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Nasrallah F, Bellapart J, Walsham J, Jacobson E, To XV, Manzanero S, Brown N, Meyer J, Stuart J, Evans T, Chandra SS, Ross J, Campbell L, Senthuran S, Newcombe V, McCullough J, Fleming J, Pollard C, Reade M. PREdiction and Diagnosis using Imaging and Clinical biomarkers Trial in Traumatic Brain Injury (PREDICT-TBI) study protocol: an observational, prospective, multicentre cohort study for the prediction of outcome in moderate-to-severe TBI. BMJ Open 2023; 13:e067740. [PMID: 37094888 PMCID: PMC10151972 DOI: 10.1136/bmjopen-2022-067740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is a heterogeneous condition with a broad spectrum of injury severity, pathophysiological processes and variable outcomes. For moderate-to-severe TBI survivors, recovery is often protracted and outcomes can range from total dependence to full recovery. Despite advances in medical treatment options, prognosis remains largely unchanged. The objective of this study is to develop a machine learning predictive model for neurological outcomes at 6 months in patients with a moderate-to-severe TBI, incorporating longitudinal clinical, multimodal neuroimaging and blood biomarker predictor variables. METHODS AND ANALYSIS A prospective, observational, cohort study will enrol 300 patients with moderate-to-severe TBI from seven Australian hospitals over 3 years. Candidate predictors including demographic and general health variables, and longitudinal clinical, neuroimaging (CT and MRI), blood biomarker and patient-reported outcome measures will be collected at multiple time points within the acute phase of injury. The predictor variables will populate novel machine learning models to predict the Glasgow Outcome Scale Extended 6 months after injury. The study will also expand on current prognostic models by including novel blood biomarkers (circulating cell-free DNA), and the results of quantitative neuroimaging such as Quantitative Susceptibility Mapping and Dynamic Contrast Enhanced MRI as predictor variables. ETHICS AND DISSEMINATION Ethical approval has been obtained by the Royal Brisbane and Women's Hospital Human Research Ethics Committee, Queensland. Participants or their substitute decision-maker/s will receive oral and written information about the study before providing written informed consent. Study findings will be disseminated by peer-review publications and presented at national and international conferences and clinical networks. TRIAL REGISTRATION NUMBER ACTRN12620001360909.
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Affiliation(s)
- Fatima Nasrallah
- The Queensland Brain Institute, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Judith Bellapart
- Intensive Care Unit, Royal Brisbane and Women's Hospital, Metro North Health Service District, Herston, Queensland, Australia
| | - James Walsham
- Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Esther Jacobson
- Jamieson Trauma Institute, Metro North Health Service District, Herston, Queensland, Australia
| | - Xuan Vinh To
- The Queensland Brain Institute, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Metro North Health Service District, Herston, Queensland, Australia
| | - Nathan Brown
- Intensive Care Unit, Royal Brisbane and Women's Hospital, Metro North Health Service District, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Jason Meyer
- Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Janine Stuart
- Intensive Care Unit, Royal Brisbane and Women's Hospital, Metro North Health Service District, Herston, Queensland, Australia
| | - Tracey Evans
- The Queensland Brain Institute, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Shekhar S Chandra
- School of Information Technology and Electrical Engineering, Architecture and Information Technology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Jason Ross
- Health and Biosecurity, CSIRO, Westmead, New South Wales, Australia
| | - Lewis Campbell
- Intensive Care Unit, Royal Darwin Hospital, Casuarina, Darwin, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Siva Senthuran
- Intensive Care Unit, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Virginia Newcombe
- University Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - James McCullough
- Intensive Care Unit, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Clifford Pollard
- School of Information Technology and Electrical Engineering, Architecture and Information Technology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Michael Reade
- Intensive Care Unit, Royal Brisbane and Women's Hospital, Metro North Health Service District, Herston, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
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Maller T, Perel N, Simonato M, Harari E, Tager S, Fink D, Jacobson E, Glikson M, Dvir D. Large multinational evaluation of time to reintervention in patients undergoing bioprosthetic valve implantation during open heart surgery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2151] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Bioprosthetic valves are increasingly utilized during open heart surgery in favor of mechanical valves. These tissue valves are prone for structural valve degeneration and failure, especially in young patients. Transcatheter aortic valve implantation (TAVI) is an appealing approach in these patients.
Purpose
To describe independent correlates for early need for reintervention.
Method
We used a large multicenter registry of patients (>45 years of age) with failed bioprosthetic surgical valves undergoing TAVI valve-in-valve (VinV) in either aortic or the mitral positions. Early reintervention was (<5 years between open-heart surgery and VinV). Multi-variable properties that were included: patient gender, age at open-heart surgery, valve size, baseline renal failure, position of valve implantation, and bioprosthetic valve label size.
Results
A total of 3,324 patients were included in the study (age at the time of open heart surgery 68.9+7.9 years). Median time to TAVI was 9 years (IQR 6–13 years). A total of 632 (19%) patients experienced early valve degeneration with median time to TAVI of only 3 years [IQR 1–5]. Patients with early degeneration were older than those without early degeneration (mean age at surgery was 72.8±9 years vs. 68.9±8 years; p<0.001). in addition, significant linear relation between older patient age and early valve degeneration (p for trend <0.001). Re-intervention in the mitral position was more common in the group of patients with early degeneration (24.4% vs 18.2% without early degeneration; p<0.001) Patient age and mitral valve position were independently associated with increased rate of early degeneration (OR 1.09 [1.08–1.11], p<0.001; OR 1.62 [1.31–2.01]; p<0.001 respectively).
Conclusions
In this large multicenter analysis of patients undergoing TAVR for failed bioprosthetic valves we identified old patient age and mitral valve (vs. aortic) as independent correlates for early intervention. A discrepancy with known association of young age and rapid bioprosthetic valve degeneration is to be determined.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Maller
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - N Perel
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - M Simonato
- Yale New Haven Hospital , New Haven , United States of America
| | - E Harari
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - S Tager
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - D Fink
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - E Jacobson
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - M Glikson
- Shaare Zedek Medical Center , Jerusalem , Israel
| | - D Dvir
- Shaare Zedek Medical Center , Jerusalem , Israel
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Valenzuela M, Duncan T, Abey A, Johnson A, Boulamatsis C, Dalton MA, Jacobson E, Brunel L, Child G, Simpson D, Buckland M, Lowe A, Siette J, Westbrook F, McGreevy P. Autologous skin-derived neural precursor cell therapy reverses canine Alzheimer dementia-like syndrome in a proof of concept veterinary trial. Stem Cell Res Ther 2022; 13:261. [PMID: 35715872 PMCID: PMC9205057 DOI: 10.1186/s13287-022-02933-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/30/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Older companion dogs naturally develop a dementia-like syndrome with biological, clinical and therapeutic similarities to Alzheimer disease (AD). Given there has been no new safe, clinically effective and widely accessible treatment for AD for almost 20 years, an all-new cell therapeutic approach was trialled in canine veterinary patients, and further modelled in aged rats for more detailed neurobiological analysis. METHODS A Phase 1/2A veterinary trial was conducted in N = 6 older companion dogs with definitive diagnosis of Canine Cognitive Dysfunction (CCD). Treatment comprised direct microinjection of 250,000 autologous skin-derived neuroprecursors (SKNs) into the bilateral hippocampus using MRI-guided stereotaxis. Safety was assessed clinically and efficacy using the validated Canine Cognitive Dysfunction Rating Scale (CCDR) at baseline and 3-month post treatment. Intention to treat analysis imputed a single patient that had a surgical adverse event requiring euthanasia. Three dog brains were donated following natural death and histology carried out to quantify Alzheimer pathology as well as immature neurons and synapses; these were compared to a brain bank (N = 12) of untreated aged dogs with and without CCD. Further, an age-related memory dysfunction rat model (N = 16) was used to more closely evaluate intrahippocampal engraftment of canine SKN cells, focusing on mnemonic and synaptic effects as well as donor cell survival, neurodifferentation and electrophysiologic circuit integration in a live hippocampal slice preparation. RESULTS Four out-of-five dogs improved on the primary clinical CCDR endpoint, three fell below diagnostic threshold, and remarkably, two underwent full syndromal reversal lasting up to 2 years. At post mortem, synaptic density in the hippocampus specifically was nine standard deviations above non-treated dogs, and intensity of new neurons also several fold higher. There was no impact on AD pathology or long-term safety signals. Modelling in aged rats replicated the main canine trial findings: hippocampally-dependent place memory deficits were reversed and synaptic depletion rescued. In addition, this model confirmed donor cell survival and migration throughout the hippocampus, neuronal differentiation in situ, and physiologically-correct integration into pyramidal layer circuits. CONCLUSIONS With further development, SKN cell therapy may have potential for treating carefully chosen AD patients based on neurosynaptic restoration in the hippocampus.
