larger phase III trials are necessary and reasonable to determine long-term efficacy and toxicities.
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Affiliation(s)
- J H Lee
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - D D Shi
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - K Y Shin
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - E Buckley
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - L Gunasti
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - C S Roldan
- Northwestern Feinberg School of Medicine, Chicago, IL
| | - E Hall
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA
| | - E Mann
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - B Spicer
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - V S Brennan
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - M A Huynh
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - A Spektor
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - Y H Chen
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - M S Krishnan
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA
| | - T A Balboni
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - L M Hertan
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA
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Ramaswamy M, Butler C, McIntyre D, McIntosh N, Mann E, Hewitt R, De Coppi P, Elliott M, Muthialu N. Stem-Cell Based Tissue-Engineered Tracheal Transplant in Pediatric Patients: A Single-Centre Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.682] [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: 04/05/2023] Open
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Kiernan MD, Rodrigues M, Mann E, Stretesky P, Defeyter MA. The Map of Need: identifying and predicting the spatial distribution of financial hardship in Scotland's veteran community. BMJ Mil Health 2022; 168:57-63. [PMID: 33664091 PMCID: PMC8788048 DOI: 10.1136/bmjmilitary-2020-001718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/03/2022]
Abstract
INTRODUCTION During military service, many household costs for both married and single service personnel are subsidised, and transition can leave veterans unprepared for the financial demands of civilian life. Armed Forces organisations such as Sailor, Soldier, Air Force Association (SSAFA) play a central role in understanding the financial challenges that UK veterans face and provide an insight into the financial hardship experienced by veterans. The aim of this study was to use SSAFA beneficiary data as a proxy to identify the nature of financial benefit, the spatial distribution of financial hardship in the Scottish SSAFA beneficiary community and explore factors that might predict where those recipients are located. METHODS Using an anonymised data set of Scottish SSAFA financial beneficiaries between 2014 and 2019, this study used a geographical methodology to identify the geospatial distribution of SSAFA benefit recipients and exploratory regression analysis to explore factors to explain where SSAFA beneficiaries are located. RESULTS Over half of benefit applicants (n=10 735) were concentrated in only 50 postcode districts, showing evidence of a clustered pattern, and modelling demonstrates association with area-level deprivation. The findings highlight strong association between older injured veterans and need for SSAFA beneficiary assistance. CONCLUSION The findings demonstrate that beneficiaries were statistically clustered into areas of high deprivation, experiencing similar challenges to that of the wider population in these areas. Military service injury or disability was strongly associated with areas of high SSAFA benefit use and in those areas high unemployment was also a significant factor to consider.
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Affiliation(s)
- Matthew D Kiernan
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
| | - M Rodrigues
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
| | - E Mann
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
| | - P Stretesky
- Department of Social Sciences, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
| | - M A Defeyter
- Health and Life Sciences, Northumbria University, Newcastle upon Tyne, Tyne and Wear, UK
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Bampoh V, Thongkhamkitcharoen M, Dicker S, Dalal W, Frerich E, Mann E, Porta C, Siddons N, Stauffer WM, Hoffman S. Nursing practice and global refugee migration: initial impressions from an Intergovernmental‐Academic Partnership. Int Nurs Rev 2020; 67:334-340. [DOI: 10.1111/inr.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/03/2020] [Accepted: 04/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- V. Bampoh
- International Organization for Migration/United Nations Migration Agency Addis Ababa Ethiopia
| | | | - S. Dicker
- International Organization for Migration/United Nations Migration Agency New York USA
| | - W. Dalal
- International Organization for Migration/United Nations Migration Agency Nairobi Kenya
| | - E. Frerich
- Minnesota Department of Health Saint PaulMNUSA
| | - E. Mann
- University of Minnesota Center for Global Health and Social Responsibility MinneapolisMNUSA
| | - C. Porta
- University of Minnesota School of Nursing MinneapolisMNUSA
| | - N. Siddons
- University of Minnesota School of Medicine Minneapolis MNUSA
| | - WM Stauffer
- Director, Human Migration and Health, Center for Global Health and Social Responsibility, Departments of Medicine and Pediatrics Minneapolis MNUSA
| | - S.J. Hoffman
- University of Minnesota School of Nursing Minneapolis MNUSA
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Mann E, Sagong C, Cuamatzi Castelan A, Singh M, Roth T, Drake CL, Cheng P. 0007 Daytime Sleep in Night Shift Workers: Quantifying the Role of Circadian Misalignment. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.006] [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
Introduction
Circadian misalignment is commonly cited as a culprit of daytime sleep disturbances in night shift workers; however, the specific impact and magnitude that circadian misalignment has on daytime sleep has not been well-characterized in larger samples of night shift workers.
Methods
Participants included fixed-night shift workers (n=52, ages 18–50) who completed an 8-hour daytime polysomnography (PSG) in the lab following a night shift. Measures of sleep disturbances included: difficulty falling asleep (sleep onset latency [SOL], latency to persistent sleep [LPS]), difficulty staying asleep (sleep efficiency [SE], wake after sleep onset [WASO]), and sleep duration (total sleep time [TST]). Melatonin samples were collected hourly for 24 hours under dim light (<10 lux) and used to determine dim light melatonin offset (DLMOff). Circadian misalignment (CM) was calculated as the time difference between bedtime and DLMOff (higher values represented sleeping after DLMOff), and correlated with PSG sleep variables.
Results
CM was significantly associated with difficulty staying asleep (WASO: r=0.48, p<0.001; SE: r=-0.45, p<0.001), and sleep duration (TST: r=-0.38, p<0.01). Specifically, every 3 hours of CM on average added 19.2 minutes of WASO and reduced TST by 15 minutes. In contrast, CM was not significantly correlated with sleep onset difficulties (SOL: r=-0.27; LPS: r=-0.02).
Conclusion
These data suggest that circadian misalignment in shift workers may be a better predictor of difficulties staying asleep and sleep duration during the day relative to difficulties falling asleep. Because longer work hours (10–12 hours) are common in night shift worker, it may be that sleep initiation difficulties associated with circadian misalignment is masked by elevated fatigue or an increased homeostatic drive from prolonged wakefulness. These results may help guide decisions about the magnitude of phase shifts required (e.g., with light therapy) for the desired improvement in daytime sleep.
Support
Support for this study was provided to PC by the NHLBI (K23HL138166)
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Affiliation(s)
- E Mann
- Henry Ford Health System, Detroit, MI
| | - C Sagong
- Henry Ford Health System, Detroit, MI
| | | | - M Singh
- Henry Ford Health System, Detroit, MI
| | - T Roth
- Henry Ford Health System, Detroit, MI
| | - C L Drake
- Henry Ford Health System, Detroit, MI
| | - P Cheng
- Henry Ford Health System, Detroit, MI
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Brown EG, Chahine LM, Goldman SM, Korell M, Mann E, Kinel DR, Arnedo V, Marek KL, Tanner CM. The Effect of the COVID-19 Pandemic on People with Parkinson's Disease. J Parkinsons Dis 2020; 10:1365-1377. [PMID: 32925107 PMCID: PMC7683050 DOI: 10.3233/jpd-202249] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The effect of the COVID-19 pandemic on people with Parkinson's disease (PD) is poorly understood. OBJECTIVE To rapidly identify areas of need and improve care in people with PD during the COVID-19 pandemic, we deployed a survey to assess COVID-19 symptoms and the pandemic's effect among those with and without COVID-19. METHODS People with and without PD participating in the online study Fox Insight (FI) were invited to complete a survey between April 23 and May 23, 2020. Among people reporting COVID-19 diagnoses, we compared symptoms and outcomes in people with and without PD. Among people not reporting COVID-19, we assessed access to healthcare and services and PD symptoms. RESULTS 7,209/9,762 active FI users responded (approximately 74% response rate), 5,429 people with PD and 1,452 without PD. COVID-19 diagnoses were reported by 51 people with and 26 without PD. Complications were more frequent in people with longer PD duration. People with PD and COVID-19 experienced new or worsening motor (63%) and nonmotor (75%) symptoms. People with PD not diagnosed with COVID-19 reported disrupted medical care (64%), exercise (21%), and social activities (57%), and worsened motor (43%) and non-motor (52%) symptoms. Disruptions were more common for those living alone, with lower income and non-White race. CONCLUSIONS The COVID-19 pandemic is associated with wide-ranging effects on people with PD, and certain groups may be at particular risk. FI provides a rapid, patient-centered means to assess these effects and identify needs that can be used to improve the health of people with PD.
