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Ghanem AI, Gilbert M, Lin CH, Khalil-Moawad R, Momin S, Chang S, Ali H, Siddiqui F. Treatment Tolerance and Toxicity in Elderly Oropharyngeal Cancer Patients and Implication on Outcomes. Int J Radiat Oncol Biol Phys 2023; 117:e584. [PMID: 37785770 DOI: 10.1016/j.ijrobp.2023.06.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To investigate the tolerance level and toxicity for standard of care treatment for oropharyngeal cancer (OP) in elderly patients and their impact on outcomes. MATERIALS/METHODS Using our in-house head and neck cancer database, we looked for non-metastatic OP cases that received definitive treatment between 1/2009-6/2020. All patients received either definitive radiation therapy (RT) +/- concomitant systemic therapy (ST), or surgery followed by adjuvant RT or RT-ST. For the elderly (age at diagnosis ≥65 years) and young (<65 years) patients, we compared treatment package time (TPT) (time from surgery to RT conclusion) for adjuvant RT, total RT duration and unplanned RT interruptions. ST details and dose/protocol modifications were also compared. We evaluated worst grade of pain and mucositis, hospitalization for non-hydration causes and febrile neutropenia (FN) during RT. Feeding tube (FT) use and weight loss were compared. The independent effect of these indicators on locoregional (LRFS), distant (DRFS) recurrence free and overall (OS) survival was assessed using multivariate analyses (MVA). RESULTS A cohort of 326 patients was included: 36% elderly (n = 118) and 64% young (n = 208), with no differences in AJCC stage distribution (8th), treatment received and HPV status (HPV+ve: 73% vs 74.6%; p = 0.86). In 23.6 % who received adjuvant RT, median TPT was 86 (range 72-128) and 81 (65-137) days for elderly vs young (p = 0.27); whereas in the definitive RT cases 76.4%, total RT duration was 49 days for both age groups. Overall, prescribed RT course was not completed in 4% and unplanned RT interruptions occurred in 22.8% and both were non-significant between age groups. Among the 261 patients that received ST, elderly utilized more cetuximab (26 vs 12%; p = 0.007). For those who received cisplatin, 20% of elderly had cumulative dose <200 mg/m2 compared to 6% among the younger age group (p = 0.006); and cisplatin was changed to carboplatin or cetuximab in 18% vs 8% (p = 0.019). Delayed/cancelled cycles and dose reductions were similar. There were more hospitalizations (47% vs 27%; p<0.001) and a trend for more FN (9% vs 3%; p = 0.09) with older age, while worst pain and mucositis was similar. FTs were used more in elderly patients (64% vs 50%; p = 0.02), for a median of 97 vs 64 days (p = 0.31); of which 19.5% vs 11% (p = 0.28) were inserted before RT start. However, % weight loss was non-significant. On MVA, longer RT duration, FT use and hospitalizations predicted worse LRFS and DRFS; and they were prognostic for OS in addition to TPT >90 days (p<0.05 for all). Nevertheless, elderly vs young had non-significant 3-year LRFS (91% vs 90% and 67% vs 69%), DRFS (86% vs 90% and 79% vs 81%) & OS (85% vs 81% and 39% vs 52%) for HPV+ve and HPV-ve respectively (p>0.05). CONCLUSION Elderly patients with OP need more multi-disciplinary supportive care when receiving RT and concurrent ST. However, survival outcomes are equivalent to younger patients. Ongoing studies should enroll more elderly candidates and stratify endpoints with age.
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Affiliation(s)
- A I Ghanem
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI; Alexandria Clinical Oncology Department, Alexandria University, Alexandria, Egypt
| | - M Gilbert
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - C H Lin
- Department of Public Health Sciences, Henry Ford Cancer Institute, Detroit, MI
| | - R Khalil-Moawad
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - S Momin
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - S Chang
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - H Ali
- Department of Medical Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - F Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
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Ghanem AI, Gilbert M, Keller C, Gardner G, Mayerhoff R, Siddiqui F. Definitive and Salvage Radiotherapy Compared to Other Modalities for Laryngeal Carcinoma in Situ. Int J Radiat Oncol Biol Phys 2023; 117:e583. [PMID: 37785769 DOI: 10.1016/j.ijrobp.2023.06.2519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We sought to analyze survival endpoints for laryngeal carcinoma in situ (CIS) undergoing definitive radiotherapy (RT) compared to other modalities. MATERIALS/METHODS Usingour prospectively maintained head and neck cancer database, we identified laryngeal CIS patients treated between 6/2001 and 12/2021. We excluded low-grade dysplasia, CIS with any synchronous invasive squamous cell carcinoma (SCC) within 3 months of the initial CIS biopsy and cases with inadequate follow up. Patients were offered either definitive RT, CO2/KTP laser ablation, photodynamic therapy (PDT) or any sort of therapeutic excision. After first line treatment, follow-up includes visits every 3-6 months with laryngoscopy and biopsies as appropriate. For recurrent CIS beyond 6 months of first line treatment, we reported salvage therapies received and long-term outcomes were reported. Using Kaplan-Meier curves and log-rank test we investigated recurrence free (RFS), progression to invasive SCC free (IFS) and overall (OS) survival across treatment groups. Patients managed with salvage RT were compared to first line RT recipients. RESULTS Atotal of 85 CIS cases were included: median age 65 years (IQR: 55-74), 73 males (85%) and 70 white (82.4%). 