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Walker J, McCarty T, McGwin G, Ordaya EE, Vergidis P, Ostrosky-Zeichner L, Mammadova M, Spec A, Rauseo AM, Perfect J, Messina J, Vilchez G, McMullen R, Jones CT, Pappas PG. Description of Cryptococcosis Following SARS-CoV-2 Infection: A Disease Survey Through the Mycosis Study Group Education and Research Consortium (MSG-19). Clin Infect Dis 2024; 78:371-377. [PMID: 37713207 PMCID: PMC10874270 DOI: 10.1093/cid/ciad551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/18/2023] [Accepted: 09/12/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Invasive fungal infections have been described throughout the COVID-19 pandemic. Cryptococcal disease after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported in several isolated case reports and 1 larger case series. We sought to describe cryptococcal infections following SARS-CoV-2 through establishing a database to investigate underlying risk factors, disease manifestations, and outcomes. METHODS We created a crowdsourced call for cases solicited through the Mycoses Study Group Education and Research Consortium, the Centers for Disease Control and Prevention Emerging Infectious Diseases Network, and infectious diseases Twitter groups. Data were collected in a web-based and secure REDCap survey without personal identifiers. RESULTS Sixty-nine cases were identified and submitted by 29 separate institutional sites. Cryptococcosis was diagnosed a median of 22 days (interquartile range, 9-42 days) after SARS-CoV-2 infection. Mortality among those with available follow-up was 72% (26/36) for the immunocompetent group and 48% (15/31) for the immunocompromised group (likelihood ratio, 4.01; P = .045). We observed a correlation between disease manifestation (central nervous system infection, proven/probable disseminated disease, and respiratory) and mortality (P = .002). CONCLUSIONS The mortality rate of 59% for patients with cryptococcosis following SARS-CoV-2 is higher than that of modern Cryptococcus cohorts. There was an association between immunocompromised status and cryptococcal disease manifestations as well as mortality. Moreover, our series emphasizes the need for clinical and laboratory assessment of opportunistic infections beyond 30 days when concerning symptoms develop.
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Affiliation(s)
- Jeremey Walker
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Todd McCarty
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Gerald McGwin
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Eloy E Ordaya
- Mayo Clinic, Infectious Diseases, Rochester, Minnesota, USA
| | | | | | - Mehriban Mammadova
- University of Texas Health Sciences Center, Infectious Disease, Houston, Texas, USA
| | - Andrej Spec
- Washington University, Division of Infectious Diseases, St Louis, Missouri, USA
| | - Adriana M Rauseo
- Washington University, Division of Infectious Diseases, St Louis, Missouri, USA
| | - John Perfect
- Duke University, Infectious Diseases, Durham, North Carolina, USA
| | - Julia Messina
- Duke University, Infectious Diseases, Durham, North Carolina, USA
| | - Gabriel Vilchez
- University of Kentucky, College of Medicine, Lexington, Kentucky, USA
| | - Rachel McMullen
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Carolynn T Jones
- The Ohio State University, College of Nursing, Columbus, Ohio, USA
| | - Peter G Pappas
- University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
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Anwar IJ, Ezekian B, DeLaura I, Manook M, Schroder P, Yoon J, Curfman V, Branum E, Messina J, Harnois M, Permar SR, Farris AB, Kwun J, Knechtle SJ. Addition of interleukin-6 receptor blockade to carfilzomib-based desensitization in a highly sensitized nonhuman primate model. Am J Transplant 2022; 22 Suppl 4:1-11. [PMID: 36239200 PMCID: PMC9722597 DOI: 10.1111/ajt.17208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023]
Abstract
Sensitized patients, those who had prior exposure to foreign human leukocyte antigens, are transplanted at lower rates due to challenges in finding suitable organs. Desensitization strategies have permitted highly sensitized patients to undergo kidney transplantation, albeit with higher rates of rejection. This study assesses targeting plasma cell and interleukin (IL)-6 receptor for desensitization in a sensitized nonhuman primate kidney transplantation model. All animals were sensitized using two sequential skin transplants from maximally major histocompatibility complex-mismatched donors. Carfilzomib (CFZ)/tocilizumab (TCZ) desensitization (N = 6) successfully decreased donor-specific antibody (DSA) titers and prevented the expansion of B cells compared to CFZ monotherapy (N = 3). Dual desensitization further delayed, but did not prevent humoral rebound, as evidenced by a delayed increase in post-kidney transplant DSA titers. Accordingly, CFZ/TCZ desensitization conferred a significant survival advantage over CFZ monotherapy. A trend toward increased T follicular helper cells was also observed in the dual therapy group along the same timeline as an increase in DSA and subsequent graft loss. Cytomegalovirus reactivation also occurred in the CFZ/TCZ group but was prevented with ganciclovir prophylaxis. In accordance with prior studies of CFZ-based dual desensitization strategies, the addition of IL-6 receptor blockade resulted in desensitization with further suppression of posttransplant humoral response compared to CFZ monotherapy.
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Affiliation(s)
- Imran J Anwar
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Brian Ezekian
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Isabel DeLaura
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Miriam Manook
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Paul Schroder
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Janghoon Yoon
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Verna Curfman
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Evelyn Branum
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Julia Messina
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC 27710
| | - Melissa Harnois
- Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710
| | - Sallie R. Permar
- Human Vaccine Institute, Duke University Medical Center, Durham, NC 27710
| | - Alton B. Farris
- Department of Pathology, Emory University School of Medicine, Atlanta, GA 30322
| | - Jean Kwun
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
| | - Stuart J. Knechtle
- Duke Transplant Center, Department of Surgery, Duke University Medical Center, Durham, NC 27710
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Sung AD, Giri VK, Tang H, Nichols KR, Lew MV, Bohannon L, Ren Y, Jung SH, Dalton T, Bush A, Van Opstal J, Artica A, Messina J, Shelby R, Frith J, Lassiter M, Burleson J, Leonard K, Potter AS, Choi T, Gasparetto CJ, Horwitz ME, Long GD, Lopez RD, Sarantopoulos S, Chao NJ. Home-Based Hematopoietic Cell Transplantation in the United States. Transplant Cell Ther 2022; 28:207.e1-207.e8. [PMID: 35066211 PMCID: PMC8977260 DOI: 10.1016/j.jtct.2022.01.015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/05/2022] [Accepted: 01/15/2022] [Indexed: 01/25/2023]
Abstract
Patients undergoing allogeneic (allo) and autologous (auto) hematopoietic cell transplantation (HCT) require extensive hospitalizations or daily clinic visits for the duration of their transplantation. Home HCT, wherein patients live at home and providers make daily trips to the patient's residence to perform assessments and deliver any necessary interventions, may enhance patient quality of life and improve outcomes. We conducted the first study of home HCT in the United States to evaluate this model in the US healthcare setting and to determine the effect on clinical outcomes and quality of life. This case-control study evaluated patients who received home HCT at Duke University in Durham, North Carolina, from November 2012 to March 2018. Each home HCT patient was matched with 2 controls from the same institution who had received standard treatment based on age, disease, and type of transplant for outcomes comparison. Clinical outcomes were abstracted from electronic health records, and quality of life was assessed via Functional Assessment of Cancer Therapy-Bone Marrow Transplant. Clinical outcomes were compared with Student's t-test or Fisher's exact test (continuous variables) or chi-square test (categorical variables). Quality of life scores were compared using the Student t-test. All analyses used a significance threshold of 0.05. Twenty-five patients received home HCT, including 8 allos and 17 autos. Clinical outcomes were not significantly different between the home HCT patients and their matched controls; home HCT patients had decreased incidence of relapse within 1 year of transplantation. Pre-HCT quality of life was well preserved for autologous home HCT patients. This Phase I study demonstrated that home HCT can be successfully implemented in the United States. There was no evidence that home HCT outcomes were inferior to standard-of-care treatment, and patients undergoing autologous home HCT were able to maintain their quality of life. A Phase II randomized trial of home versus standard HCT is currently underway to better compare outcomes and costs.