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Affiliation(s)
- Ethan G. Brown
- Department of Neurology, Weill Institute for the Neurosciences, University of California San Francisco, & San Francisco VA Health Care System, San Francisco, CA, USA
| | - Lana M. Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samuel M. Goldman
- Department of Occupational and Environmental Medicine, University of California San Francisco, & San Francisco VA Health Care System, San Francisco, CA, USA
| | - Monica Korell
- Department of Neurology, Weill Institute for the Neurosciences, University of California San Francisco, & San Francisco VA Health Care System, San Francisco, CA, USA
| | - Emerald Mann
- Department of Neurology, Weill Institute for the Neurosciences, University of California San Francisco, & San Francisco VA Health Care System, San Francisco, CA, USA
| | | | | | - Kenneth L. Marek
- The Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | - Caroline M. Tanner
- Department of Neurology, Weill Institute for the Neurosciences, University of California San Francisco, & San Francisco VA Health Care System, San Francisco, CA, USA
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Stalder GL, Pinior B, Zwirzitz B, Loncaric I, Jakupović D, Vetter SG, Smith S, Posautz A, Hoelzl F, Wagner M, Hoffmann D, Kübber-Heiss A, Mann E. Gut microbiota of the European Brown Hare (Lepus europaeus). Sci Rep 2019; 9:2738. [PMID: 30804494 PMCID: PMC6390100 DOI: 10.1038/s41598-019-39638-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 07/20/2018] [Accepted: 01/21/2019] [Indexed: 12/14/2022] Open
Abstract
Diseases of the gastrointestinal tract due to changes in the bacterial flora have been described with increasing incidence in the European brown hare. Despite extensive demographic and phylogeographic research, little is known about the composition of its gut microbiota and how it might vary based on potential environmental or host factors. We analysed the intestinal and faecal microbiota of 3 hare populations by Illumina MiSeq 16S rRNA gene amplicon sequencing. The phyla and OTU abundance composition differed significantly between intestinal and faecal samples (PERMANOVA: P = 0.002 and P = 0.031, respectively), but in both sample types Firmicutes and Bacteroidetes dominated the microbial community composition (45.51% and 19.30% relative abundance). Intestinal samples contained an enrichment of Proteobacteria compared with faecal samples (15.71-fold change, P < 0.001). At OTU level, a significant enrichment with best BLAST hits to the Escherichia-Shigella group, Eubacterium limosum, Sphingomonas kyeonggiensis, Flintibacter butyricus and Blautia faecis were detected in intestinal samples (P < 0.05). In our statistical model, geographic location and possibly associated environmental factors had a greater impact on the microbiota composition than host factors. Population had a significant effect on the composition of abundant intestinal and faecal OTUs, and on the abundance of potential pathogenic bacteria of the family Enterobacteriaceae, regularly associated with intestinal dysbiosis in hares, in faecal samples. Our study is the first to describe the microbiota in brown hares and provides a foundation to generate hypothesis aiming to test the role of gut health in population fluctuations of the species.
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Affiliation(s)
- G L Stalder
- Research Institute of Wildlife Ecology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria.
| | - B Pinior
- Department for Farm Animals and Veterinary Public Health, Institute for Veterinary Public Health, University of Veterinary Medicine, Vienna, 1210, Vienna, Austria
| | - B Zwirzitz
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, 1210, Vienna, Austria.,Austrian Competence Centre for Feed and Food Quality, Safety and Innovation FFoQSI GmbH, Technopark 1C, 3430, Tulln, Austria
| | - I Loncaric
- Department of Pathobiology, Institute of Microbiology, University of Veterinary Medicine, Vienna, 1210, Vienna, Austria
| | - D Jakupović
- Research Institute of Wildlife Ecology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria
| | - S G Vetter
- Research Institute of Wildlife Ecology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria
| | - S Smith
- Konrad Lorenz Institute of Ethology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria
| | - A Posautz
- Research Institute of Wildlife Ecology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria
| | - F Hoelzl
- Konrad Lorenz Institute of Ethology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria
| | - M Wagner
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, 1210, Vienna, Austria.,Austrian Competence Centre for Feed and Food Quality, Safety and Innovation FFoQSI GmbH, Technopark 1C, 3430, Tulln, Austria
| | - D Hoffmann
- Game Conservancy Deutschland e. V., Schloßstrasse 1, 86732, Oettingen, Germany
| | - A Kübber-Heiss
- Research Institute of Wildlife Ecology, Department of Integrative Biology and Evolution, University of Veterinary Medicine, Vienna, 1160, Vienna, Austria
| | - E Mann
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, 1210, Vienna, Austria
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Mann E, White A, Beavin C, Dys G. Foreign objects in college bodies: College women’s feelings about long-acting reversible contraceptives. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.091] [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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Vélez J, Vazquez-Santos M, Amarilla J, Tartaj P, Herradón B, Mann E, del Río C, Morales E. Asymmetrical imidazolium-trialkylammonium room temperature dicationic ionic liquid electrolytes for Li-ion batteries. Electrochim Acta 2018. [DOI: 10.1016/j.electacta.2018.05.103] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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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Neubauer V, Petri R, Humer E, Kröger I, Mann E, Reisinger N, Wagner M, Zebeli Q. High-grain diets supplemented with phytogenic compounds or autolyzed yeast modulate ruminal bacterial community and fermentation in dry cows. J Dairy Sci 2018; 101:2335-2349. [DOI: 10.3168/jds.2017-13565] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/20/2017] [Indexed: 12/26/2022]
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Vélez J, Álvarez L, del Río C, Herradón B, Mann E, Morales E. Imidazolium-based Mono and Dicationic Ionic Liquid Sodium Polymer Gel Electrolytes. Electrochim Acta 2017. [DOI: 10.1016/j.electacta.2017.04.096] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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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Wetzels SU, Mann E, Pourazad P, Qumar M, Pinior B, Metzler-Zebeli BU, Wagner M, Schmitz-Esser S, Zebeli Q. Epimural bacterial community structure in the rumen of Holstein cows with different responses to a long-term subacute ruminal acidosis diet challenge. J Dairy Sci 2016; 100:1829-1844. [PMID: 28041738 DOI: 10.3168/jds.2016-11620] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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: 06/15/2016] [Accepted: 11/09/2016] [Indexed: 12/19/2022]
Abstract
Subacute ruminal acidosis (SARA) is a prevalent metabolic disorder in cattle, characterized by intermittent drops in ruminal pH. This study investigated the effect of a gradual adaptation and continuously induced long-term SARA challenge diet on the epimural bacterial community structure in the rumen of cows. Eight rumen-cannulated nonlactating Holstein cows were transitioned over 1 wk from a forage-based baseline feeding diet (grass silage-hay mix) to a SARA challenge diet, which they were fed for 4 wk. The SARA challenge diet consisted of 60% concentrates (dry matter basis) and 40% grass silage-hay mix. Rumen papillae biopsies were taken at the baseline, on the last day of the 1-wk adaptation, and on the last day of the 4-wk SARA challenge period; ruminal pH was measured using wireless sensors. We isolated DNA from papillae samples for 16S rRNA gene amplicon sequencing using Illumina MiSeq. Sequencing results of most abundant key phylotypes were confirmed by quantitative PCR. Although they were fed similar amounts of concentrate, cows responded differently in terms of ruminal pH during the SARA feeding challenge. Cows were therefore classified as responders (n = 4) and nonresponders (n = 4): only responders met the SARA criterion of a ruminal pH drop below 5.8 for longer than 330 min/d. Data showed that Proteobacteria, Firmicutes, and Bacteroidetes were the most abundant phyla, and at genus level, Campylobacter and Kingella showed highest relative abundance, at 15.5 and 7.8%, respectively. Diversity analyses revealed a significant increase of diversity after the 1-wk adaptation but a decrease of diversity and species richness after the 4-wk SARA feeding challenge, although without distinction between responders and nonresponders. At the level of the operational taxonomic unit, we detected diet-specific shifts in epimural community structure, but in the overall epimural bacterial community structure, we found no differences between responders and nonresponders. Correlation analysis revealed significant associations between grain intake and operational taxonomic unit abundance. The study revealed major shifts in the 3 dominating phyla and, most importantly, a loss of diversity in the epimural bacterial communities during a long-term SARA diet challenge, in which 60% concentrate supply for 4 wk was instrumental rather than the magnitude of the drop of ruminal pH below 5.8.