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Affiliation(s)
- Michael Valenzuela
- Skin2Neuron Pty Ltd, Sydney, Australia.
- University of New South Wales, Sydney, Australia.
| | - T Duncan
- University of New South Wales, Sydney, Australia
| | - A Abey
- University of Sydney, Sydney, Australia
| | - A Johnson
- Skin2Neuron Pty Ltd, Sydney, Australia
| | | | | | - E Jacobson
- Sydney Children's Hospital, Sydney, Australia
| | - L Brunel
- University of Sydney, Sydney, Australia
| | - G Child
- University of Sydney, Sydney, Australia
| | - D Simpson
- Animal Referral Hospital Homebush, Sydney, Australia
| | - M Buckland
- University of Sydney, Sydney, Australia
- Royal Prince Alfred Hospital, Sydney, Australia
| | - A Lowe
- University of New South Wales, Sydney, Australia
| | - J Siette
- Western Sydney University, Sydney, Australia
| | - F Westbrook
- University of New South Wales, Sydney, Australia
| | - P McGreevy
- University of New England, Armidale, Australia
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Jogia T, Lübstorf T, Jacobson E, Scriven E, Atresh S, Nguyen QH, Liebscher T, Schwab JM, Kopp MA, Walsham J, Campbell KE, Ruitenberg MJ. Prognostic value of early leukocyte fluctuations for recovery from traumatic spinal cord injury. Clin Transl Med 2021; 11:e272. [PMID: 33463065 PMCID: PMC7805435 DOI: 10.1002/ctm2.272] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute traumatic spinal cord injury (SCI) induces a systemic immune response involving circulating white blood cells (WBCs). How this response is influenced by overall trauma severity, the neurological level of injury and/or correlates with patient outcomes is poorly understood. The objective of this study was to identify relationships between early changes in circulating WBCs, injury characteristics and long-term patient outcomes in individuals with traumatic SCI. METHODS We retrospectively analysed data from 161 SCI patients admitted to Brisbane's Princess Alexandra Hospital (exploration cohort). Logistic regression models in conjunction with receiver operating characteristic (ROC) analyses were used to assess the strength of specific links between the WBC response, respiratory infection incidence and neurological outcomes (American Spinal Injury Association Impairment Scale (AIS) grade conversion). An independent validation cohort from the Trauma Hospital Berlin, Germany (n = 49) was then probed to assess the robustness of effects and disentangle centre effects. RESULTS We find that the extent of acute neutrophilia in human SCI patients is positively correlated with New Injury Severity Scores but inversely with the neurological outcome (AIS grade). Multivariate analysis demonstrated that acute SCI-induced neutrophilia is an independent predictor of AIS grade conversion failure, with an odds ratio (OR) of 4.16 and ROC area under curve (AUC) of 0.82 (P < 0.0001). SCI-induced lymphopenia was separately identified as an independent predictor of better recovery (OR = 24.15; ROC AUC = 0.85, P < 0.0001). Acute neutrophilia and increased neutrophil-lymphocyte ratios were otherwise significantly associated with respiratory infection presentation in both patient cohorts. CONCLUSIONS Our findings demonstrate the prognostic value of modelling early circulating neutrophil and lymphocyte counts with patient characteristics for predicting the longer term recovery after SCI.
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Affiliation(s)
- Trisha Jogia
- School of Biomedical SciencesFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Tom Lübstorf
- Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology)Department of Neurology and Experimental NeurologyCharité – Universitätsmedizin BerlinGermany
| | - Esther Jacobson
- School of Biomedical SciencesFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Elissa Scriven
- Trauma ServicePrincess Alexandra HospitalBrisbaneQueenslandAustralia
| | - Sridhar Atresh
- Spinal Injuries UnitPrincess Alexandra HospitalBrisbaneQueenslandAustralia
- Princess Alexandra Hospital – Southside Clinical SchoolFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Quan H. Nguyen
- Institute for Molecular BioscienceThe University of QueenslandBrisbaneQueenslandAustralia
| | - Thomas Liebscher
- Treatment Centre for Spinal Cord InjuriesTrauma Hospital BerlinGermany
| | - Jan M. Schwab
- Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology)Department of Neurology and Experimental NeurologyCharité – Universitätsmedizin BerlinGermany
- Belford Center for Spinal Cord InjuryThe Ohio State University, Wexner Medical CenterColumbusOhio
- Department of Neurology, Spinal Cord Injury DivisionThe Ohio State University, Wexner Medical CenterColumbusOhio
- Department of Physical Medicine and RehabilitationThe Ohio State University, Wexner Medical CenterColumbusOhio
- Department of NeuroscienceThe Ohio State University, Wexner Medical CenterColumbusOhio
- The Neuroscience InstituteThe Ohio State University, Wexner Medical CenterColumbusOhio
| | - Marcel A. Kopp
- Clinical and Experimental Spinal Cord Injury Research (Neuroparaplegiology)Department of Neurology and Experimental NeurologyCharité – Universitätsmedizin BerlinGermany
- QUEST – Center for Transforming Biomedical ResearchBerlin Institute of HealthBerlinGermany
| | - James Walsham
- Princess Alexandra Hospital – Southside Clinical SchoolFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Intensive Care UnitPrincess Alexandra HospitalBrisbaneQueenslandAustralia
| | - Kate E. Campbell
- Princess Alexandra Hospital – Southside Clinical SchoolFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Orthopaedic DepartmentPrincess Alexandra HospitalBrisbaneQueenslandAustralia
| | - Marc J. Ruitenberg
- School of Biomedical SciencesFaculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Trauma, Critical Care and RecoveryBrisbane Diamantina Health PartnersBrisbaneQueenslandAustralia
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Palermo J, Overbeek C, Dumont A, Jacobson E, El-Gabalwy R, Kavosh M, Saha T, Tanzola R, Dumertonshore D, Avidan M, Oberhaus J, Mickle A, Djaiani G, Deschamps A. Encephalography guidance of anesthesia to alleviate geriatric syndromes (Engages-Canada) study in cardiac surgery patients: a pragmatic, randomized clinical trial. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Brennan FH, Jogia T, Gillespie ER, Blomster LV, Li XX, Nowlan B, Williams GM, Jacobson E, Osborne GW, Meunier FA, Taylor SM, Campbell KE, MacDonald KP, Levesque JP, Woodruff TM, Ruitenberg MJ. Complement receptor C3aR1 controls neutrophil mobilization following spinal cord injury through physiological antagonism of CXCR2. JCI Insight 2019; 4:98254. [PMID: 31045582 DOI: 10.1172/jci.insight.98254] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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: 05/23/2018] [Accepted: 03/21/2019] [Indexed: 12/18/2022] Open
Abstract
Traumatic spinal cord injury (SCI) triggers an acute-phase response that leads to systemic inflammation and rapid mobilization of bone marrow (BM) neutrophils into the blood. These mobilized neutrophils then accumulate in visceral organs and the injured spinal cord where they cause inflammatory tissue damage. The receptor for complement activation product 3a, C3aR1, has been implicated in negatively regulating the BM neutrophil response to tissue injury. However, the mechanism via which C3aR1 controls BM neutrophil mobilization, and also its influence over SCI outcomes, are unknown. Here, we show that the C3a/C3aR1 axis exerts neuroprotection in SCI by acting as a physiological antagonist against neutrophil chemotactic signals. We show that C3aR1 engages phosphatase and tensin homolog (PTEN), a negative regulator of the phosphatidylinositol 3-kinase (PI3K)/AKT pathway, to restrain C-X-C chemokine receptor type 2-driven BM neutrophil mobilization following trauma. These findings are of direct clinical significance as lower circulating neutrophil numbers at presentation were identified as a marker for improved recovery in human SCI. Our work thus identifies C3aR1 and its downstream intermediary, PTEN, as therapeutic targets to broadly inhibit neutrophil mobilization/recruitment following tissue injury and reduce inflammatory pathology.