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Affiliation(s)
- Anthony D. Sung
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University, Durham, NC, USA
| | - Vinay K. Giri
- Stanford Department of Internal Medicine, Stanford, CA, USA
| | - Helen Tang
- Duke University School of Medicine, Durham, NC, USA
| | - Krista Rowe Nichols
- Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, NC, USA
| | - Meagan V. Lew
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Lauren Bohannon
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Yi Ren
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Sin-Ho Jung
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Tara Dalton
- Duke University School of Medicine, Durham, NC, USA
| | - Amy Bush
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Jolien Van Opstal
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Alexandra Artica
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Julia Messina
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Rebecca Shelby
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer Frith
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Martha Lassiter
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Jill Burleson
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Kari Leonard
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Ashley S. Potter
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Taewoong Choi
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Cristina J. Gasparetto
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Mitchell E. Horwitz
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Gwynn D. Long
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Richard D. Lopez
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Stefanie Sarantopoulos
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
| | - Nelson J. Chao
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, NC, USA
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Isom J, Messina J, Seminario-Vidal L, Sokol L. LB774 Comparison of clinical and pathologic assessment of lesions in Mycosis Fungoides. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.040] [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: 10/20/2022]
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Abstract
The growth of social media has catalyzed a shift in marketing expenditure away from traditional print media. As Instagram posts featuring left cheek poses gain more "likes" than right cheek poses, advertisers and social media influencers would likely benefit from favoring the left cheek. While previous investigations of posing biases in print advertising present a conflicting picture, research has yet to investigate posing biases in Instagram advertisements. Given that left cheek images garner more "likes" than right cheek images, we hypothesized a left cheek bias for Instagram advertisements. Two thousand posts (F = M) were sourced by searching Instagram's "Most Recent" feed using the #ad, and coded for pose orientation, image type, and model gender. As predicted, Instagram advertisements showed a left cheek bias (59.8 percent) that was evident across genders and image types, being stronger for female than male models, and for full body than head and torso poses. As such, these data indicate that the left cheek bias that characterizes painted and photographic portraits extends to paid Instagram promotions. The difference in bias from previous investigations of posing orientation in print media advertisements may reflect the importance of emotion in driving attentional capture in social media's highly competitive and content-overloaded landscape.
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Affiliation(s)
- Julia Messina
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Annukka K Lindell
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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6
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Thompson J, Ren Y, Romero K, Lew M, Bush A, Messina J, Jung SH, Miller J, Zenko Z, Jenq RR, Peled JU, van den Brink MR, Chao NJ, Sung AD. Financial Incentives to Increase Stool Collection Rates for Microbiome Studies in Adult Bone Marrow Transplant Patients. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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7
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Kim S, Khushalani N, Eroglu Z, Russell J, Wuthrick E, Caudell J, Harrison L, Aoki M, Shah H, Blakaj D, Markowitz J, Chen DT, Messina J, Rose T, Tsai K, Brohl A. A phase II, randomized study of nivolumab (NIVO) and Ipilimumab (IPI) versus NIVO, IPI and stereotactic body radiation therapy (SBRT) for metastatic Merkel cell carcinoma (MCC, NCT03071406): A preliminary report. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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8
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Valli-Pulaski H, Peters KA, Gassei K, Steimer SR, Sukhwani M, Hermann BP, Dwomor L, David S, Fayomi AP, Munyoki SK, Chu T, Chaudhry R, Cannon GM, Fox PJ, Jaffe TM, Sanfilippo JS, Menke MN, Lunenfeld E, Abofoul-Azab M, Sender LS, Messina J, Klimpel LM, Gosiengfiao Y, Rowell EE, Hsieh MH, Granberg CF, Reddy PP, Sandlow JI, Huleihel M, Orwig KE. Testicular tissue cryopreservation: 8 years of experience from a coordinated network of academic centers. Hum Reprod 2019; 34:966-977. [PMID: 31111889 PMCID: PMC6554046 DOI: 10.1093/humrep/dez043] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [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: 06/25/2018] [Revised: 02/28/2019] [Indexed: 12/31/2022] Open
Abstract
STUDY QUESTION Is it feasible to disseminate testicular tissue cryopreservation with a standardized protocol through a coordinated network of centers and provide centralized processing/freezing for centers that do not have those capabilities? SUMMARY ANSWER Centralized processing and freezing of testicular tissue from multiple sites is feasible and accelerates recruitment, providing the statistical power to make inferences that may inform fertility preservation practice. WHAT IS KNOWN ALREADY Several centers in the USA and abroad are preserving testicular biopsies for patients who cannot preserve sperm in anticipation that cell- or tissue-based therapies can be used in the future to generate sperm and offspring. STUDY DESIGN, SIZE, DURATION Testicular tissue samples from 189 patients were cryopreserved between January 2011 and November 2018. Medical diagnosis, previous chemotherapy exposure, tissue weight, and presence of germ cells were recorded. PARTICIPANTS/MATERIALS, SETTING, METHODS Human testicular tissue samples were obtained from patients undergoing treatments likely to cause infertility. Twenty five percent of the patient's tissue was donated to research and 75% was stored for patient's future use. The tissue was weighed, and research tissue was fixed for histological analysis with Periodic acid-Schiff hematoxylin staining and/or immunofluorescence staining for DEAD-box helicase 4, and/or undifferentiated embryonic cell transcription factor 1. MAIN RESULTS AND THE ROLE OF CHANCE The average age of fertility preservation patients was 7.9 (SD = 5) years and ranged from 5 months to 34 years. The average amount of tissue collected was 411.3 (SD = 837.3) mg and ranged from 14.4 mg-6880.2 mg. Malignancies (n = 118) were the most common indication for testicular tissue freezing, followed by blood disorders (n = 45) and other conditions (n = 26). Thirty nine percent (n = 74) of patients had initiated their chemotherapy prior to undergoing testicular biopsy. Of the 189 patients recruited to date, 137 have been analyzed for the presence of germ cells and germ cells were confirmed in 132. LIMITATIONS, REASONS FOR CAUTION This is a descriptive study of testicular tissues obtained from patients who were at risk of infertility. The function of spermatogonia in those biopsies could not be tested by transplantation due limited sample size. WIDER IMPLICATIONS OF THE FINDINGS Patients and/or guardians are willing to pursue an experimental fertility preservation procedure when no alternatives are available. Our coordinated network of centers found that many patients request fertility preservation after initiating gonadotoxic therapies. This study demonstrates that undifferentiated stem and progenitor spermatogonia may be recovered from the testicular tissues of patients who are in the early stages of their treatment and have not yet received an ablative dose of therapy. The function of those spermatogonia was not tested. STUDY FUNDING/COMPETING INTEREST(S) Support for the research was from the Eunice Kennedy Shriver National Institute for Child Health and Human Development grants HD061289 and HD092084, the Scaife Foundation, the Richard King Mellon Foundation, the Departments of Ob/Gyn & Reproductive Sciences and Urology of the University of Pittsburgh Medical Center, United States-Israel Binational Science Foundation (BSF), and the Kahn Foundation. The authors declare that they do not have competing financial interests.