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Affiliation(s)
- S U Wetzels
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Institute for Milk Hygiene, Milk Technology and Food Science, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Research Cluster, Animal Gut Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - E Mann
- Institute for Milk Hygiene, Milk Technology and Food Science, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Research Cluster, Animal Gut Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - P Pourazad
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - M Qumar
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - B Pinior
- Institute for Veterinary Public Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - B U Metzler-Zebeli
- Research Cluster, Animal Gut Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; University Clinic for Swine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - M Wagner
- Institute for Milk Hygiene, Milk Technology and Food Science, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Research Cluster, Animal Gut Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - S Schmitz-Esser
- Institute for Milk Hygiene, Milk Technology and Food Science, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Research Cluster, Animal Gut Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Q Zebeli
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Research Cluster, Animal Gut Health, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria.
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Piskorz A, Lin K, Morris J, Mann E, Oza A, Coleman R, O'Malley D, Friedlander M, Cragun J, Ma L, Giordano H, Raponi M, McNeish I, Swisher E, Brenton J. Feasibility of monitoring response to the PARP inhibitor rucaparib with targeted deep sequencing of circulating tumor DNA (ctDNA) in women with high grade ovarian carcinoma on the ARIEL2 trial. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32966-5] [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: 11/16/2022]
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Phelan R, Mann E, Napurski C, DeFor TE, Petryk A, Miller WP, Wagner JE, Verneris MR, Smith AR. Ovarian function after hematopoietic cell transplantation: a descriptive study following the use of GnRH agonists for myeloablative conditioning and observation only for reduced-intensity conditioning. Bone Marrow Transplant 2016; 51:1369-1375. [PMID: 27272448 DOI: 10.1038/bmt.2016.150] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 12/11/2022]
Abstract
Gonadal failure is a health and quality-of-life concern in hematopoietic cell transplant (HCT) survivors. While ovarian dysfunction is nearly universal following myeloablative (MA) conditioning, the risk is unclear after reduced-intensity conditioning (RIC). Gonadotropin-releasing hormone agonists decrease ovarian failure rates following conventional chemotherapy, but little is known about its effectiveness with HCT. We investigated the impact of leuprolide on ovarian function after MA conditioning and monitored ovarian function after RIC in this descriptive pilot study. Post-menarchal females <50 years undergoing HCT with adequate baseline ovarian function (follicle-stimulating hormone (FSH) level <40 mIU/mL and normal menstruation) were eligible. Prior to MA conditioning, leuprolide was administered. Those undergoing RIC were observed. FSH was measured at various time points. Seventeen women aged 12-45 years were evaluated (7 in the intervention group and 10 in the observation group). Compared to the historical high rate of ovarian failure after MA conditioning, 3 of 7 evaluable Lupron recipients had ovarian failure at a median of 703 days post transplant. Ovarian failure occurred in 1 of 10 recipients of RIC at a median follow-up of 901 days. In conclusion, leuprolide may protect ovarian function after MA conditioning. Additionally, RIC with cyclophosphamide, fludarabine and low-dose TBI has a low risk of ovarian failure.
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Affiliation(s)
- R Phelan
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - E Mann
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - C Napurski
- Cancer Survivorship Program, University of Minnesota, Minneapolis, MN, USA
| | - T E DeFor
- BMT Research Program, University of Minnesota, Minneapolis, MN, USA
| | - A Petryk
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - W P Miller
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - J E Wagner
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - M R Verneris
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - A R Smith
- Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Mann E, Reimer T, Gerber B. Akute Schwangerschaftsfettleber. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566673] [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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16
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Burton R, Tomek J, Aslam S, Bilton S, Larsen H, Sharkey A, Stephens G, Mann E, Paterson D, Bub G. Sympathetic stellate neurons increases cardiac conduction velocity and alters wave patterns in a myocyte-neuron co-culture model system. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.062] [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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17
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Mann E, Dzieciol M, Pinior B, Neubauer V, Metzler-Zebeli BU, Wagner M, Schmitz-Esser S. High diversity of viable bacteria isolated from lymph nodes of slaughter pigs and its possible impacts for food safety. J Appl Microbiol 2015; 119:1420-32. [PMID: 26283649 DOI: 10.1111/jam.12933] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/17/2015] [Accepted: 08/02/2015] [Indexed: 12/15/2022]
Abstract
AIMS Ileocaecal lymph nodes (ICLNs) of pigs, the key immune inductive site for bacterial systemic invasion, were examined in this study with emphasis on viable and cultivable bacteria. METHODS AND RESULTS Asymptomatic and pathologically altered ICLNs of slaughter pigs (n = 16) with hyperplasia, purulence or granulomatous formations were aerobically and anaerobically cultivated. In total, 209 isolates were collected and the near full-length 16S rRNA gene from each isolate was sequenced. Taxonomic classification revealed that 68% of the isolates belonged to Proteobacteria, 27% to Firmicutes and 5% to Actinobacteria. Purulent and granulomatous ICLNs generally tended to contain more Proteobacteria than asymptomatic and enlarged ICLNs (P = 0·061). The isolates could be assigned to 25 species belonging to 17 genera including Escherichia, Carnobacterium, Lactobacillus, Staphylococcus and Acinetobacter. Furthermore, pathogens such as Streptococcus suis and Salmonella enterica were detected. The most abundant isolate (57%) was most similar (>99%) to Escherichia coli. Random amplified polymorphic DNA (RAPD) profiling revealed a high genetic diversity among E. coli isolates and 24% of these isolates were positive for at least one gene associated with enterohemorrhagic disease (eae, fliC, stx1 or hlyA). Compared with a recently published DNA-based high-throughput sequencing data set including the same ICLNs, 4% of species detected were cultivable. CONCLUSIONS The presence of viable, commensal and pathogenic bacterial phylotypes could be proven in ICLNs with Proteobacteria being dominant. SIGNIFICANCE AND IMPACT OF THE STUDY This is the first study that broadly characterizes viable bacteria from ICLNs of pigs. The presence of bacteria in lymph nodes of farm animals has practical relevance for host colonization and possible chronic infection. It is also of great interest for basic research investigating translocation of bacteria from the gastrointestinal tract to ICLNs.