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Affiliation(s)
| | - Trisha Jogia
- School of Biomedical Sciences, Faculty of Medicine
| | | | | | - Xaria X Li
- School of Biomedical Sciences, Faculty of Medicine
| | - Bianca Nowlan
- Blood and Bone Diseases Program, Mater Research Institute
| | | | | | - Geoff W Osborne
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Frederic A Meunier
- Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | | | - Kate E Campbell
- Orthopaedic Department, Princess Alexandra Hospital, Brisbane, Australia.,Princess Alexandra Hospital - Southside Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Kelli Pa MacDonald
- Antigen Presentation and Immunoregulation Laboratory, QIMR Berghofer Medical Research Institute, Brisbane Australia
| | | | | | - Marc J Ruitenberg
- School of Biomedical Sciences, Faculty of Medicine.,Trauma, Critical Care and Recovery, Brisbane Diamantina Health Partners, Brisbane, Australia
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Jacobson E, Roth L, Sanders J, Turok D, Bullock H. Changes in IUD uptake with the availability of a low-cost levonorgestrel IUD — a retrospective review of Title X clinics. Contraception 2016. [DOI: 10.1016/j.contraception.2016.07.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sharab LY, Morford LA, Dempsey J, Falcão-Alencar G, Mason A, Jacobson E, Kluemper GT, Macri JV, Hartsfield JK. Genetic and treatment-related risk factors associated with external apical root resorption (EARR) concurrent with orthodontia. Orthod Craniofac Res 2016; 18 Suppl 1:71-82. [PMID: 25865535 DOI: 10.1111/ocr.12078] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 01/11/2023]
Abstract
OBJECTIVE As genetic variation accounts for two-thirds of the variation in external apical root resorption (EARR) concurrent with orthodontic treatment, we analyzed the association of selected genetic and treatment-related factors with EARR concurrent with orthodontic treatment. SETTING AND SAMPLE POPULATION This case-control study of 134 unrelated, orthodontically treated Caucasian individuals was conducted in part at an Indiana Private Practice, Indiana University and the University of Kentucky. METHODS Utilizing a research data bank containing information from ~1450 orthodontically treated patients, pre- and post-treatment radiographs from 460 individuals were evaluated for EARR of the four permanent maxillary incisors. Sixty-seven unrelated Caucasians with moderate to severe EARR were identified and were age-/sex-matched with orthodontically treated Caucasian controls yielding 38 females and 29 males per group. Factors tested for an association with EARR included the following: 1) treatment duration, 2) extraction of maxillary premolars, 3) numerous cephalometric measurements, and 4) DNA polymorphisms within/near candidate genes in a pathway previously implicated in EARR such as the purinergic-receptor-P2X, ligand-gated ion channel 7 (P2RX7; rs208294, rs1718119, and rs2230912), caspase-1 (CASP1; rs530537, rs580253, and rs554344), interleukin-1 beta (IL1B; rs1143634), interleukin-1 alpha (IL1A; rs1800587), and interleukin-1 receptor antagonist (IL1RA; rs419598) genes. Stepwise logistic regression was utilized to identify the factors significantly associated (significance taken at or less than the layered Bonferroni correction alpha) with the occurrence of EARR. RESULTS A long length of treatment and the presence of specific genotypes for P2RX7 SNP rs208294 were significantly associated with EARR. CONCLUSION EARR occurrence was associated with both genetic and treatment-related variables, which together explained 25% of the total variation associated with EARR in the sample tested.
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Affiliation(s)
- L Y Sharab
- Department of Oral Health Practice, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - L A Morford
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - J Dempsey
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - G Falcão-Alencar
- Hereditary Genomics Laboratory, Center for Oral Health Research, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - A Mason
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - E Jacobson
- Hereditary Genomics Laboratory, Center for Oral Health Research, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - G T Kluemper
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, KY, USA
| | - J V Macri
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - J K Hartsfield
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, KY, USA
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Brattwall M, Jacobson E, Forssblad M, Jakobsson J. Knee arthroscopy routines and practice. Knee Surg Sports Traumatol Arthrosc 2010; 18:1656-60. [PMID: 20857086 DOI: 10.1007/s00167-010-1266-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 08/31/2010] [Indexed: 12/14/2022]
Abstract
PURPOSE Knee arthroscopy is one of most commonly performed day-case orthopaedic procedures, thus consuming huge medical resources. The aim of the present questionnaire survey was to study knee arthroscopy routines and practice. METHODS An electronic web-based survey including questions around pre-, per- and postoperative routines for elective knee arthroscopy was send to all orthopaedic units associated to the Swedish Arthroscopic Society (n = 60). RESULTS Responses covering 37 centres out of 60 (response rate 62%) were returned. Preoperative radiograph routines varied considerable between centres; conventional radiograph varied between 5 and 100% and preoperative MRI between 5 and 80% of patients. General anaesthesia was the preferred intra-operative technique used in all centres (median 79% of patients), local anaesthesia with or without light sedation was used in all 28 out of the 37 centres responding (median 10% of cases) and spinal anaesthesia was used in 15 centres (median 5% of cases). Intra-articular local anaesthesia was provided in all but one of centres. Perioperative administration of oral NSAIDs was common (31 out 37), 6 centres (all teaching hospitals) did not routinely give pre- or postoperative NSAID. Analgesic prescription was provided on a regular base in 18 (49%) of centres; an NSAID being the most commonly prescribed. All but one centre provided written information and instruction at discharge. Referral to physiotherapy, prescribed sick leave and scheduled follow-up in the outpatient clinic diverged considerably. CONCLUSION Routines and practice associated to elective knee arthroscopy differed; however, no clear differences in practice were seen between teaching centres, general or local hospitals apart from a lower usage of NSAID for perioperative analgesia. There is an obvious room for further standardisation in the routine handling of patients undergoing elective arthroscopy of the knee.