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Affiliation(s)
- H Valli-Pulaski
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - K A Peters
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - K Gassei
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - S R Steimer
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - M Sukhwani
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - B P Hermann
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - L Dwomor
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - S David
- Department of Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A P Fayomi
- Department of Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - S K Munyoki
- Integrative Systems Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - T Chu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - R Chaudhry
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - G M Cannon
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - P J Fox
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - T M Jaffe
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - J S Sanfilippo
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M N Menke
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - E Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Depratment of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - M Abofoul-Azab
- Depratment of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - L S Sender
- Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
| | - J Messina
- Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
| | - L M Klimpel
- Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
| | - Y Gosiengfiao
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - E E Rowell
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - M H Hsieh
- Sheik Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, Washington, DC, USA
| | - C F Granberg
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - P P Reddy
- Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J I Sandlow
- Department of Urology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Huleihel
- The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev, Beer-Sheva, Israel
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - K E Orwig
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Integrative Systems Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
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Zhao Y, Fenske N, Cherpelis B, Messina J, Giuliano AR, Mckay-Chopin S, Gheit T, Tommasino M, Rollison DE. Association Between Recent Ultraviolet Radiation Exposure and Cutaneous Beta Human Papillomavirus Infection. Cancer Epidemiol Biomarkers Prev 2019. [DOI: 10.1158/1055-9965.epi-19-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Keratinocyte carcinoma (KC), comprised of squamous cell carcinoma and basal cell carcinoma, is the most common cancer in the United States. The effects of ultraviolet radiation (UVR), an established risk factor for KC, on cutaneous human papillomavirus (HPV) infection, a suggested risk factor currently under investigation, are not well established. We assessed cross sectional associations between UVR exposure and cutaneous beta HPV infection, using data obtained from the Viruses in Skin Cancer Study (VIRUSCAN), a prospective cohort study conducted at the Moffitt Cancer Center and the University of South Florida. Methods: Eyebrow hairs (EBH), skin swabs (SSW) and spectrophotometer-based measurements of recent UVR exposure were obtained from 1,179 skin cancer screening patients enrolled in the VIRUSCAN study. Viral DNA was measured using a multiplex PCR assay for 46 beta HPV types in both skin swab samples and eyebrow hair follicles. Logistic regression was used to examine the association between UVR exposure and cutaneous HPV infection in individual sites. Ordinal logistic regression was used to examine the effect of UVR exposure on the trend of having the same HPV infection across two sites, adjusted for age and sex. Results: Patients with higher UVR exposure were more likely to test positive for beta HPV 19, 47, 100 and 145 in EBH. In SSW, beta 38, 49, 76, 100, 124 were positively associated with UVR exposure. When considering viral infection across two sites, we found UVR exposure to be significantly associated with the odds of having infection in both EBH and SSW for beta HPV 19 (OR = 1.12, 95% CI: 1.03–1.23, p-trend = 0.04), 38 (OR = 1.08, 95% CI: 1.04–1.13, p-trend < 0.01), 76 (OR = 1.06, 95% CI: 1.00–1.12, p-trend = 0.01), and 100 (OR = 1.10, 95% CI: 1.04–1.17, p-trend = 0.01). Conclusions: UVR exposure is positively associated with beta cutaneous HPV at the type level, in both individual sites and across skin swab and eyebrow hair. Future research is needed to better understand the biological mechanisms mediating the associations between UVR and cutaneous HPV infection.
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Messina J, Miller MH, Sung A, Alexander BD, Chao N. 1017. Impact of Enterococcal Bloodstream Infection on Mortality in Patients With Acute Myelogenous Leukemia. Open Forum Infect Dis 2018. [PMCID: PMC6255501 DOI: 10.1093/ofid/ofy210.854] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Though enterococcal bloodstream infection (EBSI) is common in patients with acute myelogenous leukemia (AML), its impact on mortality requires further elucidation. Our objectives were to: (1) determine attributable mortality to EBSI and (2) compare overall, 1-year, relapse-related mortality (RRM), and treatment-related mortality (TRM) between AML patients with and without EBSI. Methods This was a retrospective cohort receiving intensive chemotherapy for AML from 2010 to 2015. EBSI was defined by _1 positive blood culture for E. faecium or faecalis and fever, hypotension, or chills. Attributable mortality to EBSI was defined by failure to achieve BSI Clearance (_1 negative culture _24 hr after last positive culture and defervescence) by the date of death. Student’s t-test was used to compare continuous variables, and C2 test was used for categorical variables. Kaplan–Meier was used for survival analyses (unadjusted), and P-values were computed by log-rank. Results Three hundred eight patients were identified during the study period: 80 with EBSI and 228 without EBSI. 5/80 patients died with EBSI (6%) although 4/5 patients had concurrent infections at the time of death (Clostridium difficile colitis, candidemia, proven invasive aspergillosis, and probable invasive fungal disease, respectively). There were no significant differences between overall and 1-year mortality (Table 1). In the survival analyses, EBSI did not significantly impact overall survival, 1-year mortality, RRM, and TRM (Figure 1). However, patients with vancomycin-resistant EBSI (VRE) trended toward increased overall mortality. Conclusion Attributable mortality to EBSI is uncommon (6%) in AML. Additionally, EBSI does not significantly impact mortality in this vulnerable patient population that already has very high rates of RRM and TRM. However, as EBSI inflicted 26% of patients over the course of this study period, further investigation is needed to elucidate the morbidity suffered from this common infection and identify potentially modifiable risk factors. Table 1. ![]()
Disclosures A. Sung, Merck: Grant Investigator, Grant recipient. Enterome: Grant Investigator, Grant recipient.
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Affiliation(s)
- Julia Messina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | | | - Anthony Sung
- Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
| | - Barbara D Alexander
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Nelson Chao
- Hematologic Malignancies and Cellular Therapy, Duke University, Durham, North Carolina
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Bensch G, Messina J, Sacks H, Mahmoud R. EDS-FLU VERSUS TRADITIONAL NASAL STEROIDS FOR TREATING CHRONIC RHINOSINUSITIS: SUMMARIZING CURRENT EVIDENCE FOR SYMPTOM BENEFITS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.050] [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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Parikh N, Chipps B, Messina J, Carothers J, Sacks H, Mahmoud R. EDS-FLU (EXHALATION DELIVERY SYSTEM WITH FLUTICASONE) BENEFITS ON NASAL POLYP DISEASE RELATIVE TO MONOCLONAL ANTIBODIES. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.051] [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: 11/16/2022]
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13
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Skoner D, Messina J, Sacks H, Carothers J, Mahmoud R. EVALUATION OF THE RISK OF OCULAR EFFECTS ASSOCIATED WITH EDS-FLU. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Murphy T, Messina J, Carothers J, Djupesland P, Mahmoud R. P440 Exhalation delivery system with fluticasone (EDS-FLU) improves sleep in patients with CRS with nasal polyps. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.09.036] [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: 10/18/2022]
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15
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Jackson W, Hornik CP, Messina J, Guglielmo K, Watwe A, Delancy G, Valdez A, MacArthur T, Peter-Wohl S, Smith PB, Tolia VN, Laughon MM. In-hospital outcomes of premature infants with severe bronchopulmonary dysplasia. J Perinatol 2017; 37:853-856. [PMID: 28383537 PMCID: PMC5562519 DOI: 10.1038/jp.2017.49] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/03/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To characterize in-hospital outcomes of premature infants diagnosed with severe bronchopulmonary dysplasia (BPD). STUDY DESIGN Retrospective cohort study including premature infants with severe BPD discharged from 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2015. RESULTS There were 10 752 infants with severe BPD, and 549/10 752 (5%) died before discharge. Infants who died were more likely to be male, small for gestational age, have received more medical interventions and more frequently diagnosed with surgical necrotizing enterocolitis, culture-proven sepsis and pulmonary hypertension following 36 weeks of postmenstrual age compared with survivors. Approximately 70% of infants with severe BPD were discharged by 44 weeks of postmenstrual age, and 86% were discharged by 48 weeks of postmenstrual age. CONCLUSIONS A majority of infants diagnosed with severe BPD were discharged home by 44 weeks of postmenstrual age. These results may inform discussions with families regarding the expected hospital course of infants diagnosed with severe BPD.