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Affiliation(s)
- E Mann
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, Austria.,Department for Farm Animals and Veterinary Public Health, Research Cluster 'Animal Gut Health', University of Veterinary Medicine, Vienna, Austria
| | - M Dzieciol
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, Austria
| | - B Pinior
- Department for Farm Animals and Veterinary Public Health, Institute for Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | - V Neubauer
- Department for Farm Animals and Veterinary Public Health, Research Cluster 'Animal Gut Health', University of Veterinary Medicine, Vienna, Austria.,Department for Farm Animals and Veterinary Public Health, Institute of Animal Nutrition and Functional Plant Compounds, University of Veterinary Medicine, Vienna, Austria
| | - B U Metzler-Zebeli
- Department for Farm Animals and Veterinary Public Health, Research Cluster 'Animal Gut Health', University of Veterinary Medicine, Vienna, Austria.,University Clinic for Swine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | - M Wagner
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, Austria.,Department for Farm Animals and Veterinary Public Health, Research Cluster 'Animal Gut Health', University of Veterinary Medicine, Vienna, Austria
| | - S Schmitz-Esser
- Department for Farm Animals and Veterinary Public Health, Institute of Milk Hygiene, Milk Technology and Food Science, University of Veterinary Medicine, Vienna, Austria.,Department for Farm Animals and Veterinary Public Health, Research Cluster 'Animal Gut Health', University of Veterinary Medicine, Vienna, Austria
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Perkins J, Voore N, Sanna S, Patel J, Mann E, Gozu A. 363 Assessment of an Emergency Department Chest Pain Patient Cohort at Low Risk for Significant Adverse Events During Admission for Acute Coronary Syndrome. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.399] [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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19
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Wetzels SU, Mann E, Metzler-Zebeli BU, Wagner M, Klevenhusen F, Zebeli Q, Schmitz-Esser S. Pyrosequencing reveals shifts in the bacterial epimural community relative to dietary concentrate amount in goats. J Dairy Sci 2015; 98:5572-87. [PMID: 26051320 DOI: 10.3168/jds.2014-9166] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/19/2015] [Indexed: 12/26/2022]
Abstract
Ecological balance in the rumen is highly sensitive to concentrate-rich diets. Yet the effects of these feeding practices on the caprine bacterial epimural microbiome (CBEM), a microbial community with putative important physiological functions in the rumen, are largely unexplored. This study aimed to investigate the effect of dietary concentrate amount on ruminal CBEM. Seventeen growing goats were fed diets with 0 [n=5; 6.2MJ of metabolizable energy (ME)/d], 30 (n=6; 7.3MJ of /d), or 60% (n=6; 10.2MJ of ME/d) concentrate for 6 wk. Two hours after their last feeding, goats were euthanized and tissue samples of the ventral rumen wall were collected, washed in phosphate-buffered saline to detach loosely attached bacteria, and stored at -20°C for further processing. Genomic DNA was isolated from thawed rumen mucosa samples and used for Roche/454 Life Science (Branford, CT) 16S rRNA gene amplicon pyrosequencing yielding 122,458 reads. Pyrosequencing data were clustered into 1,879 operational taxonomic units (OTU; 0.03 distance level). Pyrosequencing revealed Proteobacteria, Bacteroidetes, Firmicutes, and Spirochaetes as the most abundant phyla (97.7%). Compared with the 30% group, both the 60 and 0% concentrate groups harbored significantly more Firmicutes and SR1, respectively. On an OTU level, a Bergeriella-related OTU was most abundant in the CBEM, followed by 2 Campylobacter OTU, which responded differently to diets: 1 OTU was significantly increased whereas the other significantly decreased with highest concentrate amount in the diet. At the genus level, the 0% concentrate group harbored increased Kingella-like sequences compared with the other feeding groups. Furthermore, the 0% concentrate group tended to have more Bergeriella than the 30 and 60% concentrate groups. The genus Bergeriella was significantly decreased in the 60% feeding group compared with the other diets. In conclusion, this is the first report of CBEM using deep-sequencing methods on the genus and OTU level, and our study revealed major shifts in the CBEM in response to concentrate-rich diets with potential health relevance in goats.
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Affiliation(s)
- S U Wetzels
- Institute of Animal Nutrition and Functional Plant Compounds, 1210 Vienna, Austria; Institute for Milk Hygiene, Milk Technology and Food Science, 1210 Vienna, Austria; Research Cluster Animal Gut Health, 1210 Vienna, Austria
| | - E Mann
- Institute for Milk Hygiene, Milk Technology and Food Science, 1210 Vienna, Austria; Research Cluster Animal Gut Health, 1210 Vienna, Austria
| | - B U Metzler-Zebeli
- Research Cluster Animal Gut Health, 1210 Vienna, Austria; University Clinic for Swine, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - M Wagner
- Institute for Milk Hygiene, Milk Technology and Food Science, 1210 Vienna, Austria; Research Cluster Animal Gut Health, 1210 Vienna, Austria
| | - F Klevenhusen
- Institute of Animal Nutrition and Functional Plant Compounds, 1210 Vienna, Austria; Research Cluster Animal Gut Health, 1210 Vienna, Austria
| | - Q Zebeli
- Institute of Animal Nutrition and Functional Plant Compounds, 1210 Vienna, Austria; Research Cluster Animal Gut Health, 1210 Vienna, Austria
| | - S Schmitz-Esser
- Institute for Milk Hygiene, Milk Technology and Food Science, 1210 Vienna, Austria; Research Cluster Animal Gut Health, 1210 Vienna, Austria.
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Amole C, Ardid M, Asner DM, Baxter D, Behnke E, Bhattacharjee P, Borsodi H, Bou-Cabo M, Brice SJ, Broemmelsiek D, Clark K, Collar JI, Cooper PS, Crisler M, Dahl CE, Das M, Debris F, Dhungana N, Farine J, Felis I, Filgas R, Fines-Neuschild M, Girard F, Giroux G, Hai M, Hall J, Harris O, Jackson CM, Jin M, Krauss C, Lafrenière M, Laurin M, Lawson I, Levine I, Lippincott WH, Mann E, Martin JP, Maurya D, Mitra P, Neilson R, Noble AJ, Plante A, Podviyanuk R, Priya S, Robinson AE, Ruschman M, Scallon O, Seth S, Sonnenschein A, Starinski N, Štekl I, Vázquez-Jáuregui E, Wells J, Wichoski U, Zacek V, Zhang J. PICASSO, COUPP and PICO - search for dark matter with bubble chambers. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20159504020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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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Ho T, Pfeffer P, Mann E, Kelly F, Matthews N, Hawrylowicz C. S48 Air Pollution Particulate Matter Promotes Dc Maturation And Enhances Their Stimulation Of Cd8 Lymphocyte Responses. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.54] [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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Mann E, Haastert B, Frühwald T, Sauermann R, Hinteregger M, Hölzl D, Keuerleber S, Scheuringer M, Meyer G. Potentially inappropriate medication in older persons in Austria: A nationwide prevalence study. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.06.035] [Citation(s) in RCA: 5] [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: 11/25/2022]
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Swisher E, Brenton J, Kaufmann S, Oza A, Coleman R, O'Malley D, Konecny G, Ma L, Harrell M, Visscher D, Hendrickson A, Lin K, Raponi M, Mann E, Giordano H, Maloney L, Rolfe L, McNeish I. 215 Updated clinical and preliminary correlative results of ARIEL2, a Phase 2 study to identify ovarian cancer patients likely to respond to rucaparib. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70341-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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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Johansson T, Fritsch G, Flamm M, Hansbauer B, Bachofner N, Mann E, Bock M, Sönnichsen AC. Effectiveness of non-cardiac preoperative testing in non-cardiac elective surgery: a systematic review. Br J Anaesth 2013; 110:926-39. [PMID: 23578861 DOI: 10.1093/bja/aet071] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [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: 02/07/2023] Open
Abstract
Elective surgery is usually preceded by preoperative diagnostics to minimize risk. The results are assumed to elicit preventive measures or even cancellation of surgery. Moreover, physicians perform preoperative tests as a baseline to detect subsequent changes. This systematic review aims to explore whether preoperative testing leads to changes in management or reduces perioperative mortality or morbidity in unselected patients undergoing elective, non-cardiac surgery. We systematically searched all relevant databases from January 2001 to February 2011 for studies investigating the relationship between preoperative diagnostics and perioperative outcome. Our methodology was based on the manual of the Ludwig Boltzmann Institute for Health Technology Assessment, the Scottish Intercollegiate Guidelines Network (SIGN) handbook, and the PRISMA statement for reporting systematic reviews. One hundred and one of the 25 281 publications retrieved met our inclusion criteria. Three test grid studies used a randomized controlled design and 98 studies used an observational design. The test grid studies show that in cataract surgery and ambulatory surgery, there are no significant differences between patients with indicated preoperative testing and no testing regarding perioperative outcome. The observational studies do not provide valid evidence that preoperative testing is beneficial in healthy adults undergoing non-cardiac surgery. There is no evidence derived from high-quality studies that supports routine preoperative testing in healthy adults undergoing non-cardiac surgery. Testing according to pathological findings in a patient's medical history or physical examination seems justified, although the evidence is scarce. High-quality studies, especially large randomized controlled trials, are needed to explore the effectiveness of indicated preoperative testing.