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Affiliation(s)
- M Brattwall
- Department of Anaesthesia, Institute for Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital, Mölndal, SE 431 80 Gothenburg, Sweden.
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Hauschild A, Eggermont AM, Jacobson E, O'Day SJ. Phase III, randomized, double-blind study of elesclomol and paclitaxel versus paclitaxel alone in stage IV metastatic melanoma (MM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.18_suppl.lba9012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA9012 Background: Elesclomol is an investigational first-in-class oxidative stress inducer that increases oxidative stress in cancer cells leading to mitochondria-induced apoptosis. Methods: Patients (pts) with Stage IV MM, no prior chemotherapy, LDH μ 2× ULN were randomized (1:1) to either 213 mg/m2 elesclomol in combination with 80 mg/m2 paclitaxel (ELPAC) or 80 mg/m2 paclitaxel alone (P); both were given weekly ×3 followed by 1 week rest until disease progression. Pts were stratified by prior non-cytotoxic treatment, M1 grade, and LDH. The primary endpoint was PFS with >90% power to detect a 2-month improvement. The primary PFS analysis was planned once all pts had been enrolled and at least 164 PFS events had occurred. Results: 651 pts were enrolled between September 2007 and February 2009. Prognostic factors were generally well balanced. PFS analysis was based on investigator assessment of 411 pts (219 events). Median PFS was 3.5 m (95% CI 2.7–3.7) in ELPAC and 1.9 m (95% CI 1.9–3.3) in P [HR 0.88; 95% CI 0.67–1.16, p=0.3695]. The median number of cycles was 3 in ELPAC and 2 in P. Safety analysis showed increased signals on ELPAC including increased ≥Gr 3 AEs (N=405, 32.8% vs. 23.5%), increased AEs leading to death (N=405, 3.5% vs <1%) and increased overall deaths (N=651, 80 vs 53; 80% censored). Most common AEs in ELPAC were fatigue (32.8%), alopecia (31.3%) and nausea (27.9%). Conclusions: There was an improvement in PFS in the ELPAC arm, but it did not achieve statistical significance. In February 2009, the study was halted based on the recommendation of the DMC to unblind the study after the DMC observed increased deaths on the ELPAC arm. The DMC could not determine whether the observed increased deaths were treatment related or not. Of note, in this analysis there were no specific target organ toxicities attributable to ELPAC that could explain the imbalance of deaths. OS data continues to be collected to determine if the observed imbalance in OS persists as the data mature. [Table: see text]
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Affiliation(s)
- A. Hauschild
- University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; Synta Pharmaceuticals Corporation, Lexington, MA; The Angeles Clinic and Research Institute, Santa Monica, CA
| | - A. M. Eggermont
- University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; Synta Pharmaceuticals Corporation, Lexington, MA; The Angeles Clinic and Research Institute, Santa Monica, CA
| | - E. Jacobson
- University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; Synta Pharmaceuticals Corporation, Lexington, MA; The Angeles Clinic and Research Institute, Santa Monica, CA
| | - S. J. O'Day
- University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; Synta Pharmaceuticals Corporation, Lexington, MA; The Angeles Clinic and Research Institute, Santa Monica, CA
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Hauschild A, Eggermont AM, Jacobson E, O'Day SJ. Phase III, randomized, double-blind study of elesclomol and paclitaxel versus paclitaxel alone in stage IV metastatic melanoma (MM). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.lba9012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA9012 The full, final text of this abstract will be available in Part II of the 2009 ASCO Annual Meeting Proceedings, distributed onsite at the Meeting on May 30, 2009, and as a supplement to the June 20, 2009, issue of the Journal of Clinical Oncology. [Table: see text]
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Affiliation(s)
- A. Hauschild
- Synta Pharmaceuticals Corp., Lexington, MA; University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; The Angeles Clinic and Research Institute, Santa Monica, CA
| | - A. M. Eggermont
- Synta Pharmaceuticals Corp., Lexington, MA; University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; The Angeles Clinic and Research Institute, Santa Monica, CA
| | - E. Jacobson
- Synta Pharmaceuticals Corp., Lexington, MA; University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; The Angeles Clinic and Research Institute, Santa Monica, CA
| | - S. J. O'Day
- Synta Pharmaceuticals Corp., Lexington, MA; University of Kiel, Kiel, Germany; Erasmus University Medical Center, Rotterdam, Netherlands; The Angeles Clinic and Research Institute, Santa Monica, CA
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Cheng S, Jacobson E, Bilston LE. Models of the pulsatile hydrodynamics of cerebrospinal fluid flow in the normal and abnormal intracranial system. Comput Methods Biomech Biomed Engin 2008; 10:151-7. [PMID: 18651281 DOI: 10.1080/10255840601124753] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Images obtained from magnetic resonance imaging have helped to ascertain that both the cerebrospinal fluid (CSF) and brain move in a pulsatile manner within the cranium. However, these images are not able to reveal any quantitative information on the physiological forces that are associated with pulsatile motion. Understanding both the pressure and velocity flow field of CSF in the ventricles is important to help understand the mechanics of hydrocephalus. Four separate fluid structure interaction models of the ventricular system in the sagittal plane were created for this purpose. The first model was of a normal brain. The second and third models were pathological brain models with aqueductal stenosis at various locations along the fluid pathway. The fourth model was of a hydrocephalic brain. Results revealed the hydrodynamics of CSF pulsatile flow in the ventricles of these models. Most importantly, it has also revealed the different changes in CSF pulsatile hydrodynamics caused by the various locations of fluid flow obstructions.
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Affiliation(s)
- S Cheng
- Prince of Wales Medical Research Institute, University of New South Wales, Randwick, Australia.