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Affiliation(s)
- Wesley Jackson
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christoph P. Hornik
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Julia Messina
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Katherine Guglielmo
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Anisha Watwe
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Glaire Delancy
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Alexander Valdez
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Timothy MacArthur
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Sigal Peter-Wohl
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - P. Brian Smith
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Veeral N. Tolia
- Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL
| | - Matthew M. Laughon
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Messina J, Sung A, Alexander BD, Chao N. Recurrent Enterococcal Bloodstream Infection in Patients with Acute Leukemia. Open Forum Infect Dis 2017. [DOI: 10.1093/ofid/ofx163.1436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Djupesland P, Messina J, Mahmoud R. P315 Enhanced nasal drug delivery with new exhalation delivery systems (EDS). Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Elkayam D, Greos L, Messina J, Djupesland P, Mahmoud R. P312 Navigate 2: FLU-EDS (fluticasone exhalation delivery system) for symptoms of chronic rhinosinusitis with nasal polyps. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Jacobson K, Steven G, Messina J, Djupesland P, Mahmoud R. O034 Exhance-12: FLU-EDS (fluticasone exhalation delivery system) reduces symptoms, need for surgery in chronic rhinosinusitis (CRS). Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.394] [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: 10/20/2022]
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20
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Messina J, Moehring RW, Fowler VG, Sexton DJ, Anderson D. Location of Acquisition Impacts the Discharge Status and Length of Stay of Patients With Gram-Positive Bloodstream Infections in Community Hospitals. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.531] [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: 11/14/2022] Open
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21
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Bergin SP, Thaden J, Ericson JE, Cross H, Messina J, Clark RH, Fowler VG, Benjamin DK, Hornik CP, Smith PB. Neonatal Escherichia coli Bloodstream Infections: Clinical Outcomes and Impact of Initial Antibiotic Therapy. Pediatr Infect Dis J 2015; 34:933-6. [PMID: 26065862 PMCID: PMC4581845 DOI: 10.1097/inf.0000000000000769] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Escherichia coli is a common cause of bloodstream infections (BSIs) in infants and is associated with high mortality and morbidity among survivors. The clinical significance of antibiotic resistance and timing of appropriate antimicrobial therapy in this population is poorly understood. METHODS We identified all infants with E. coli BSIs discharged from 77 neonatal intensive care units managed by the Pediatrix Medical Group in 2012. We used multivariable logistic regression to evaluate the association between 30-day mortality and ampicillin-resistant E. coli BSI, as well as the number of active empiric antimicrobial agents administered, controlling for gestational age, small-for-gestational age status, early-onset versus late-onset BSI, oxygen requirement, ventilator support and inotropic support on the day of the first positive blood culture. RESULTS We identified 258 episodes of E. coli BSI, including 123 (48%) ampicillin-resistant isolates. Unadjusted 30-day mortality did not significantly differ between infants with ampicillin-resistant versus ampicillin-susceptible E. coli BSI [11 of 123 (9%) vs. 7 of 135 (5%); P = 0.33; adjusted odds ratio = 1.37 (95% confidence interval: 0.39, 4.77)]. Among ampicillin-resistant E. coli BSIs, 30-day mortality was not significantly lower for infants treated with at least one empiric antimicrobial active against ampicillin-resistant E. coli versus infants receiving no active empiric agent [adjusted odds ratio = 1.50 (0.07, 33.6)]. CONCLUSIONS In this population of infants with E. coli BSI, ampicillin resistance was not associated with significantly increased mortality. Among the subset of infants with ampicillin-resistant E. coli, appropriate empirical antibiotic therapy was not associated with lower mortality.
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Affiliation(s)
- Stephen P. Bergin
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Joshua Thaden
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Jessica E. Ericson
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Heather Cross
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Julia Messina
- Department of Medicine, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Reese H. Clark
- Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL
| | - Vance G. Fowler
- Department of Medicine, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Daniel K. Benjamin
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - Christoph P. Hornik
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
| | - P. Brian Smith
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
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Messina J, Cober E, Richter SS, Kaye K, Salata R, Evans S, Bonomo RA, Fowler V, Van Duin D. 1804Use of Tigecycline in Patients with Carbapenem-resistant Klebsiella pneumoniae (CRKP) is Associated with Increased Risk for Readmissions with CRKP. Open Forum Infect Dis 2014. [DOI: 10.1093/ofid/ofu051.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Eric Cober
- Infectious Disease, Cleveland Clinic, Cleveland, OH
| | | | | | - Robert Salata
- University Hospitals Case Medical Center, Cleveland, OH
| | - Scott Evans
- Center for Biostatistics in AIDS Research, Harvard University, Boston, MA
| | - Robert A. Bonomo
- Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH
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Giordano A, Lugaresi A, Confalonieri P, Granella F, Radice D, Trojano M, Martinelli V, Solari A, Giordano A, Martinelli V, Lugaresi A, Pucci E, Granella F, Trojano M, Solari A, Martinelli V, Pucci E, Messmer Uccelli M, Lugaresi A, Giordano A, Granella F, Solari A, Giordano A, Ferrari G, Martini F, Solari A, Radice D, D’Annunzio G, Lugaresi A, Farina D, Travaglini D, Pietrolongo E, Onofrj M, Torri Clerici V, Bonanno S, Brambilla L, Confalonieri P, Martinelli V, Radaelli M, Messina J, Comi G, Tortorella C, Luciannatelli E, Trojano M, Senesi C, Tsantes E, Granella F, Conti MZ, Rottoli MR, Bellantonio P, Fischetti M, Fantozzi R, Pala A, Traccis S, Di Battista G, Bianchi M, Benedetti MD, Gaetani L, Di Filippo M, Carolei A, Totaro R, Lanzillo R, Brescia Morra V, Coppola R, Cottone S, Chiavazza C, Cavalla P, Leonardi C, Aguglia U, Ziuliani C, Valla P, Sasanelli F, Valentino P, Quattrone A, Martino PG, Russo M, Vita G, Immovilli P. Implementation of the ‘Sapere Migliora’ information aid for newly diagnosed people with multiple sclerosis in routine clinical practice: a late-phase controlled trial. Mult Scler 2014; 20:1234-43. [DOI: 10.1177/1352458513519180] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/11/2013] [Indexed: 11/16/2022]
Abstract
Background: The SIMS-Trial showed that the ‘Sapere Migliora’ information aid (IA) for newly diagnosed people with multiple sclerosis (PwMS) effectively improved patient knowledge and satisfaction with care. Objectives: The objectives of this paper are to assess the effectiveness of the IA in clinical practice and to compare the whole IA with the take-home booklet/website component alone. Methods: After updating the IA and replacing the CD with a website, a prospective, open-label non-randomised controlled trial compared the whole IA (group A, five SIMS-Trial centres) to take-home (group B, 16 centres). One month after the intervention, participants completed the MS Knowledge Questionnaire (MSKQ), care satisfaction questionnaire (COSM-R) (primary study outcomes), Hospital and Anxiety Depression Scale, and ad hoc questionnaire appraising the IA. Results: We enrolled 159 newly diagnosed PwMS (May 2012–March 2013). Drop-outs were four of 77 (5%, group A) and 11/82 (13%, group B). Primary endpoint (highest tertile both for MSKQ and COSM-R section 2 scores) was achieved by 38/77 (49%) group A and 33/82 (40%) group B ( p = 0.25). Attainment of secondary outcomes was also similar between groups. Conclusions: This study shows that the entire IA is not superior to the booklet/website alone, and that both are comparable in efficacy to the intervention arm of the SIMS-Trial. Trial registration number: ISRCTN78940214.
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Affiliation(s)
- A Giordano
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Italy
| | - A Lugaresi
- Department of Neuroscience and Imaging, University G. d’Annunzio of Chieti-Pescara, Italy
| | - P Confalonieri
- Department of Neuroimmunology, Foundation IRCCS Neurological Institute C. Besta, Italy
| | - F Granella
- Department of Neurosciences, Neurology Unit, University of Parma, Italy
| | - D Radice
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Italy
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Italy
| | - V Martinelli
- Department of Neurology, Scientific Institute Hospital San Raffaele, Italy
| | - A Solari
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Italy
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Messina J, Freeman C, Rees A, Goyder E, Hoy A, Ellis S, Ainsworth N. A Systematic Review of Contextual Factors Relating to Smokeless Tobacco Use Among South Asian Users in England. Nicotine Tob Res 2012; 15:875-82. [DOI: 10.1093/ntr/nts193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Simpson D, Xie F, Messina J. 194 FENTANYL BUCCAL TABLET (FBT) IN THE TREATMENT OF BREAKTHROUGH PAIN IN OPIOID-TOLERANT PATIENTS WITH CHRONIC NEUROPATHIC PAIN: RANDOMIZED, PLACEBO-CONTROLLED STUDY. Eur J Pain 2012. [DOI: 10.1016/j.ejpain.2007.03.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mathoulin C, Messina J. [Treatment of acute scapholunate ligament tears with simple wiring and arthroscopic assistance]. Chir Main 2010; 29:72-77. [PMID: 20149711 DOI: 10.1016/j.main.2009.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 10/26/2009] [Accepted: 12/28/2009] [Indexed: 05/28/2023]
Abstract
Scapholunate ligament tears give chronic instability leading in SLAC. The wrist arthroscopy allows to see the lesions, even in early stage, and to treat them, with a simple K-Wires fixation in acute cases. The patients were operated on in outpatient basis with tourniquet and local general anaesthesia. In acute cases, the scapholunate dissociation was reduced by external and internal manoeuvres. The fixation was done with two pins under arthroscopic and fluoroscopic controls. We report a series of 66 acute cases (less than 45 days after trauma). Forty-four patients were males and 22 females. The average age was 39 years old (range 19-46). Our average follow-up in acute cases was 36 months (range 14-61). According the "Mayo Wrist Score", we obtained 92 % of good or excellent results. The wrist arthroscopy is the best technique for early diagnosis, guarantee of best functional results.