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Affiliation(s)
- T Johansson
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
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Barinoff J, Hils R, Bender A, Groß J, Kurz C, Tauchert S, Mann E, Schwidde I, Ipsen B, Sawitzki K, Heitz F, Harter P, Traut A, du Bois A. Clinicopathological differences between breast cancer in patients with primary metastatic disease and those without: a multicentre study. Eur J Cancer 2012; 49:305-11. [PMID: 22940292 DOI: 10.1016/j.ejca.2012.07.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 07/17/2012] [Accepted: 07/26/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Approximately 6% of breast cancer (BC) patients present with primary metastatic disease (pmBC) at first diagnosis. The clinicopathological differences between tumours from patients who have metastatic disease and those who do not are unclear. METHODS This study was an exploratory analysis of patients with pmBC treated in 8 German breast cancer centres between 1998 and 2010. Phenotypes were defined using the following immunohistochemical markers: oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2). The control arm included the group of patients who had neither local recurrence nor distant metastases at a follow-up of at least 30 months after initial diagnosis. RESULTS A total of 2214 patients were included. Of these, 1642 had non metastatic BC, and 572 had pmBC. Eighty-five patients (15%) with pmBC were diagnosed at stage T1. On multivariate analysis, factors associated with pmBC were as follows: positive lymph node status, grade 3, lobular histology and Luminal B phenotype (Her 2 positive). Of the sample, 197 patients (34%) with pmBC were diagnosed as stage T2, 90 patients (16%) were diagnosed as stage T3, and 200 patients (35%) were diagnosed as stage T4. Only positive lymph node status and grade 3 were reported as risk factors for distant metastases in patients with stage T3 and T4 cancer. CONCLUSION There are differences in the clinicopathological features among breast cancer patients with primary metastases and those without. Receptor expression and histological type play a minor role in the risk for metastasis in patients with stage T3 and T4 disease when compared to patients with T1 pmBC tumours. On initial diagnosis, lobular histology and Luminal B positivity (Her 2 positive) in T1 pmBC were determined to be risk factors for primary metastatic disease.
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Mann E, Singer D, Pitkin J, Panay N, Hunter M. 139 PSYCHOSOCIAL ADJUSTMENT IN WOMENWITH PREMATURE MENOPAUSE: A CROSS-SECTIONAL SURVEY. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70250-5] [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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Mann E, Singer D, Pitkin J, Panay N, Hunter MS. Psychosocial adjustment in women with premature menopause: a cross-sectional survey. Climacteric 2012; 15:481-9. [DOI: 10.3109/13697137.2011.647841] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Barinoff J, Hils R, Bender A, Gross J, Kurz C, Tauchert S, Mann E, Schwidde I, Ipsen B, Sawitzki K, Heitz F, Harter P, Traut A, du BA. P4-10-07: Clinico-Pathologic Features of Breast Cancer Patients with Primary Metastatic Disease Versus Localized Disease: A Multicenter Study. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-10-07] [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
Objective: Approximately 6% of breast cancer patients present with primary metastatic disease (pmBC) at first diagnosis. Clinicopathological differences to non-metastatic patients are undetermined.
Methods: Exploratory analysis of patients with pmBC treated in 8 breast cancer units between 1998 and 2010. Tumor characteristics of these patients were compared with non-metastatic breast cancer patients (BC) of one breast cancer center who had neither local-recurrence nor distant metastases during 30 months of follow-up after first diagnosis. Standard staging in patients with first diagnosis of BC included chest X-ray, abdominal ultrasonography and bone scan. Molecular subtypes were analyzed and defined by immunohistochemical markers (ER, PR, Her2-receptor).
Results: 2.214 patients were included, 1.642 with BC and 572 with pmBC, respectively. Patients with pmBC were 7 years older (BC 58 years of age vs. pmBC 65 years; p=0.000) and were more likely to be postmenopausal (74% vs. 83%; p=0.000). Most common localizations of distant first metastases were bone (61,5%), liver (24%), lung (21%) and non-axillary lymph nodes (12%).
85 (15%) patients with pmBC were diagnosed in stage T1. Factors associated with pmBC in multivariate analysis for this group were positive lymph node status (OR 3.4; 95%CI 2.3−6.0; p=0.000), grading 3 (OR 2.3; 95%CI 1.3−4.0; p=0.003), lobular histology (OR 2.3; 95%CI 1.2−4.5; p=0,010) and phenotype Luminal B (OR 2.4; 95%CI 1.25−5.0; p=0.014). 197 (34%) patients with pmBC were diagnosed in stage T2; positive lymph node status (OR 4.8; 95%CI 1.1−3.0; p=0.017) and grading 3 (OR 1.6; 95% CI 1.6−2.3; p=0.019) were reported as risk factors for this group. 90 (16%) and 200 (35%) patients were diagnosed with stages T3 and T4, respectively. In T3/4 tumors a positive lymph node status (OR 5.2; 95% CI 2.9−9.3; p=0.000) and grading 3 (OR 2.2; 95%CI 1.2−3.9; p=0.009) could be defined as significant risk factors for distant metastases. Postmenopausal status was associated with primary metastases in stage T2 (OR 1.8; 95%CI 1.2−2.9; p=0.008) and T3/4 (OR 2.4; 95%CI 1.2−4.7; p=0.011) but not in T1 tumors (OR 1.3; 95%CI 0.7−2.1; p=0.420). There was no association with hormone or Her2 receptor status nor with a specific phenotype for T2-4 tumors.
Conclusion: The clinico-pathological features of breast cancer patients with or without primary metastases differ. In all stages positive lymph node status and higher grading were associated with pmBC significantly. Lobular histology was reported as a risk factor for T1-2 compared to patients without metastases. This feature was not found for T3/4 pmBC. T1 pmBC were likely to be associated with luminal B phenotype. T3-4 pmBC have not been associated with any phenotype or hormone receptor constellation as risk factor for metastases. Tumor biology seems to play a minor role for risk of metastases in T3-4 stages compared to patients with T1-tumors. Findings from this analysis should be considered in the choice of staging methods, especially in stage T1.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-10-07.
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Affiliation(s)
- J Barinoff
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - R Hils
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - A Bender
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - J Gross
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - C Kurz
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - S Tauchert
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - E Mann
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - I Schwidde
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - B Ipsen
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - K Sawitzki
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - F Heitz
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - P Harter
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - A Traut
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
| | - Bois A du
- 1Kliniken Essen Mitte, Essen, Germany; Dr.-Horst-Schmidt-Klinik, Wiesbaden, Germany; Asklepios Klinik, Lich, Germany; Sankt Gertrauden-Krankenhaus, Berlin-Wilmersdorf, Germany; Klinikum Esslingen, Esslingen am Neckar, Germany; Caritsklinik St. Theresia, Saarbrücken, Germany; Universitätsklinikum Gieβen und Marburg, Standort Marburg, Marburg, Germany; Klinikum Frankfurt Höchst, Frankfurt am Main, Germany; Evangelisches Krankenhaus Wesel, Wesel, Germany
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Mann E, Hagen K, Gerber B. Die vaginale Entbindungsrate und das fetale Outcome in Abhängigkeit von der Länge der Austreibungsperiode (AP). Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293334] [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: 10/15/2022]
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Kellar I, Mann E, Kinmonth A, Prevost A, Sutton S, Marteau T. Can informed choice invitations lead to inequities in intentions to make lifestyle changes among participants in a primary care diabetes screening programme? Evidence from a randomized trial. Public Health 2011; 125:645-52. [DOI: 10.1016/j.puhe.2011.05.010] [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] [Received: 05/25/2010] [Revised: 02/28/2011] [Accepted: 05/26/2011] [Indexed: 11/28/2022]
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Hasmann S, Hampel O, Schaadt AK, Böhm R, Engler-Plörer S, Mundt D, Mann E, Scherbarth-Roschmann P, Walter A, Ewers D, Melder L, Holl R, Petermann F, Hasmann R. Psychosoziale Aspekte bei motorischen Behinderungen. Monatsschr Kinderheilkd 2010. [DOI: 10.1007/s00112-009-2123-6] [Citation(s) in RCA: 8] [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: 11/28/2022]
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Kiezebrink K, Campbell D, Mann E, Blundell J. Similarities and differences between excessive exercising anorexia nervosa patients compared with DSM-IV defined anorexia nervosa subtypes. Eat Weight Disord 2009; 14:e199-204. [PMID: 20179406 DOI: 10.1007/bf03325117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
This study describes anorexia nervosa (AN) patients who use excessive exercise for weight management and how this behaviour relates to the classical Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) sub-grouping of AN. The study compared 428 clinical AN patients with 119 age and gender-matched controls. The AN cases were initially dichotomised according to DSM-IV subtype criteria into restricting (RAN; N=198) and binge-purge (BPAN; N=230) anorexia. The psychometric instruments were chosen to reflect key features concerning the diagnosis of eating disorders and characteristics of eating and food behaviour and included the 26-item Eating Attitude Test (EAT-26), Three Factor Eating Questionnaire (TFEQ), Dutch Eating Behaviour Questionnaire (DEBQ), Eysenck Personality Inventory (EPI) and Rosenberg Self-Esteem scale (RSE). Structured clinical interviews (1) were carried out in order to identify the subgroup of patients who use excessive exercise in order to facilitate weight control (EAN). The three groups (RAN, BPAN, EAN) did not differ in measures of current age, current body mass index, age of onset of AN and measures of restrained eating. However, significant differences were observed on EAT-26, DEBQ emotional and external factors, TFEQ disinhibition and hunger factors, EPI extraversion and neuroticism, and self-esteem. The EAN were similar to the RAN on the majority of variables but showed significant differences on extraversion, neuroticism, self-esteem and disease pathology (EAT-26). Compared with BPAN, EAN had lower disease pathology (EAT-26 scores), scored higher on the EPI extraversion scale, lower on the neuroticism scale and had greater self-esteem. The EAN also displayed significantly lower emotional and external eating (DEBQ) than BPAN and significantly lower disinhibition and hunger scores (TFEQ). These data suggest that EAN group display a mixed profile of characteristics resembling both BPAN and RAN. When EAN are defined as a separate group they appear to be phenotypically more similar to RAN than BPAN on this particular profile of variables. However when DSM-IV criteria are applied they are almost exclusively classified as BPAN. This outcome suggests that EAN do constitute an identifiable group that can be distinguished from RAN and BPAN. Consequently it is likely that the behaviour of excessive exercising should be considered as clinically relevant on the outcome of treatment.