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Lawson DH, Gonzalez R, Weber RW, Hutchins LF, Anderson CM, Williams KN, Kong S, Jacobson E, O’Day SJ. 2-year overall survival (OS) results of a phase II trial of elesclomol (formerly STA-4783) and paclitaxel in stage IV metastatic melanoma (MM). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gonzalez R, Lawson DH, Weber RW, Hutchins LF, Anderson CM, Williams KN, Kong S, Jacobson E, O’Day SJ. Phase II trial of elesclomol (formerly STA-4783) and paclitaxel in stage IV metastatic melanoma (MM): Subgroup analysis by prior chemotherapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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O'Day S, Gonzalez R, Lawson D, Weber R, Hutchins L, Anderson C, McLeod M, Hurwitz C, Haddad J, Jacobson E. Subgroup analysis of efficacy and safety analysis of a randomized, double-blinded controlled phase II study of STA-4783 in combination with paclitaxel in patients with metastatic melanoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8528 Background: STA-4783 (S), an inducer of heat shock protein 70 (hsp70) is a bis-thiobenzoylhydrazide compound. S leads to up-regulation of hsp70 in tumor cell lines. Xenograft models of solid tumors showed synergistic anti-tumor activity in combination with paclitaxel (P). The combination P + S, in phase I and II studies, showed dose-related hsp70 induction (evidence of biological activity) and tolerability. Methods: Eligibility was based on a diagnosis of metastatic cutaneous melanoma, ECOG <=2, and prior treatment with 1 or no chemotherapy regimens. A total of 81 patients (pts) were randomized 2:1 (P 80 mg/m2 + S 213 mg/m2:P 80 mg/m2) 3 weeks out of 4 at 21 US clinical sites. The primary endpoint was progression free survival (PFS); secondary endpoints were response rate (RR), and adverse events (AEs). Results: Based on intent-to-treat analysis, the median PFS was 3.68 months (m) for P + S vs. 1.84 m in the P only arm (p=.035). RR was 15.1% in the P + S arm and 3.6% in the P arm. Subgroup analysis showed chemo- naive pts (n=23) with P + S showed a median PFS of 8.28 m vs. 2.40 in the P arm (n=9). For pts with 1 prior chemotherapy, (n=29), PFS on P + S was 3.12 m vs. 1.77 m on P (n=19). Of 19 pts who crossed over at progression, data are available for 14. PFS ranged from 0.72 to 5.5 m. Three of the 14 evaluable pts treated with P alone had rapid progression (0.95, 1.6, and 1.7 m) then significant inversion of the time to progression with the addition of S to P (2.3, 5.5, and 4.2 m) suggesting study drug effect. Scans were done at identical intervals (8 weeks). The proportion of pts with AEs of grade 3 or higher was 54% (n=52) in the P + S group and 57% in the P group (n=28); pts on P received a median of 2 cycles, while pts in the P + S group received a median of 4. Adverse events leading to discontinuation were low in both groups: 10% for the P + S, and 14% for P. Conclusions: The addition of S to P showed an increase in PFS vs. P alone particularly in chemo-naïve pts. A few pts failing single agent P appeared to benefit from P + S. Despite the additional treatment duration in the P + S group the drugs were well- tolerated, and showed mainly P related adverse events. A phase III study is planned to confirm a role for P + S in metastatic melanoma. [Table: see text]
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Affiliation(s)
- S. O'Day
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - R. Gonzalez
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - D. Lawson
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - R. Weber
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - L. Hutchins
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - C. Anderson
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - M. McLeod
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - C. Hurwitz
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - J. Haddad
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
| | - E. Jacobson
- The Angeles Clinic and Research Institute, Santa Monica, CA; University of Colorado Health Sciences Center, Aurora, CO; Emory Winship Cancer Institute, Atlanta, GA; St. Francis Memorial Hospital, San Francisco, CA; University of Arkansas for Medical Sciences, Little Rock, AR; Ellis Fischel Cancer Center, Columbia, MO; Synta Pharmaceuticals, Lexington, MA
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Assareh H, Jacobson E, Doolke A, Jakobsson JG, Anderson RE. Is administration time of oral non-steroid anti-inflammatory drugs important? A clinical study in patients undergoing arthroscopic subacromial decompression. Eur J Anaesthesiol 2007; 24:467-9. [PMID: 17207296 DOI: 10.1017/s0265021506002043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2006] [Indexed: 11/05/2022]
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20
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Patel SM, Stason WB, Legedza A, Ock SM, Kaptchuk TJ, Conboy L, Canenguez K, Park JK, Kelly E, Jacobson E, Kerr CE, Lembo AJ. The placebo effect in irritable bowel syndrome trials: a meta-analysis. Neurogastroenterol Motil 2005; 17:332-40. [PMID: 15916620 DOI: 10.1111/j.1365-2982.2005.00650.x] [Citation(s) in RCA: 213] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Despite the apparent high placebo response rate in randomized placebo-controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response. OBJECTIVES To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response. METHODS We performed a meta-analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run-in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied. FINDINGS Forty-five placebo-controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population-weighted average of 40.2%, 95% CI (35.9-44.4). Significant associations with lower placebo response rates were fulfillment of the Rome criteria for study entry (P=0.049) and an increased number of office visits (P=0.026). CONCLUSIONS Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.
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Affiliation(s)
- S M Patel
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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21
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Patel SM, Stason WB, Legedza A, Ock SM, Kaptchuk TJ, Conboy L, Canenguez K, Park JK, Kelly E, Jacobson E, Kerr CE, Lembo AJ. The placebo effect in irritable bowel syndrome trials: a meta-analysis. Neurogastroenterol Motil 2005. [PMID: 15916620 DOI: 10.1111/j.1365-2982.2015.00650.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Despite the apparent high placebo response rate in randomized placebo-controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response. OBJECTIVES To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response. METHODS We performed a meta-analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run-in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied. FINDINGS Forty-five placebo-controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population-weighted average of 40.2%, 95% CI (35.9-44.4). Significant associations with lower placebo response rates were fulfillment of the Rome criteria for study entry (P=0.049) and an increased number of office visits (P=0.026). CONCLUSIONS Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.
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Affiliation(s)
- S M Patel
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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22
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Greene PJ, Wayne PM, Kerr CE, Weiger WA, Jacobson E, Goldman P, Kaptchuk TJ. The powerful placebo: doubting the doubters. Adv Mind Body Med 2002; 17:298-307; discussion 312-8. [PMID: 11931055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- P J Greene
- Center for Health Communication, Harvard School of Public Health, Boston, MA 02115, USA.
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Abstract
The input-output relation of a single neuron stands at the basis of every biologically oriented description of the brain. This report shows that the input-output relation of cultured cortical neurons is non-linearly tuned by the input frequency. Increasing the rate of stimulation results in the appearance of ordered temporal firing patterns, which are qualitatively different for different input frequencies. The experimental results of this study lead to the conclusion that frequency tuning of neuronal input-output relation arises from activity-dependent rates at the molecular level underlying the mechanism of excitability itself.
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Affiliation(s)
- D Tal
- The Bernard Katz Minerva Center for Cell Biophysics, Department of Physiology and Biophysics, Faculty of Medicine, Technion, 31096, Haifa, Israel
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25
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Uhl EW, Jacobson E, Bartick TE, Micinilio J, Schimdt R. Aural-pharyngeal polyps associated with Cryptosporidium infection in three iguanas (Iguana iguana). Vet Pathol 2001; 38:239-42. [PMID: 11280385 DOI: 10.1354/vp.38-2-239] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 11/19/2022]
Abstract
Cryptosporidium spp. infection was associated with aural-pharyngeal polyps in three iguanas (Iguana iguana). All iguanas were presented for masses protruding from the ear canal, and the disease was characterized by a chronic clinical course. The masses consisted of nests of cystic glands surrounded by abundant fibrous connective tissue and lined by hyperplastic cuboidal to pseudostratified columnar epithelium that was moderately to heavily colonized by cryptosporidial organisms. Electron microscopy revealed that the majority of organisms were trophozoites.
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Affiliation(s)
- E W Uhl
- Department of Pathobiology, College of Veterinary Medicine, University of Florida, Gainesville 32610-0145, USA
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26
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Abstract
Fifteen snakes representing seven species with segmental, proliferative osteoarthritis and osteoarthrosis of the spine were presented for examination. All the snakes were captive, privately owned, and fed domestic rodents. Physical examination, radiography, blood culture, bone culture, necropsy, and histopathology were performed on each snake. All the snakes had similar physical examination, radiologic, and necropsy findings. There were three histologic types of lesions: active bacterial osteoarthritis, predominantly noninflammatory osteoarthrosis with multifocal inflammation suggestive of chronic bacterial osteoarthritis, and noninflammatory lesions consistent with osteoarthrosis without evidence of inflammation or bacteria. These findings suggest that all these snakes represent a single disease process, bacterial infection of the vertebrae. The different histologic lesions observed in these snakes may be a continuum of lesions, from acute to chronic. Gram-negative bacteria were isolated from the blood or bone lesions of 8 of the 15 snakes. In six of these eight snakes, Salmonella species were isolated. Gram-positive bacteria (Streptococcus sp.) were isolated from two other snakes. Blood and bone culture results were well correlated, so blood culture may be effective for detecting active bacterial osteoarthritis.