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Affiliation(s)
- C Mathoulin
- Institut de la main, clinique Jouvenet, Paris, France.
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Ashburn M, Slevin K, Messina J, Xie F. Fentanyl buccal tablet vs oxycodone immediate-release for the management of breakthrough pain in opioid-tolerant patients with chronic pain: patient disposition and dose titration. The Journal of Pain 2010. [DOI: 10.1016/j.jpain.2010.01.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Su M, Soohoo D, Lukin M, Patel S, Zhang S, O'Donnell M, Messina J, Ward M. 253: The C.I.N. Study: Is Contrast-Induced Nephropathy a Problem in High-Risk Emergency Department Patients? Ann Emerg Med 2009. [DOI: 10.1016/j.annemergmed.2009.06.283] [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: 10/20/2022]
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Scalf L, Baldwin B, Messina J. Aquagenic Syringeal Acrokeratoderma. J Cutan Pathol 2008. [DOI: 10.1111/j.0303-6987.2005.320go.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Slatkin N, Xie F, Segal T, Messina J. A double-blind, randomized, placebo-controlled study of fentanyl buccal tablet (FBT) in opioid-tolerant patients with chronic cancer pain and breakthrough pain. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.9057] [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: 11/20/2022] Open
Abstract
9057 Background: Episodes of cancer-related breakthrough pain (BTP) often peak in intensity in minutes. Pain relief with traditional, short-acting oral opioids is often not achieved for =30 min. Fentanyl buccal tablet (FBT) has a rapid onset of analgesia. This double- blind, randomized, placebo-controlled study evaluated the efficacy and safety of FBT in opioid-tolerant patients with cancer and BTP. Methods: After open-label titration to establish a successful dose of FBT, patients were randomized to prespecified, double-blinded sequences of 10 tablets (7 FBT, 3 placebo). Pain intensity (PI) was assessed from 5 to 120 min post dose. The primary efficacy measure was the sum of PI differences (PIDs) for the first 60 min (SPID60); secondary measures included PIDs, =33% and =50% improvements in PI, and global medication performance (GMP). Use of supplemental BTP medication and adverse events (AEs) were reported. Results: 129 patients were enrolled; 87/125 treated (70%) identified an effective FBT dose and entered the double-blind phase. SPID60 significantly favored FBT vs placebo (mean±SEM, 9.7±0.63 vs 4.9±0.50; p<0.0001). PID differed significantly vs placebo at 10 min (mean±SEM, 0.9±0.09 vs 0.5±0.09; p<0.0001) and at all time points through 2 hr (p<0.0001). Improvements in PI of =33% and =50% from baseline occurred in a larger proportion of episodes following FBT vs placebo from 10 min (16% vs 10% and 7% vs 4%, respectively; p<0.05) through 2 hr (74% vs 38% and 66% vs 28%; p<0.0001). Ratings of GMP were superior for FBT vs placebo at 60 and 120 min (p<0.0001). Supplemental opioids were required for approximately 3 times more BTP episodes following placebo compared with FBT. AEs were typical for opioids, e.g. nausea (13%), dizziness (11%), fatigue (8%), and constipation (6%). Application site-related AEs occurred in 12 patients (10%). A total of 11/125 (9%) patients had =1 serious AE; these were considered not/unlikely to be related to study drug. Conclusions: FBT was effective and well tolerated in the management of BTP in opioid-tolerant patients with cancer-related pain, with an early onset of analgesia and a sustained duration of effect. No significant financial relationships to disclose.
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Affiliation(s)
- N. Slatkin
- City of Hope National Medical Center, Duarte, CA; Cephalon Inc, Frazer, PA; New York University Medical Center, New York, NY
| | - F. Xie
- City of Hope National Medical Center, Duarte, CA; Cephalon Inc, Frazer, PA; New York University Medical Center, New York, NY
| | - T. Segal
- City of Hope National Medical Center, Duarte, CA; Cephalon Inc, Frazer, PA; New York University Medical Center, New York, NY
| | - J. Messina
- City of Hope National Medical Center, Duarte, CA; Cephalon Inc, Frazer, PA; New York University Medical Center, New York, NY
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Thakur R, Vaughan JA, Messina J, Xie F, Taylor DR. Efficacy and tolerability of fentanyl buccal tablet (FBT) in opioid-tolerant cancer patients with neuropathic pain. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19549] [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: 11/20/2022] Open
Abstract
19549 Background: Fentanyl buccal tablet (FBT), a new formulation recently approved by the FDA for opioid-tolerant patients with cancer-related breakthrough pain (BTP), provides rapid-onset analgesia. Neuropathic pain is the primary pain pathophysiology in a significant proportion of patients with chronic cancer pain; therefore, the efficacy and safety of FBT was studied in this subpopulation. Methods: The efficacy and safety of FBT in the treatment of BTP in opioid-tolerant cancer patients with neuropathic pain were evaluated as a sub-analysis of two randomized, double-blind, placebo-controlled studies. Of the 45 patients in the sub-analysis (50% male, 86% white, mean age 56 years), 30 identified an effective FBT dose during open-label titration and were randomly assigned to double-blind crossover dose sequences of 10 tablets (7 FBT, 3 placebo). Pain intensity (PI) and pain relief (PR) were recorded at intervals after dosing. The primary efficacy measures were the sum of pain intensity differences (PIDs) for the first 30 (SPID30) and 60 minutes (SPID60); secondary efficacy measures included PIDs, PR, and total pain relief (TOTPAR). Use of supplemental BTP medication and adverse events (AEs) were recorded. Results: Combined data (all values mean ±SD) favored FBT vs placebo for SPID30 (3.35±3.11 vs 1.88±2.58) and were significant for SPID60 (9.90±7.19 vs 5.51±6.06; 95% CI, 2.99, 5.81). There was a greater reduction in PI following FBT vs placebo at 10 minutes (PID, 0.55±0.89 vs 0.24±0.48), which continued through observation periods of up to 2 hours (3.43±2.44 vs 1.95±1.99). Higher PR scores were noted following FBT vs placebo at 10 minutes (0.43±0.39 vs 0.21±0.28), which continued for up to 2 hours (1.99±0.72 vs 1.36±0.60). TOTPAR was better following FBT vs placebo at 15 (0.88±0.89 vs 0.48±0.73), 30 (2.42±1.85 vs 1.40±1.65), 45 (4.29±2.90 vs 2.61±2.68), and 60 minutes (6.34±4.02 vs 3.94±3.81). Patients were more than twice as likely to require supplemental opioids for BTP episodes following placebo vs FBT. AEs were typical for opioids; e.g., headache (23%), nausea (18%), dizziness (18%), vomiting (14%), and fatigue (11%). Conclusions: FBT was effective and well tolerated in a subgroup of cancer patients with BTP in association with chronic neuropathic pain. No significant financial relationships to disclose.