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Affiliation(s)
- K Kiezebrink
- University of Abertary Dundee, School of Contemporary Sciences, Dundee DD1 1HG, UK.
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Schild RL, Plath H, Hofstaetter C, Brenner R, Mann E, Mundegar RR, Steinbach P, Hansmann M. Polyhydramnios: an association with congenital myotonic dystrophy. J OBSTET GYNAECOL 2009; 18:484-5. [PMID: 15512152 DOI: 10.1080/01443619866877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- R L Schild
- Department of Perinatal Diagnosis and Therapy, University Hospital, Bonn, Germany
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González C, Mann E, Miller E. A propósito de la displasia renal multiquística segmentaria. Radiología 2008; 50:443-4. [DOI: 10.1016/s0033-8338(08)76066-1] [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: 11/15/2022]
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Dieterich M, Mann E, Gerber B. Anaphylaktischer Schock nach Zervixreifung mit Dinoproston 0,5mg bei einer 28-jährigen 1. Gravida. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1088930] [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: 10/19/2022] Open
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Abstract
INTRODUCTION Osteoporosis associated proximal femoral fracture is a major public health problem. Diagnostic assessment includes patients history, laboratory testings and bone mineral density measurements. Hereby, dual X-ray absorptiometry (DXA) is regarded as the "Goldstandard". Quantitative ultrasonometry (QUS) of bone is a safe, simple, free of radiation, portable, cost-effective and therefore powerful diagnostic tool. QUS should be taken in account for primary assessment in patients with supposed osteoporosis in clinical practice. AIM OF THE STUDY We performed this cross sectional pilot study to evaluate the ability of two different QUS-devices (os calcis) in comparison to DXA (lumbar spine and femoral neck) to discriminate postmenopausal women with proximal femoral fractures from healthy, age- and BMI-matched controls. PATIENTS AND METHODS All together, 44 postmenopausal women were included. Of these, 22 suffered a proximal femoral fracture and were compared with 22 healthy, age- and BMI-matched controls. Bone assessments were performed by DXA (femoral neck and lumbar spine) and QUS of the heel using Achilles and Insight. RESULTS T- and Z-Score of DXA (femoral neck) were significantly lower in women with hip fracture compared to controls (p < 0.008 and p < 0.01). QUS-Insight also revealed significantly lower values of T- and Z-Score in women with hip fracture compared to controls (p < 0.01 and p < 0.005). QUS-Achilles measurement results also comprised significant differences between the groups (T-Score und Z-Score: p < 0.02). In accordance to the T-Score (femoral neck), all three devices (DXA femoral neck, Achilles and Insight) showed an equal significant correlation (p < 0.001). The correlation in between both QUS-devices was higher (0.956; p < 0.0001) than in between DXA-results (femoral neck vs. lumbar spine, 0.577; p < 0.01). The Z-Score also showed a significant correlation. DXA (lumbar spine) didn't show any significant differences in T- and Z-Score. CONCLUSION In comparison to the gold standard DXA (femoral neck), both QUS-devices showed an equal ability to significantly discriminate postmenopausal women with proximal femoral fractures from healthy, age- and BMI-matched controls. If our results are confirmed by more cross-sectional and longitudinal studies, QUS could be a helpful and valuable technique in clinical practice. Finally, all patients with osteoporosis-related fractures should be thoroughly investigated during their hospitalisation and effective treatment must be instituted.
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Affiliation(s)
- M Schnabel
- Klinik für Unfall-, Wiederherstellungs- und Handchirurgie der Philipps-Universität Marburg.
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Abstract
Renal biopsies studied by light and electron microscopy as well as by immunohistochemistry seem to be continually necessary for an adequate typing and therapy of glomerulonephritis (GN) and other glomerular diseases. Basing on 653 renal biopsies examined in Rostock from 1990 to 1999, the morphological classification in a total of 585 cases with glomerular diseases is presented in comparison to their clinical syndromes according to the WHO classification. A nephrotic syndrome was most frequent and clinically reported in 258 of the 585 biopsy cases with glomerular diseases (44%). It was seen in 77 of the 87 cases with minimal change nephropathy (55%), in 46 of the 74 cases with focal segmental glomerulosclerosis (62%), and in 19 of the 24 diffuse membranous GN cases (79%). The majority of the varying histological subtypes of diffuse GN was not combined with a specific clinical syndrome except of diffuse crescentic GN presenting with a rapidly progressive nephritic syndrome in 14 of 16 cases (88%). IgA nephropathy was the most often diagnosed entity of glomerular diseases found in 122 of the 502 cases with primary or secondary GN (24%). It is obvious that a given morphological GN type can but must not be combined with a specific clinical GN syndrome, so that the clinical importance of renal biopsy is stressed.
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Affiliation(s)
- H Nizze
- Institut für Pathologie der Universität Rostock.
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Abstract
There is compelling evidence that despite growing research into the complex neurophysiology of pain, the development of acute pain services, increasing educational interest in pain management and the proliferation of literature, many patients continue to suffer from unrelieved acute pain while in hospital. Educational efforts to bring about a change in practice have been relatively unsuccessful or slow to have real impact. Although it is still recognized that poor knowledge of pain control by all healthcare professionals is the major barrier to improving pain management, contemporary studies show that other, more subtle barriers can just as effectively inhibit a timely and effective response to patients' reports of pain. These barriers are not just the ones created by poor knowledge, myth and misconception; the most powerful barriers to change may be the invisible institutional barriers that can be entrenched within hospital policies and nursing rituals.