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Affiliation(s)
- R Isaza
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610, USA
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Jacobson E, Forssblad M, Rosenberg J, Westman L, Weidenhielm L. Can local anesthesia be recommended for routine use in elective knee arthroscopy? A comparison between local, spinal, and general anesthesia. Arthroscopy 2000; 16:183-90. [PMID: 10705331 DOI: 10.1016/s0749-8063(00)90034-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Local anesthesia (LA) for outpatient knee arthroscopy is not a standard procedure at most hospitals. To evaluate the LA technique for knee arthroscopy on medically healthy patients, this study compared 3 anesthesia techniques. Four hundred patients were randomized to either local (n = 200), general (n = 100), or spinal (n = 100) anesthesia. Evaluated outcomes included the patient's subjective view of the procedure, and nausea and pain at rest and during active movement. All variables were recorded perioperatively and postoperatively. In addition, the performing surgeon's opinion of the degree of patient pain and the technical difficulty of the procedure were noted. Three hundred forty-two patients completed the study. In the group receiving local anesthesia (n = 180) the median visual analog scale pain score during surgery was 6 mm (mean, 17.5; SD, 23.2; range, 0 to 100 mm). Twenty-one LA patients would have preferred another form of anesthesia. In 29 patients, LA was not considered as the optimal anesthesia by the performing surgeon. Eight LA patients agreed with the surgeon that the anesthesia method used was not optimal, of these patients, 5 had synovitis (3%). In 5% of the LA patients there were technical problems. Thus, this study shows that elective knee arthroscopy can be performed under local anesthesia in 92% of the patients from a technical point of view. Excluding patients who do not choose local anesthesia and those who have hypertrophic synovitis preoperatively, knee arthroscopies can be performed as safely and effectively under local anesthesia as under any other form of anesthesia. For most patients, local anesthesia can be recommended as the standard procedure for outpatient knee arthroscopy.
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Affiliation(s)
- E Jacobson
- Artro Clinic, S:t Görans Hospital, Stockholm, Sweden.
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Elnicki DM, Linger B, Asch E, Curry R, Fagan M, Jacobson E, Loftus T, Ogden P, Pangaro L, Papadakis M, Szauter K, Wallach P. Patterns of medical student abuse during the internal medicine clerkship: perspectives of students at 11 medical schools. Acad Med 1999; 74:S99-S101. [PMID: 10536607 DOI: 10.1097/00001888-199910000-00053] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- D M Elnicki
- Department of Medicine, R. C. Byrd HSC, Morgantown, WVA 26506, USA
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Robins HI, Tutsch K, Katschinski DM, Jacobson E, Mehta M, Olsen M, Cohen JD, Tiggelaar CL, Arzoomanian RZ, Alberti D, Feierabend C, Wilding G. Phase I trial of intravenous thymidine and carboplatin in patients with advanced cancer. J Clin Oncol 1999; 17:2922-31. [PMID: 10561372 DOI: 10.1200/jco.1999.17.9.2922] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the biologic interactions and toxicities of carboplatin combined with a 24-hour infusion of thymidine 75 mg/m(2) in a phase I trial. PATIENTS AND METHODS Thirty-two patients with cancer refractory to conventional therapy were treated. The first set of patients (n = 7) received thymidine alone 4 weeks before subsequent planned courses of thymidine combined with carboplatin followed (4 weeks) by carboplatin alone. Carboplatin was administered over 20 minutes at hour 20 of the 24-hour thymidine infusion. The carboplatin dose was escalated in patient groups: 200 mg/m(2) (n = 3); 300 mg/m(2) (n = 7); 350 mg/m(2) (n = 4); 400 mg/m(2) (n = 3); 480 mg/m(2) (n = 10); and 576 mg/m(2) (n = 5). At the maximum-tolerated dose (480 mg/m(2)), five patients received combined therapy first and carboplatin alone second, and five patients received carboplatin first and combined therapy second. Maintenance therapy for stable or responding patients was combined therapy. RESULTS Evaluation demonstrated a trend toward thymidine protection of carboplatin-induced treatment-limiting thrombocytopenia. Neutropenia with carboplatin alone or in combination was negligible. Thymidine alone had no myelosuppressive effects and produced reversible grade 1 or 2 nausea and vomiting (57%), headache (25%), and grade 1 neurotoxicity (22%). Thymidine did not enhance expected carboplatin toxicities. There was no therapy-related infection or bleeding. Analysis of platinum in plasma ultrafiltrate and urine showed no effect by thymidine. Similarly, thymidine pharmacokinetics was not affected by carboplatin. As predicted, nicotinamide adenine dinucleotide levels in peripheral lymphocytes were increased during exposure to carboplatin and/or thymidine but were decreased by carboplatin alone. In three patients with high-grade glioma, responses included one complete remission (21 months) and one partial remission (14 months) at the 480-mg/m(2)-dose level, and disease stabilization (7 months) at the 400-mg/m(2-dose) level. A minor response was observed in a patient with metastatic colon cancer (5 months) at the 480-mg/m(2)-dose level. CONCLUSION The combination of carboplatin and thymidine as described is well tolerated. The data presented have resulted in a phase II study by the North American Brain Tumor Consortium.
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Affiliation(s)
- H I Robins
- University of Wisconsin Comprehensive Cancer Center, Madison, WI 53792, USA.
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Fydryk J, Jacobson E, Kurzawska O, Małecka G, Gonet B, Urasiński T, Brodkiewicz A, Bukowska H. Antioxidant status of children with steroid-sensitive nephrotic syndrome. Pediatr Nephrol 1998; 12:751-4. [PMID: 9874320 DOI: 10.1007/s004670050539] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Eighteen children with steroid-sensitive nephrotic syndrome (SSNS) were studied. The control group comprised 20 healthy children. The following indirect parameters of reactive oxygen species activity were determined in nephrotic patients during four stages of the disease (full relapse before prednisone administration, disappearance of proteinuria, prednisone cessation, unmaintained remission): plasma malondialdehyde (MDA) levels, copper/zinc superoxide dismutase (CuZn SOD) activity and glutathione peroxidase (GPX) activity in erythrocytes, reduced glutathione (GSH) and vitamin C levels in whole blood, and vitamin E level in serum. Increased MDA levels, reduced vitamin C levels, and enhanced CuZn SOD activity were found in relapse. GSH concentration was high during all four stages. Vitamin E level was also increased, parallel to the pattern of serum lipids. GPX activity remained low during the proteinuria stage and in remission. We conclude that the majority of abnormal findings can be attributed to the hyperlipidemia of NS. Low GPX activity may be a factor limiting the antioxidant capacity in NS. The present study is inconclusive regarding the role of free radicals in the proteinuria of NS.