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Affiliation(s)
- R. Thakur
- University of Rochester, Rochester, NY; Cephalon Inc, Frazer, PA; Comprehensive Pain Care, Marietta, GA
| | - J. A. Vaughan
- University of Rochester, Rochester, NY; Cephalon Inc, Frazer, PA; Comprehensive Pain Care, Marietta, GA
| | - J. Messina
- University of Rochester, Rochester, NY; Cephalon Inc, Frazer, PA; Comprehensive Pain Care, Marietta, GA
| | - F. Xie
- University of Rochester, Rochester, NY; Cephalon Inc, Frazer, PA; Comprehensive Pain Care, Marietta, GA
| | - D. R. Taylor
- University of Rochester, Rochester, NY; Cephalon Inc, Frazer, PA; Comprehensive Pain Care, Marietta, GA
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Matthay KK, Yanik G, Messina J, Quach A, Huberty J, Cheng SC, Veatch J, Goldsby R, Brophy P, Kersun LS, Hawkins RA, Maris JM. Phase II study on the effect of disease sites, age, and prior therapy on response to iodine-131-metaiodobenzylguanidine therapy in refractory neuroblastoma. J Clin Oncol 2007; 25:1054-60. [PMID: 17369569 DOI: 10.1200/jco.2006.09.3484] [Citation(s) in RCA: 174] [Impact Index Per Article: 10.2] [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 effect of disease sites and prior therapy on response and toxicity after iodine-131-metaiodobenzylguanidine (131I-MIBG) treatment of patients with resistant neuroblastoma. PATIENTS AND METHODS One hundred sixty-four patients with progressive, refractory or relapsed high-risk neuroblastoma, age 2 to 30 years, were treated in a limited institution phase II study. Patients with cryopreserved hematopoietic stem cells (n = 148) were treated with 18 mCi/kg of 131I-MIBG. Those without hematopoietic stem cells (n = 16) received 12 mCi/kg. Patients were stratified according to prior myeloablative therapy and whether they had measurable soft tissue involvement or only bone and/or bone marrow disease. RESULTS Hematologic toxicity was common, with 33% of patients receiving autologous hematopoietic stem cell support. Nonhematologic grade 3 or 4 toxicity was rare, with 5% of patients experiencing hepatic, 3.6% pulmonary, 10.9% infectious toxicity, and 9.7% with febrile neutropenia. The overall complete plus partial response rate was 36%. The response rate was significantly higher for patients with disease limited either to bone and bone marrow, or to soft tissue (compared with patients with both) for patients with fewer than three prior treatment regimens and for patients older than 12 years. The event-free survival (EFS) and overall survival (OS) times were significantly longer for patients achieving response, for those older than 12 years and with fewer than three prior treatment regimens. The OS was 49% at 1 year and 29% at 2 years; EFS was 18% at 1 year. CONCLUSION The high response rate and low nonhematologic toxicity with 131I-MIBG suggest incorporation of this agent into initial multimodal therapy of neuroblastoma.
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Affiliation(s)
- Katherine K Matthay
- Department of Pediatrics, University of California at San Francisco, and UCSF Children's Hospital, San Francisco, CA 94143-0106, USA.
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Shors AR, Kim S, White E, Argenyi Z, Barnhill RL, Duray P, Erickson L, Guitart J, Horenstein MG, Lowe L, Messina J, Rabkin MS, Schmidt B, Shea CR, Trotter MJ, Piepkorn MW. Dysplastic naevi with moderate to severe histological dysplasia: a risk factor for melanoma. Br J Dermatol 2007; 155:988-93. [PMID: 17034530 DOI: 10.1111/j.1365-2133.2006.07466.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [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: 11/28/2022]
Abstract
BACKGROUND The risk of malignant melanoma associated with histologically dysplastic naevi (HDN) has not been defined. While clinically atypical naevi appear to confer an independent risk of melanoma, no study has evaluated the extent to which HDN are predictive of melanoma. OBJECTIVES To estimate the risk of melanoma associated with HDN. Secondarily, the risk associated with number of naevi and large naevi is estimated. METHODS We enrolled 80 patients with newly diagnosed melanoma along with 80 spousal controls. After obtaining information on melanoma risk factors and performing a complete cutaneous examination, the most clinically atypical naevus was biopsied in both cases and controls. Histological dysplasia was then assessed independently by 13 dermatopathologists (0, no dysplasia; 1, mild dysplasia; 2, moderate dysplasia; 3, severe dysplasia). The dermatopathologists were blinded as to whether the naevi were from melanoma subjects or controls. Multivariate analyses were performed to determine if there was an independent association between the degree of histological dysplasia in naevi and a personal history of melanoma. RESULTS In persons with naevi receiving an average score of > 1 (i.e. naevi considered to have greater than mild histological dysplasia), there was an increased risk of melanoma [odds ratio (OR) 2.60, 95% confidence interval (CI) 0.99-6.86] which persisted after adjustment for confounders (OR 3.99, 95% CI 1.02-15.71). Very few dermatopathologists reliably graded naevi of subjects with melanoma as being more dysplastic than naevi of control subjects. Among the entire group, the interobserver reliability associated with grading histological dysplasia in naevi was poor (weighted kappa 0.28). CONCLUSIONS HDN do appear to confer an independent risk of melanoma. However, this result may add more to our biological understanding of melanoma risk than to clinical assessment of risk, because HDN assessed by a single pathologist generally cannot be used to assess risk of melanoma. Future studies should be directed at establishing reproducible, predictive criteria for grading naevi.
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Affiliation(s)
- A R Shors
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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Abstract
The chondral changes of the carpus are frequent, often after trauma but also being able to be secondary with degenerative disease. The wrist arthroscopy generally makes it possible to make the diagnosis of these lesions, before they are visible by the usual paraclinic examinations. It will make it possible to withdraw foreign body, cartilage or osseous fragments free in the articulation at the origin of pains. It will also allow the abrasion of small size area of chondral change. Lastly, it will be an essential tool for a secondary conventional treatment. The installation of partial implants in necrosis of proximal pole by arthroscopy is a recent technique very well adapted.
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Affiliation(s)
- C Mathoulin
- Institut de la main, clinique Jouvenet, 6, square Jouvenet, 75016 Paris, France
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Mathoulin C, Messina J. [Arthroscopic management of articular cartilage defect]. Chir Main 2006; 25 Suppl 1:S231-43. [PMID: 17361894] [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: 05/14/2023]
Abstract
The chondral changes of the carpus are frequent, often after trauma but also being able to be secondary with degenerative disease. The wrist arthroscopy generally makes it possible to make the diagnosis of these lesions, before they are visible by the usual paraclinic examinations. It will make it possible to withdraw foreign body, cartilage or osseous fragments free in the articulation at the origin of pains. It will also allow the abrasion of small size area of chondral change. Lastly, it will be an essential tool for a secondary conventional treatment. The installation of partial implants in necrosis of proximal pole by arthroscopy is a recent technique very well adapted.
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Affiliation(s)
- C Mathoulin
- Institut de la main, clinique Jouvenet, 6, square Jouvenet, 75016 Paris, France.
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Weick JK, Tremmel L, Messina J, Portenoy RK. Finding an appropriate dose of fentanyl effervescent buccal tablets for relief of cancer-related breakthrough pain. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8564] [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: 11/20/2022] Open
Abstract
8564 Background: The recommended dose of a short-acting oral opioid used to treat cancer-related breakthrough pain (BTP) is 5%-15% of the equianalgesic around-the-clock (ATC) opioid dose used to control persistent pain; however, this dosing strategy may not be successful when oral transmucosal fentanyl citrate is used. The applicability of this strategy to fentanyl effervescent buccal tablets (FEBT) use was assessed as part of a multicenter study in opioid-treated patients with cancer BTP. Methods: This double-blind, randomized, placebo-controlled, crossover study required 63 evaluable patients for adequate statistical power. Eligible adults were to receive ≥60 mg/day morphine or equivalent for chronic cancer pain and to have experienced 1–4 BTP episodes daily. After open-label titration to an effective FEBT dose, patients were randomized to 1 of 18 predefined sequences of 10 tablets (7 FEBT, 3 placebo). Pain was assessed repeatedly after each dose; the primary efficacy variable was the sum of pain intensity differences at 30 minutes postdose (SPID30). Results: Of 123 enrolled patients, 77 found an effective FEBT dose (100–800 μg) and continued in the double-blind period; 72 were evaluable for efficacy. The SPID30 was 3.0±0.12 (mean±SE) for FEBT vs 1.8±0.18 for placebo (P<.0001). Ratios of the effective FEBT dose to ATC opioid or prior supplemental opioid dose showed no consistent trend (table). An effective FEBT dose showed no meaningful correlation with prior supplemental dose (r2=.094; Pearson’s coefficient=.3066), with ATC dose in patients using oral opioids (r2=.0609; Pearson’s coefficient=.2468), or with ATC dose in patients using transdermal fentanyl or combinations (r2=.1842; Pearson’s coefficient=.4292). Conclusions: There was no relationship between the effective FEBT dose and either ATC opioids or prior supplemental drugs. Therefore, titration, rather than use of a percentage of the ATC dose, is likely to be important in establishing an effective FEBT dose for each patient. [Table: see text] [Table: see text]