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Strawn LM, Kabbinavar F, Schwartz DP, Mann E, Shawver LK, Slamon DJ, Cherrington JM. Effects of SU101 in combination with cytotoxic agents on the growth of subcutaneous tumor xenografts. Clin Cancer Res 2000; 6:2931-40. [PMID: 10914743] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
SU101 (leflunomide, N-[4-(trifluoromethyl)-phenyl] 5-methylisoxazole-4-carboxamide), an inhibitor of platelet-derived growth factor receptor signaling, has shown promising clinical activity in Phase I and II studies. Currently, SU101 in combination with cytotoxic agents is in late-stage clinical development for the treatment of cancers. In previous reports, efficacy in vivo versus varied tumor xenografts was observed. As part of the preclinical development of SU101 as a cancer therapy, the combination of SU101 with cytotoxic agents was studied in athymic mice bearing small, established, s.c. human tumor cell xenografts of glioblastoma (SF763T cells), lung (Calu-6 cells), or head and neck (KB cells) origin. In the SF763T model, the combination of SU101 with carmustine resulted in a statistically significant growth inhibition of 74% compared with the vehicle control; this combination was more effective than either agent alone. In the Calu-6 model, the combination of SU101, cisplatin, and etoposide resulted in a growth inhibition of 75% that was statistically greater than that of the vehicle-treated control group and groups treated with one or two agents. In the KB model, the combination of SU101, 5-fluorouracil, and cisplatin resulted in a statistically significant growth inhibition of 69% compared with the vehicle control. Treatment with one or two agents did not significantly inhibit growth in this model. Importantly, in addition to enhanced efficacy resulting from combination therapies, the combination treatments tested were well tolerated, as evidenced by lack of mortality. These data suggest that SU101 in combination with cytotoxic agents may provide clinical benefit and warrant further clinical investigation.
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Affiliation(s)
- L M Strawn
- SUGEN, Inc., South San Francisco, California 94080, USA
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41
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Mann E. Using acupuncture and acupressure to treat postoperative emesis. Prof Nurse 1999; 14:691-4. [PMID: 10481718] [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: 02/13/2023]
Abstract
Interest in non-pharmacological strategies to manage health-care problems is increasing. Effective treatment for postoperative nausea and vomiting continues to be elusive, despite the introduction of new anti-emetic drugs. Acupuncture and acupressure might offer an effective, safe, simple and cheap therapy.
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Affiliation(s)
- E Mann
- Poole Hospital (NHS) Trust
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Adams KJ, Barnard KL, Swank AM, Mann E, Kushnick MR, Denny DM. Combined high-intensity strength and aerobic training in diverse phase II cardiac rehabilitation patients. J Cardiopulm Rehabil 1999; 19:209-15. [PMID: 10453427 DOI: 10.1097/00008483-199907000-00001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Developing adequate levels of muscular strength in the cardiac rehabilitation (CR) patient helps return the patient to an active lifestyle. This study evaluated the effects and safety of an 8-week high-intensity strength training (ST) program combined with a traditional aerobic-based CR program on the muscular strength of a diverse phase II CR population. METHODS Sixty-one phase II CR patients (age = 60.5 +/- 10.6 years) stratified by risk (high risk: n = 18, ejection fraction = 23.6 +/- 7.8%; intermediate risk: n = 19, ejection fraction = 40.0 +/- 4.6%; low risk: n = 24, ejection fraction = 58.0 +/- 7.7%) and gender (males = 46, females = 15) participated. One repetition maximum (1RM) testing was performed on the horizontal squat, shoulder press, leg extension, lat pulldown, and biceps curl. Patients performed two sets of each exercise 2 days per week at an intensity that started at 60% 1RM and progressed to 80% 1RM by week 4. Weeks 4 to 8 intensity was adjusted individually to maintain 8RM per set. Blood pressure and heart rate/rhythm responses to 1RM testing were monitored in high-risk patients. Muscle soreness and injury were monitored for all patients immediately after 1RM testing and on days 2 and 7. RESULTS All patient groups made significant gains (P < 0.05) in muscle strength (mean increase: lower body = 15.3%, upper body = 16.7%). No injury or significant muscle soreness occurred due to 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients. CONCLUSIONS Diverse phase II CR patients can improve their strength significantly with a combination of high-intensity strength and aerobic training.
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Affiliation(s)
- K J Adams
- Exercise Physiology Lab, Crawford Gym, University of Louisville, KY 40292, USA
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Odumeru JA, Steele M, Fruhner L, Larkin C, Jiang J, Mann E, McNab WB. Evaluation of accuracy and repeatability of identification of food-borne pathogens by automated bacterial identification systems. J Clin Microbiol 1999; 37:944-9. [PMID: 10074506 PMCID: PMC88629 DOI: 10.1128/jcm.37.4.944-949.1999] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The performances of five automated microbial identification systems, relative to that of a reference identification system, for their ability to accurately and repeatedly identify six common food-borne pathogens were assessed. The systems assessed were the MicroLog system (Biolog Inc., Hayward, Calif.), the Microbial Identification System (MIS; MIDI Inc., Newark, Del.), the VITEK system (bioMérieux Vitek, Hazelwood, Mo.), the MicroScan WalkAway 40 system (Dade-MicroScan International, West Sacramento, Calif.), and the Replianalyzer system (Oxoid Inc., Nepean, Ontario, Canada). The sensitivities and specificities of these systems for the identification of food-borne isolates of Bacillus cereus, Campylobacter jejuni, Listeria monocytogenes, Staphylococcus aureus, Salmonella spp., and verotoxigenic Escherichia coli were determined with 40 reference positive isolates and 40 reference negative isolates for each pathogen. The sensitivities of these systems for the identification of these pathogens ranged from 42.5 to 100%, and the specificities of these systems for the identification of these pathogens ranged from 32.5 to 100%. Some of the systems had difficulty correctly identifying the reference isolates when the results were compared to those from the reference identification tests. The sensitivity of MIS for the identification of S. aureus, B. cereus, E. coli, and C. jejuni, for example, ranged from 47.5 to 72. 5%. The sensitivity of the Microlog system for the identification of E. coli was 72.5%, and the sensitivity of the VITEK system for the identification of B. cereus was 42.5%. The specificities of four of the five systems for the identification of all of the species tested with the available databases were greater than or equal to 97.5%; the exception was MIS for the identification of C. jejuni, which displayed a specificity of 32.5% when it was tested with reference negative isolates including Campylobacter coli and other Campylobacter species. All systems had >80% sensitivities for the identification of Salmonella species and Listeria species at the genus level. The repeatability of these systems for the identification of test isolates ranged from 30 to 100%. Not all systems included all six pathogens in their databases; thus, some species could not be tested with all systems. The choice of automated microbial identification system for the identification of a food-borne pathogen would depend on the availability of identification libraries within the systems and the performance of the systems for the identification of the pathogen.
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Affiliation(s)
- J A Odumeru
- Laboratory Services Division, University of Guelph, Guelph, Ontario, Canada N1H 8J7.
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Schempp H, Denke A, Mann E, Schneider W, Elstner EF. Biochemical activities of extracts from Hypericum perforatum L. 3rd Communication: modulation of peroxidase activity as a simple method for standardization. Arzneimittelforschung 1999; 49:115-9. [PMID: 10083979 DOI: 10.1055/s-0031-1300370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Alcoholic extracts from the herb "St. John's wort" (Hypericum perforatum L.) are widely used to counteract depressive situations, where the question on the mainly active principle is still under discussion. Thus, standardization of the drug on the basis of dry matter has been chosen instead of the popular leading component, hypericin. Inhibition of myeloperoxidase-catalyzed dimerization of enkephalins by Hypericum extracts has recently been reported. This method is based on the separation and quantification of enkephalin dimers by HPLC. In order to simplify this assay myeloperoxidase could be substituted by the cheaper horseradish peroxidase and the enkephalins by the amino acid tyrosine without loss of significance. In this communication we represent a more rapid photometric method based on peroxidase-catalyzed indole acetic acid oxidation suitable for quick, simple and economic drug standardization.
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Affiliation(s)
- H Schempp
- Lehrstuhl für Phytopathologie, Labor für angewandte Biochemie, Technische Universität München, Freising-Weihenstephan, Germany
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Denke A, Schempp H, Mann E, Schneider W, Elstner EF. Biochemical activities of extracts from Hypericum perforatum L. 4th Communication: influence of different cultivation methods. Arzneimittelforschung 1999; 49:120-5. [PMID: 10083980 DOI: 10.1055/s-0031-1300371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Extracts from the herb "St. John's wort" (Hypericum perforatum L.), know since ancient times as medical plant, besides other activities such as wound healing, antighout, antirheumatic and diuretic properties, is used in the treatment of mild to moderate depression. Increasing application continuously makes cultivation under controlled conditions of Hypericum perforatum L. more important. This report shows the results of three-years cultivation experiments with Hypericum perforatum L. The findings indicate that N-fertilizing yields more plant material but results in a drug with less quantity of secondary metabolites. Important components of the drug were quantified by HPLC and their activities were analyzed with the aid of biochemical test systems. Narrowleaved and broadleaved varieties of Hypericum perforatum L. show differences both in activity and quality. In this experiments the most active extract was a methanolic extract derived from non-fertilized, broadleaved plants.