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Affiliation(s)
- J Fydryk
- I Department of Pediatrics, Pomeranian Academy of Medicine, Szczecin, Poland
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Johnston I, Jacobson E, Besser M. The acquired Chiari malformation and syringomyelia following spinal CSF drainage: a study of incidence and management. Acta Neurochir (Wien) 1998; 140:417-27; discussion 427-8. [PMID: 9728240 DOI: 10.1007/s007010050119] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Firstly, 14 patients are described who developed either an acquired Chiari malformation (ACM) alone (7 cases) or ACM and syringomyelia (7 cases) after lumbar subarachnoid space (SAS) shunting or in one case, epidural anaesthesia with SAS penetration. Four groups are considered: 3 cases with craniofacial dysostosis and communicating hydrocephalus (CH), 4 cases with CH alone, 3 cases with pseudotumour cerebri (PTC) and a miscellaneous group (4 cases). Initial treatment was varied: resiting the shunt to ventricle or cisterna magna [6], adding an H-V valve [1], syrinx shunting [4] and posterior fossa decompression [3]. Further treatment was required in 6 cases. Secondly, incidence was examined in 87 patients with PTC initially treated either by lumbar SAS shunting [70] or cisterna magna shunting [17]. In the first sub-group, 11 cases (15.7 per cent) developed an ACM, 3 symptomatic (as above) and eight asymptomatic with 1 case also having syringomyelia whereas 1 case occurred in the second group with a questionanably symptomatic ACM. While accurate for symptomatic lesions, these figures are tentative with respect to asymptomatic lesions due to inadequate pre-treatment radiology and detailed MR follow-up. The main conclusions are, first, that the incidence of symptomatic ACM and/or syringomyelia is not high enough to warrant abandoning SAS shunting; second that asymptomatic lesions need not necessarily be treated and third, that when treatment is required, shunt resiting is the first choice.
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Affiliation(s)
- I Johnston
- Department of Neurosurgery, New Children's Hospital, Australia
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Robert M, Gibbs BF, Jacobson E, Gagnon C. Characterization of prostate-specific antigen proteolytic activity on its major physiological substrate, the sperm motility inhibitor precursor/semenogelin I. Biochemistry 1997; 36:3811-9. [PMID: 9092810 DOI: 10.1021/bi9626158] [Citation(s) in RCA: 132] [Impact Index Per Article: 4.9] [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: 02/04/2023]
Abstract
The protease prostate-specific antigen (PSA) is a marker widely used clinically for monitoring prostatic malignancies. Under normal conditions, this enzyme is mainly involved in the post ejaculation degradation of the major human seminal protein, the seminal plasma motility inhibitor precursor/semenogelin I (SPMIP/SgI), which is the predominant protein component of human semen coagulum. PSA primary structure and activity on synthetic substrates predict a chymotrypsin-like activity whose specificity remains to be established. The present study was aimed at characterizing the proteolytic processing of the SPMIP/SgI by PSA. Purified SPMIP/SgI was incubated with PSA in the presence or absence of protease inhibitors. General serine protease inhibitors, heavy metal cations (Zn2+ and Hg2+), and the heavy metal chelator 1,10-phenanthroline partially or totally inhibited the proteolytic activity of PSA toward SPMIP/SgI. Under identical conditions, other proteins, such as bovine serum albumin, ovalbumin, and casein, were very poor substrates for PSA. Hydrolysis products were separated by reverse-phase high-performance liquid chromatography, assayed for sperm motility inhibitory activity, and analyzed by immunoblotting and mass spectrometry. The region responsible for the sperm motility inhibitory activity and containing an SPMI antiserum epitope was localized to the N-terminal portion of the molecule between residues 85 and 136. On the other hand, a monoclonal antibody against a seminal vesicle-specific antigen (MHS-5) recognized fragments derived from the central part of the SPMIP/SgI (residues 198-223). PSA hydrolysis occurred almost exclusively at either leucine or tyrosine residues, demonstrating directly for the first time a restricted chymotrypsin-like activity on a physiological substrate. The results suggest that PSA is the main enzyme responsible for the processing of SPMIP/SgI in human semen and that this protease manifests unusual specificity with respect to hydrolyzable substrates and sites of hydrolysis.
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Affiliation(s)
- M Robert
- Urology Research Laboratory, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Pan YX, Cheng J, Xu J, Rossi G, Jacobson E, Ryan-Moro J, Brooks AI, Dean GE, Standifer KM, Pasternak GW. Cloning and functional characterization through antisense mapping of a kappa 3-related opioid receptor. Mol Pharmacol 1995; 47:1180-8. [PMID: 7603458] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
We have identified a putative opioid receptor from mouse brain (KOR-3), belonging to the G protein-coupled receptor family, that is distinct from the previously cloned mu, delta, and kappa 1 receptors. Assignment of the clone to the opioid receptor family derives from both structural and functional studies. Its predicted amino acid sequence is highly homologous to that of the other opioid receptors, particularly in many of the transmembrane regions, where long stretches are identical to mu, delta, and kappa 1 receptors. Both cyclazocine and nalorphine inhibit cAMP accumulation in COS-7 cells stably expressing the clone. Northern analysis shows that the mRNA is present in brain but not in a number of other organs. Southern analysis suggests a single gene encoding the receptor. A highly selective monoclonal antibody directed against the native kappa 3 receptor recognizes, in Western analysis, the clone expressed in COS-7 cells. The in vitro translation product is also labeled by the antibody. Additional clones reveal the presence of several introns, including one in the second extracellular loop and another in the first transmembrane region. Antisense studies with an oligodeoxynucleotide directed against a region of the second extracellular loop reveal a selective blockade of kappa 3 analgesia in vivo that is not observed with a mismatch oligodeoxynucleotide based upon the antisense sequence. The mu, delta, and kappa 1 analgesia is unaffected by this antisense treatment. Antisense mapping of the clone downstream from the splice site in the first transmembrane region reveals that six different antisense oligodeoxynucleotides all block kappa 3 analgesia. In contrast, only one of an additional six different antisense oligodeoxynucleotides directed at regions upstream from this splice site is effective. This strong demarcation between the two regions raises the possibility of splice variants of the receptor. An additional clone reveals an insert in the 3' untranslated region. In conclusion, the antibody and antisense studies strongly associate KOR-3 with the kappa 3-opioid receptor, although it is not clear whether it is the kappa 3 receptor itself or a splice variant.
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MESH Headings
- Amino Acid Sequence
- Animals
- Base Sequence
- Blotting, Northern
- Blotting, Southern
- Blotting, Western
- Cell Line
- Cloning, Molecular
- Male
- Mice
- Molecular Sequence Data
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/metabolism
- Oligonucleotides, Antisense
- Receptors, Opioid
- Receptors, Opioid, kappa/genetics
- Receptors, Opioid, kappa/metabolism
- Sequence Homology, Amino Acid
- Nociceptin Receptor
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Affiliation(s)
- Y X Pan
- Cotzias Laboratory of Neuro-Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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Daehnick WW, Dytman SA, Hardie JG, Brooks WK, Flammang RW, Bland L, Jacobs WW, Rinckel T, Pancella PV, Brown JD, Jacobson E. Differential cross sections for pp-->pn pi + near threshold. Phys Rev Lett 1995; 74:2913-2916. [PMID: 10058056 DOI: 10.1103/physrevlett.74.2913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Abstract
Angiomyolipomas are well recognized but uncommon tumors that can involve the kidney. To our knowledge a well documented case of malignant change of angiomyolipoma has never been reported. We report a case of renal angiomyolipoma and leiomyosarcoma with a clearly identified transition of benign to malignant elements seen in the resected tissue.