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Affiliation(s)
- J. K. Weick
- Hematology Oncology Associates of the Palm Beaches, Lake Worth, FL; Cephalon, Inc., Frazer, PA; Beth Israel Medical Center, New York, NY
| | - L. Tremmel
- Hematology Oncology Associates of the Palm Beaches, Lake Worth, FL; Cephalon, Inc., Frazer, PA; Beth Israel Medical Center, New York, NY
| | - J. Messina
- Hematology Oncology Associates of the Palm Beaches, Lake Worth, FL; Cephalon, Inc., Frazer, PA; Beth Israel Medical Center, New York, NY
| | - R. K. Portenoy
- Hematology Oncology Associates of the Palm Beaches, Lake Worth, FL; Cephalon, Inc., Frazer, PA; Beth Israel Medical Center, New York, NY
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Abstract
8025 Background: The Src/Stat 3 pathway has been implicated in the pathogenesis of several malignancies including melanoma. In the current study we evaluated the prevalence of Src and Stat3 activation in human melanoma and the effect of Src inhibitors alone or in combination with chemotherapeutic agents on melanoma cell lines. Methods: Activation of Src was measured by staining for Src-phosphotyrosine 416 (P-Src) and Stat3 by phosphotyrosine 705 Stat3 (P-Stat3). Immunohistochemistry was performed with anti-pStat3-Y705 and anti-pSrc-Y416 antibodies (Cell Signaling, Beverly, MA) on 3 melanoma subtypes. Staining of tumor cells for P-Stat3 was scored by percentage of stained cells as follows: 0 (no staining), 1 (1–25%), 2 (26–50%), 3 (>50%), and intensity 0–3 (0: absent, 1: low, 2: moderate, and 3: high). The sum of these was the composite P-Stat3 score: 0 (0), 1 (1–2), 2 (3–4), and 3 (5–6). P-Src staining was scored by intensity. Melanoma cell lines, A-375, SK-Mel-5 and SK-Mel-28 were exposed to Src inhibitors, SKI-606, PD 180970 and BMS 354825 alone or in combination with standard chemotherapy agents and IC-50 was determined by MTT assay at 24 and 72 hours. Results: 35 biopsies were stained. Median age was 66 years (range 23–90); 60% were women. 48% of all melanoma stained express P-Src; all samples express pStat3. We found a positive correlation between P-Src and P-Stat3 (Spearman coefficient=0.346, p=0.042). 46% stained only for pStat3 and 6% did not stain for either P-Src or P-Stat3. Most positively stained biopsies stained weakly for P-Src and moderately or strongly for pStat3. Src inhibitors inhibited the proliferation of melanoma cell lines; furthermore Src inhibitor treatment synergized with platinum and topoisomerase I inhibitors but not temozolomide. Conclusions: 1) Immunohistochemistry shows variable expression of P-Src and P-Stat3 in human melanoma 2) All tumors staining for P-Src also stain for P-Stat3 and the strength of staining is significantly related. 3) This data may be useful in planning future clinical trials with Src inhibitors in melanoma. [Table: see text] [Table: see text]
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Affiliation(s)
- J. Homsi
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - J. Messina
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - C. Cubutt
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - S. Maunglay
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - L. Scalf
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - A. Komarla
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - H. Yu
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - R. Jove
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
| | - A. Daud
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL; University of Illinois, Chicago, IL; Mayo Clinic, Rochester, MN; City of Hope, Duarte, CA
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Maris JM, Yanik G, Messina J, Kersun L, Goldsby RE, Huberty J, Veatch J, Brophy P, Cheng SC, Hawkins RE, Matthay KK. A phase II study of 131I-MIBG for refractory neuroblastoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. M. Maris
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - G. Yanik
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - J. Messina
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - L. Kersun
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - R. E. Goldsby
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - J. Huberty
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - J. Veatch
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - P. Brophy
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - S. C. Cheng
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - R. E. Hawkins
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
| | - K. K. Matthay
- Children’s Hosp of Philadelphia, Philadelphia, PA; Univ of Michigan, Ann Arbor, MI; Univ of CA, San Francisco, San Francisco, CA
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Deconti RC, Messina J, Decker M, Welsh R, Mora L, Jove R, Daud A. Expression of STAT proteins and interferon receptors in benign and malignant melanocytic lesions: Correlation with recurrence. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - M. Decker
- H. Lee Moffitt Cancer Center, Tampa, FL
| | - R. Welsh
- H. Lee Moffitt Cancer Center, Tampa, FL
| | - L. Mora
- H. Lee Moffitt Cancer Center, Tampa, FL
| | - R. Jove
- H. Lee Moffitt Cancer Center, Tampa, FL
| | - A. Daud
- H. Lee Moffitt Cancer Center, Tampa, FL
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DuBois SG, Messina J, Maris JM, Huberty J, Glidden DV, Veatch J, Charron M, Hawkins R, Matthay KK. Hematologic Toxicity of High-Dose Iodine-131–Metaiodobenzylguanidine Therapy for Advanced Neuroblastoma. J Clin Oncol 2004; 22:2452-60. [PMID: 15197208 DOI: 10.1200/jco.2004.08.058] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [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 Iodine-131–metaiodobenzylguanidine (131I-MIBG) has been shown to be active against refractory neuroblastoma. The primary toxicity of 131I-MIBG is myelosuppression, which might necessitate autologous hematopoietic stem-cell transplantation (AHSCT). The goal of this study was to determine risk factors for myelosuppression and the need for AHSCT after 131I-MIBG treatment. Patients and Methods Fifty-three patients with refractory or relapsed neuroblastoma were treated with 18 mCi/kg 131I-MIBG on a phase I/II protocol. The median whole-body radiation dose was 2.92 Gy. Results Almost all patients required at least one platelet (96%) or red cell (91%) transfusion and most patients (79%) developed neutropenia (< 0.5 × 103/μL). Patients reached platelet nadir earlier than neutrophil nadir (P < .0001). Earlier platelet nadir correlated with bone marrow tumor, more extensive bone involvement, higher whole-body radiation dose, and longer time from diagnosis to 131I-MIBG therapy (P ≤ .04). In patients who did not require AHSCT, bone marrow disease predicted longer periods of neutropenia and platelet transfusion dependence (P ≤ .03). Nineteen patients (36%) received AHSCT for prolonged myelosuppression. Of patients who received AHSCT, 100% recovered neutrophils, 73% recovered red cells, and 60% recovered platelets. Failure to recover red cells or platelets correlated with higher whole-body radiation dose (P ≤ .04). Conclusion These results demonstrate the substantial hematotoxicity associated with high-dose 131I-MIBG therapy, with severe thrombocytopenia an early and nearly universal finding. Bone marrow tumor at time of treatment was the most useful predictor of hematotoxicity, whereas whole-body radiation dose was the most useful predictor of failure to recover platelets after AHSCT.
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Affiliation(s)
- Steven G DuBois
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143, USA
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Potkin SG, Anand R, Fleming K, Alva G, Keator D, Carreon D, Messina J, Wu JC, Hartman R, Fallon JH. Brain metabolic and clinical effects of rivastigmine in Alzheimer's disease. Int J Neuropsychopharmacol 2001; 4:223-30. [PMID: 11602028 DOI: 10.1017/s1461145701002528] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [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] [Revised: 11/26/2000] [Indexed: 11/07/2022] Open
Abstract
In-vivo metabolic measures with positron emission tomography using (18)F-fluorodeoxyglucose (FDG-PET) have demonstrated hypometabolism in temporal, frontal, and hippocampal areas during the early stages of Alzheimer's disease (AD). Progression of the dementia in AD involves compromised cholinergic functioning. Cholinesterase inhibitors have demonstrated efficacy in improving cognition and behaviour in AD. In this study, we demonstrate the usefulness of FDG-PET in measuring the progression of untreated AD and its modification by treatment with rivastigmine (Exelon, Novartis Pharmaceuticals, East Hanover, New Jersey, USA), a centrally selective cholinesterase inhibitor of the carbamate type. Patients with mild to moderate probable AD (Mini-Mental Status Exam scores of 10-26, inclusive) were enrolled in a double-blind, placebo controlled comparison of three fixed daily doses of rivastigmine (3, 6, or 9 mg/d) or placebo for 26 wk. FDG-PET scans were obtained on 27 patients at baseline and following 26 wk of treatment using the Snodgrass Picture Naming activation task. A total of 71.4% of the patients treated with placebo deteriorated clinically compared to only 25.0% of the patients treated with rivastigmine (chi2 = 4.8; p & 0.03). Rivastigmine-responders (i.e. those who clinically improved or remained clinically stable as measured by the Clinicianaposs Interview-Based Impression of Change-plus) showed a marked increase in brain metabolism (p <0.01) involving, but not limited to, structures comprising the memory-related cortices and the prefrontal system. These metabolic changes were not observed in the placebo-treated patients or the rivastigmine non-responders. Of note is that responders increased hippocampal metabolism by 32.5% (p < 0.03) compared to a non-significant decrease in the non-responders (6.4%) and placebo-treated patients (4.1%). These results are consistent with the literature suggesting that FDG-PET can sensitively measure the progression of AD and its improvement with cholinesterase inhibitors. Rivastigmine prevented the expected deterioration in clinical status and dramatically increased brain metabolic activity in a majority of patients.