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Affiliation(s)
- A Denke
- Lehrstuhl für Phytopathologie, Labor für angewandte Biochemie, Technische Universität München, Freising-Weihenstephan, Germany
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Barnard KL, Adams KJ, Swank AM, Mann E, Denny DM. Injuries and muscle soreness during the one repetition maximum assessment in a cardiac rehabilitation population. J Cardiopulm Rehabil 1999; 19:52-8. [PMID: 10079421 DOI: 10.1097/00008483-199901000-00007] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Strength training (ST) may be beneficial for preservation of lean tissue, increasing bone mineral content, decreasing falls, and enhancing quality of life. Strength training is becoming an appropriate mode of exercise for cardiac rehabilitation (CR) patients. One method for determining optimal exercise intensity for safe and effective ST requires one repetition maximum (1RM) testing. Clinicians may be reluctant to perform 1RM testing in CR patients because of potential muscle soreness/injury and adverse hemodynamic responses in deconditioned patients. The purpose of this investigation was to perform 1RM testing in CR patients and determine muscle soreness/injury rate. METHODS Seventy-four CR patients stratified by risk (low n = 30, intermediate n = 21, high n = 23) and sex (males = 55, females = 19) participated. Subject's ages ranged from 39 to 76 years and time from procedure ranged from 19 days to 2 years. No patient had ever undergone 1RM testing. The method of Kraemer and Fry was used to assess 1RM. High-risk patients' heart rates/rhythms and blood pressures were monitored. Patients were evaluated for occurrence of muscle soreness/injury immediately after 1RM testing and on days 2 and 7 using a soreness scale developed by Shaw et al. Muscle soreness/injury was considered significant if a patient reported altering or stopping physical activities. RESULTS No injury or significant muscle soreness occurred as a result of 1RM testing. No abnormal heart rate/rhythm or blood pressure responses occurred in high-risk patients. CONCLUSIONS Results indicate that with proper technique, 1RM testing may be performed in CR patients without injury or significant muscle soreness.
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Affiliation(s)
- K L Barnard
- River Cities Cardiology Cardiac Rehabilitation Center, Jeffersonville, Indiana, USA
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Mann E. Epidural analgesia: have we got it right? Nurs Times 1998; 94:52-4. [PMID: 9752182] [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: 02/08/2023]
Abstract
Epidural infusions are being employed more frequently for postoperative and posttraumatic pain. This paper looks at the possible complications involved in the use of epidural analgesia. The evidence concerning possible causes of infection and abscess formation is discussed. The small amount of literature available suggests that the potential for infection is increased when ward-based staff are involved with changing epidural infusions. The potential benefits of ready-prepared solutions for epidural analgesia are considered.
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Affiliation(s)
- E Mann
- Poole Hospitals NHS Trust
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48
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Abstract
In vivo adsorption of salivary albumin and alpha-amylase onto titanium, enamel and dentin was analysed following their exposure to the oral cavity for 2h. Oral appliances in six adults served as a platform for carrying 4-mm discs of the three materials. Adherent proteins were eluted from the discs and the amounts of salivary albumin and alpha-amylase were measured by an enzyme-linked immunosorbent assay. While significant difference between the adsorption of albumin and alpha-amylase onto enamel as compared with dentin was observed, adsorption onto titanium was significantly lower. A sample of whole saliva was also collected from each participant. The mean total amounts of albumin and alpha-amylase in the participants' whole saliva were 0.03 and 0.54 mg ml-1, respectively. Titanium adsorbed significantly less (4.43%) of the total albumin than did enamel (14.30%) or dentin (18.80%). No significant difference was found in the relative amounts of alpha-amylase adsorbed by the three materials. This significantly selective adsorption of proteins may enable the attachment of specific bacteria and thus alter the composition of the dental plaque and its potential pathogenicity.
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Affiliation(s)
- D Kohavi
- Oral Implant Center, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel
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49
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Shawver LK, Schwartz DP, Mann E, Chen H, Tsai J, Chu L, Taylorson L, Longhi M, Meredith S, Germain L, Jacobs JS, Tang C, Ullrich A, Berens ME, Hersh E, McMahon G, Hirth KP, Powell TJ. Inhibition of platelet-derived growth factor-mediated signal transduction and tumor growth by N-[4-(trifluoromethyl)-phenyl]5-methylisoxazole-4-carboxamide. Clin Cancer Res 1997; 3:1167-77. [PMID: 9815796] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Many reports have cited coexpression of platelet-derived growth factor (PDGF) and its receptors by tumor cells or cells supporting tumor growth, suggesting both autocrine and paracrine mechanisms for PDGF-mediated tumor growth. We found that a small organic molecule, N-[4-(trifluoromethyl)phenyl] 5-methylisoxazole-4-carboxamide (SU101, leflunomide), inhibited PDGF-mediated signaling events, including receptor tyrosine phosphorylation, DNA synthesis, cell cycle progression, and cell proliferation. SU101 inhibited PDGF-stimulated tyrosine phosphorylation of PDGF receptor (PDGFR) beta in C6 (rat glioma) and NIH3T3 cells engineered to overexpress human PDGFRbeta (3T3-PDGFRbeta). SU101 blocked both PDGF- and epidermal growth factor (EGF)-stimulated DNA synthesis. Previously, this compound was shown to inhibit pyrimidine biosynthesis by interfering with the enzymatic activity of dihydroorotate dehydrogenase. In the current study, EGF-stimulated DNA synthesis was restored by the addition of saturating quantities of uridine, whereas PDGF-induced DNA synthesis was not, suggesting that the compound demonstrated some selectivity for the PDGFR pathway that was independent of pyrimidine biosynthesis. Selectivity was further demonstrated by the ability of the compound to block the entry of PDGF-stimulated cells into the S phase of the cell cycle, without affecting cell cycle progression of EGF-stimulated cells. In cell growth assays, SU101 selectively inhibited the growth of PDGFRbeta-expressing cell lines more efficiently than it inhibited the growth of PDGFRbeta-negative cell lines. SU101 inhibited the s.c., i.p., and intracerebral growth of a panel of cell lines including cells from glioma, ovarian, and prostate origin. In contrast, SU101 failed to inhibit the in vitro or s.c. growth of A431 and KB tumor cells, both of which express EGF receptor but not PDGFRbeta. SU101 also inhibited the growth of D1B and L1210 (murine leukemia) cells in syngeneic immunocompetent mice, without causing adverse effects on the immune response of the animals. In an i.p. model of tumor growth in syngeneic immunocompetent mice, SU101 prevented tumor growth and induced long-term survivors in animals implanted with 7TD1 (murine B-cell hybridoma) tumor cells. Because PDGFRbeta was detected on most of the tumor cell lines in which in vivo growth was inhibited by SU101, these data suggest that SU101 is an effective inhibitor of PDGF-driven tumor growth in vivo.
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Affiliation(s)
- L K Shawver
- SUGEN, Inc., Redwood City, California 94063, USA
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50
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Bidwell RJ, Mueller CW, Mann E, Mew S, Goo C, Dunbar H, McGrady G, Vera M, Liebow E, Lovely RH. Teen perspectives on HIV and the relevance of Hawaii's health providers. Hawaii Med J 1996; 55:205-11. [PMID: 8942118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Based on focus group interviews with adolescents from an urban Honolulu community, the present article describes how these adolescents view HIV, HIV-prevention and the role of health care providers in addressing HIV-related needs. Although medical providers are known to be knowledgeable experts in a variety of health care areas, other research points to an underutilization of this potential. While knowledgeable about HIV, many of the youth in this study continue to engage in risky behavior. Few perceive they have others they can meaningfully talk to about their HIV and other health concerns. Even when probed for, almost none of these teens saw health care providers as pertinent to HIV or their health beyond the traditional illness/prescription role. Suggestions for ways to get more involved in the prevention of HIV and, more generally, positive health development in teens are discussed.
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Affiliation(s)
- R J Bidwell
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu 96826, USA
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