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Affiliation(s)
- B A Lowe
- Division of Urology, Oregon Health Sciences University, Portland
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Caligiuri R, Kollias GV, Jacobson E, McNab B, Clark CH, Wilson RC. The effects of ambient temperature on amikacin pharmacokinetics in gopher tortoises. J Vet Pharmacol Ther 1990; 13:287-91. [PMID: 2231869 DOI: 10.1111/j.1365-2885.1990.tb00778.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The pharmacokinetics of amikacin were compared in two groups of tortoises, one held at 20 degrees C and the other at 30 degrees C. The mean (+/- SD) residence time for amikacin in the 30 degrees C tortoises was 22.67 +/- 0.50 h; significantly (P less than 0.05) less than those held at 20 degrees C (41.83 +/- 3.23 h). There was no significant difference (P greater than 0.05) in the steady-state volume of distribution (Vd(ss] between the tortoises held at 30 degrees C (0.241 +/- 0.520 l/kg) and those held at 20 degrees C (0.221 +/- 0.019 l/kg). The clearance rate was faster (P less than 0.05) in the warmer tortoises (10.65 +/- 2.42 ml/min/kg at 30 degrees C compared to 5.27 +/- 0.152 ml/min/kg at 20 degrees C). These data indicate that while the volume of distribution was approximately the same, amikacin remained in the colder tortoises longer because of its slower elimination. The oxygen consumption and metabolism were measured and found to be lower in the colder tortoises, almost by the same 2:1 ratio as clearance time (Cl), mean residence time (MRT), and area under the curve (AUC). The data derived from this limited study indicated that an appropriate therapeutic dosage regimen for amikacin in gopher tortoises at 30 degrees C is 5 mg/kg given i.m. every 48 h.
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Affiliation(s)
- R Caligiuri
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville 32610
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Jacobson E. Washington metro jobfocus. Capital ideas. Am J Nurs 1990; 90:51, 53-60. [PMID: 2372028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Jacobson E. Carolina jobfocus. Carolina comfort. Am J Nurs 1990; 90:61-6. [PMID: 2372029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Jacobson E. Three new ways to deliver care. Am J Nurs 1990; 90:24-6. [PMID: 2363455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Wilson VC, Jacobson E. How can we dignify death in the ICU? Am J Nurs 1990; 90:38-42. [PMID: 2337137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- V C Wilson
- Douglas General Hospital, Douglasville, GA
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Jacobson E. Hospital hazards. Part 2. How to protect yourself. Am J Nurs 1990; 90:48-53. [PMID: 2157340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Jacobson E. New hospital hazards. How to protect yourself. Am J Nurs 1990; 90:36-41. [PMID: 2305823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Jacobson E. The sad state of children's health includes a rise in abuse. Am J Nurs 1989; 89:1115-6. [PMID: 2774012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Jacobson E. HIV-infected kids in NYC: an invisible emergency. Am J Nurs 1989; 89:643. [PMID: 2712087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Hansson Y, Jacobson E, Ortlund J, Paulie S, Perlmann P. A rapid method for detection of cellular proliferation using carboxyfluorescein. Assay of growth factors (IL-2, IL-1) and growth inhibiting antibodies. J Immunol Methods 1987; 100:261-7. [PMID: 3036952 DOI: 10.1016/0022-1759(87)90197-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The uptake of carboxyfluorescein diacetate (CFDA) into live cells was used as the basis for a simple, rapid and fully automated micromethod for determination of cell growth. The aim of the investigation was to adapt the CFDA method for detection of cell growth factors from cell culture supernatants. Thus, the biological activities of the growth factors IL-2 or IL-1 could be detected and quantitated at the same level of sensitivity as with the conventional [3H]thymidine incorporation. Similarly, the method was well suited to assay inhibition of IL-2-dependent lymphocyte growth by the monoclonal antibody anti-Tac, binding to the human lymphocyte membrane receptor for IL-2. The CFDA method proved to be rapid, reliable and well suited for several applications involving limiting numbers of cells and biological reagents.
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Jacobson E. : Art, Myth, and Ritual: The Path to Political Authority in Ancient China . K. C. Chang. American Anthropologist 1985. [DOI: 10.1525/aa.1985.87.4.02a00240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Martin HD, Turner T, Kollias GV, Lin SL, Heard DJ, Jacobson E. Cementoblastoma in a Dama gazelle. J Am Vet Med Assoc 1985; 187:1246-7. [PMID: 4077655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Jacobson E, Clubb S, Greiner E. Amebiasis in red-footed tortoises. J Am Vet Med Assoc 1983; 183:1192-4. [PMID: 6643231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Of 500 red-footed tortoises imported to southern Florida, approximately 200 died during a 2-month period. Clinical signs were nonspecific and included anorexia, listlessness, and watery diarrhea, with lingering death. Necropsy consistently revealed thickened duodenum, with necrotic mucosa and multifocal to diffuse areas of hepatic necrosis. Histologic evaluation of tissues demonstrated numerous amebae in intestinal and hepatic lesions.
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Abstract
Cultured human lymphoblastoid cells take up taurine from the medium by two processes: 1) a temperature-dependent, Na+-dependent, saturable "active"-transport system and 2) diffusion. The active transport has properties similar to those reported for taurine transport by other tissues. Apparent Km is about 25 microM and Vmax about 7.2 pmol/min/10(6) cells; saturation occurs at 100 microM taurine. Uptake is competitively inhibited by the beta-amino acids hypotaurine (50% inhibition at 44 microM) and beta-alanine (50% at 152 microM), as measured at 50 microM taurine. Taurocyamine inhibits 50% at 260 microM. Chlorpromazine and imipramine are strong uncompetitive inhibitors, giving 50% inhibition at 26 microM and 115 microM, respectively; at these concentrations cellular viability per se is not affected. Ouabain inhibits 40-50% over a concentration range of 4-500 microM. Diffusion of taurine into the cells is proportional to concentration up to 20 mM. However, at the concentration of taurine in human plasma, 40-100 microM, active transport would provide 90% of the taurine taken up.
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Abstract
The safety and efficacy of intravenous quinidine were evaluated in a patient population with a high prevalence of left ventricular dysfunction and intraventricular conduction delays. Quinidine gluconate (mean dose 9.1 +/- 1.6 mg/kg) was administered during electrophysiologic study to 100 patients with ventricular or supraventricular tachyarrhythmias. Clinical heart failure was present in 68 percent of the patients. Left ventricular end-diastolic pressure, cardiac index, and left ventricular ejection fraction were abnormal in 62, 48, and 70 percent, respectively. Major intraventricular conduction delays (QRS of 120 msec or more) were present in 27 percent, and the H-V interval was prolonged (over 55 msec) in 28 percent. Despite the prevalence of these abnormalities, quinidine was discontinued because of hypotension in only 10 patients. Saline solution was infused to maintain preload in 37 percent, and hypotension responded promptly to saline solution infusion or discontinuation of quinidine infusion in all subjects. Hypotension was not more common in patients with more severe left ventricular dysfunction. QRS duration, H-V interval, QTc, and right ventricular effective refractory period increased significantly (p less than 0.001) after quinidine administration. Heart block or QRS widening of 50 percent or more did not occur. Quinidine prevented arrhythmia induction in 26 percent of patients who received full doses. Ventricular tachycardia cycle length increased in all 41 patients in whom identical forms were induced before and after quinidine (287 +/- 71 msec versus 361 +/- 93 msec, p less than 0.001). Intravenous quinidine may be administered safely to patients with intraventricular conduction delays and moderate heart failure. When antiarrhythmic efficacy is assessed by electrophysiologic study, quinidine compares favorably with other antiarrhythmic agents.
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