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Affiliation(s)
- S G Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA 92627-3960, USA.
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Cherpelis BS, Haddad F, Messina J, Cantor AB, Fitzmorris K, Reintgen DS, Fenske NA, Glass LF. Sentinel lymph node micrometastasis and other histologic factors that predict outcome in patients with thicker melanomas. J Am Acad Dermatol 2001; 44:762-6. [PMID: 11312421 DOI: 10.1067/mjd.2001.112346] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [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: 11/22/2022]
Abstract
BACKGROUND In patients with melanoma, lymph node staging information is obtainable by the surgical techniques of lymphatic mapping and sentinel lymph node (SLN) biopsy. Although no survival benefit has been proven for the procedure, the staging information is useful in identifying patients who may benefit from further surgery or adjuvant therapy. Currently, however, it is not being recommended for patients with thick melanomas (> 3-4 mm). The risk of hematogenous dissemination is considered too great in these patients. Recent studies indicate, however, that a surprising number of patients with thick melanomas become long-term survivors, and the lymph node status may be predictive. None of the conventional microscopic features used to gauge prognosis in patients with melanoma have proven helpful in distinguishing the survivors with thick melanoma from those who will die of their disease. OBJECTIVE Our purpose was to evaluate the influence of SLN histology and other microscopic parameters on survival of patients with thick melanomas. METHODS A computerized patient database at the Cutaneous Oncology Clinic at H. Lee Moffitt Cancer Center was accessed to obtain records on patients with melanomas thicker than 3.0 mm (AJCC T3b). A retrospective analysis was conducted with attention paid to histologic variables, sentinel node status, and survival. Survival curves were constructed with the Kaplan-Meier method, and a Cox-Mantel rank testing was used to establish statistical significance. RESULTS Between 1991 and 1999, 201 patients were diagnosed with melanoma thicker than 3.0 mm, and 180 were alive at an average follow-up of 51 months. Of these, 166 were alive without disease. The mean overall and disease-free survival rates were 78% and 66%, respectively. There was a statistically significant difference in disease-free survival (3-year) between SLN-positive and SLN-negative patients (37% vs 73%, respectively; P =.02). The overall survival (3-year) for the SLN-positive patients was less than the node-negative patients (70% vs 82%), but it was not statistically significant (P =.08). The disease-free survival for patients with ulcerated lesions was less than for nonulcerated lesions (77% vs 93%, P =.05). None of the other histologic parameters studied, including Breslow thickness, Clark level, mitotic rate, or regression, had an influence on the overall or disease-free survival in this group of patients with thick tumors. CONCLUSIONS The results indicate that the SLN node status is predictive of disease-free survival for patients with thick melanomas. A surprising number of patients in the study were free of disease after prolonged follow-up. None of the histologic features of the primary tumor were helpful in predicting outcome, except for ulceration. SLN biopsy appears to be justified for prognostic purposes in patients with thick melanomas.
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Affiliation(s)
- B S Cherpelis
- Division of Dermatology and Cutaneous Surgery, Cutaneous Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa 33612, USA
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Ichida F, Tsubata S, Bowles KR, Haneda N, Uese K, Miyawaki T, Dreyer WJ, Messina J, Li H, Bowles NE, Towbin JA. Novel gene mutations in patients with left ventricular noncompaction or Barth syndrome. Circulation 2001; 103:1256-63. [PMID: 11238270 DOI: 10.1161/01.cir.103.9.1256] [Citation(s) in RCA: 331] [Impact Index Per Article: 14.4] [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: 11/16/2022]
Abstract
BACKGROUND Mutations in the gene G4.5 result in a wide spectrum of severe infantile cardiomyopathic phenotypes, including isolated left ventricular noncompaction (LVNC), as well as Barth syndrome (BTHS) with dilated cardiomyopathy (DCM). The purpose of this study was to investigate patients with LVNC or BTHS for mutations in G4.5 or other novel genes. METHODS AND RESULTS DNA was isolated from 2 families and 3 individuals with isolated LVNC or LVNC with congenital heart disease (CHD), as well as 4 families with BTHS associated with LVNC or DCM, and screened for mutations by single-strand DNA conformation polymorphism analysis and DNA sequencing. In 1 family with LVNC and CHD, a C-->T mutation was identified at nucleotide 362 of alpha-dystrobrevin, changing a proline to leucine (P121L). Mutations in G4.5 were identified in 2 families with isolated LVNC: a missense mutation in exon 4 (C118R) in 1 and a splice donor mutation (IVS10+2T-->A) in intron 10 in the other. In a family with cardiomyopathies ranging from BTHS or fatal infantile cardiomyopathy to asymptomatic DCM, a splice acceptor mutation in exon 2 of G4.5 (398-2 A-->G) was identified, and a 1-bp deletion in exon 2 of G4.5, resulting in a stop codon after amino acid 41, was identified in a sporadic case of BTHS. CONCLUSIONS These data demonstrate genetic heterogeneity in LVNC, with mutation of a novel gene, alpha-dystrobrevin, identified in LVNC associated with CHD. In addition, these results confirm that mutations in G4.5 result in a wide phenotypic spectrum of cardiomyopathies.
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Affiliation(s)
- F Ichida
- Department of Pediatrics, Toyama Medical and Pharmaceutical University, Toyama, Japan
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Farlow MR, Hake A, Messina J, Hartman R, Veach J, Anand R. Response of patients with Alzheimer disease to rivastigmine treatment is predicted by the rate of disease progression. Arch Neurol 2001; 58:417-22. [PMID: 11255445 DOI: 10.1001/archneur.58.3.417] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Evidence suggests that disease severity predicts the response of patients with Alzheimer disease (AD) to cholinesterase inhibitor treatment, raising the question of whether disease progression also predicts response to this treatment. OBJECTIVE To evaluate retrospectively whether rate of disease progression during placebo treatment affects response to subsequent rivastigmine tartrate therapy for patients with mild to moderately severe AD. DESIGN A 26-week, open-label extension study following a 26-week, double-blind, randomized, placebo-controlled trial. SETTING Outpatient research centers at 22 sites in the United States. PATIENTS We studied 187 of 235 patients originally randomized to receive placebo treatment in the double-blind phase of the trial who continued with open-label (rivastigmine) extension therapy. INTERVENTION Placebo treatment for 26 weeks followed by rivastigmine treatment, 2 to 12 mg/d, for 26 weeks. MAIN OUTCOME MEASURES Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog), Progressive Deterioration Scale, Mini-Mental State Examination, and Global Deterioration Scale scores. RESULTS Rivastigmine administration during open-label extension therapy benefited patients who had progressed slowly and those who had progressed rapidly during initial double-blind placebo treatment. Slowly progressive patients responded with a mean 1.03-point improvement in the week 26 (ie, start of open-label rivastigmine treatment) ADAS-Cog score at 12 weeks of rivastigmine treatment (week 38 of treatment; P =.02 vs week 26). However, more rapidly progressive patients had a significantly larger mean 4.97-point improvement from the week 26 ADAS-Cog score at 12 weeks (with respect to week 26 of treatment and slowly progressive patient scores, P<.001 for both). Thus, a more rapid disease progression rate while receiving placebo treatment was predictive of a significantly stronger patient response to rivastigmine therapy. This relation also was observed with the other 3 outcome measures and was still apparent when accounting for disease severity. CONCLUSIONS Rate of disease progression for patients with mild to moderate AD seems to predict response to rivastigmine treatment. Patients with more rapidly progressive disease might be particularly likely to benefit from rivastigmine therapy.
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Affiliation(s)
- M R Farlow
- Department of Neurology, Indiana University School of Medicine, CL583, 541 Clinical Dr., Indianapolis, IN 46202-5111, USA.
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