86% had a history of smoking with median pack year of 38 (IQR: 20-55) and 66% had a history of alcohol use. CIS was glottic in most of the cases (90.6%: 66% unilateral, 21% bilateral & 13% involved commissure); with only 9.4% in the supraglottic region. RT was used in 49.4% (n = 42) after biopsy (55%) or surgery (45%) with median dose of 63 Gy/28 fractions, mainly by 3D conformal RT (76%). The remaining 50.6% (n = 43) got therapeutic excision alone (commonly microflap excision) (46.5%), CO2/KTP laser (32.6%) or PDT (20.9%). Demographics and clinicopathological details were non-different between RT and non-RT patients except for Charlson comorbidity index: median 2 (IQR 1-3) in non-RT vs 1 (IQR 0-2) in 1ry RT; p = 0.007. After a median follow-up of 4.8 years (IQR 3.5), 51.8% had recurrent disease, 21.2% progressed to invasive SCC and 9.4% had laryngectomies mainly for invasive SCC after RT. First line RT had improved 2-(83% vs 39%) and 5-(74% vs 22%) year RFS vs non-RT therapies (p<0.001). Nevertheless, 2- and 5-year IFS (89% vs 98% and 80% vs 79%) and OS (92% vs 93% and 81% vs 77%) were non-significant among both (p>0.05 for all). Among non-RT cases with CIS recurrences, 12/35 (34%) had salvage RT. Following RT, salvage RT patients had similar 2- and 5-year RFS (81% vs 83% and 81% vs 74%) and IFS (81% vs 89% and 81% vs 80%) compared to first line RT (p>0.05 for all). All cases with CIS recurrences were salvaged successfully with 100% living with no CIS at latest follow-up. CONCLUSION Laryngeal CIS can be treated with a wide range of modalities including 1ry RT which has better recurrence free survival. Nevertheless, non-RT recurrent CIS can be salvaged successfully with many options including RT with equivalent long-term results.
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Affiliation(s)
- A I Ghanem
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI; Alexandria Clinical Oncology Department, Alexandria University, Alexandria, Egypt
| | - M Gilbert
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - C Keller
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI
| | - G Gardner
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - R Mayerhoff
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - F Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
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Zhu S, Gilbert M, Ghanem AI, Siddiqui F, Thind K. Feasibility of Using Zero-Shot Learning in Transformer-Based Natural Language Processing Algorithm for Key Information Extraction from Head and Neck Tumor Board Notes. Int J Radiat Oncol Biol Phys 2023; 117:e500. [PMID: 37785573 DOI: 10.1016/j.ijrobp.2023.06.1743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Natural language processing (NLP) technology has the potential to automate information aggregation and summarization in oncology. One example is the automation of patient registry creation. In this work, we aim to show (1) the feasibility of using modern NLP algorithms to extract key information from tumor board notes, and (2) the impact of prompt engineering on the quality of the results. MATERIALS/METHODS In this IRB-approved study, we obtained the texts of head and neck tumor board notes for 306 unique patients. Five key pieces of information used to create a patient registry were predefined: age, gender, tumor histology, tumor stage, and primary location. The NLP algorithm used was a modified Text-To-Text Transfer Transformer (T5) model that was initially trained on the Colossal Clean Crawled Corpus (C4) dataset and subsequently fine-tuned on the Stanford Question Answering Dataset (SQuAD) to perform the downstream task of extractive question answering. The NLP model and trained weights were obtained from the Hugging Face platform. During inference, the entire body of the tumor board note and a related question were fed as inputs, and the model predicted a sequence of texts in response to the question. Two sets of questions of similar semantic meanings were used. Questions in prompt set #1 included "What is the gender?", "What is the age?", "What is the type of carcinoma in pathological diagnosis?", "What is the stage?", and "Where is the carcinoma located at?". Questions in prompt set #2 include "Is the patient male or female?", "How old is the patient?", "What kind of cancer?", "What is the cancer stage?", and "What is the tumor location?". Each model-predicted response was compared to the ground truth extracted from the tumor board notes. A response was classified as true if it is consistent with the ground truth, otherwise, it was deemed false. The response accuracy for each question was subsequently calculated. RESULTS The median number of words in each tumor board note was 448 (range, 219 - 1505). The accuracy of the NLP algorithm for each question from either set is reported in Table 1. Algorithm performance is higher for extracting objective information such as age, gender, and histology. In addition, it was found that questions of similar semantic meanings but with different wording can lead to significantly different results. CONCLUSION We demonstrated that a transformer-based extractive question-answering NLP algorithm can be successfully used for extracting information from head and neck tumor board notes with zero-shot learning. Furthermore, our results highlight the significance of prompt engineering for applying NLP for this task. Future work on finetuning these algorithms to oncology-specific texts can potentially enhance algorithm performance for more difficult tasks.
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Affiliation(s)
- S Zhu
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - M Gilbert
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - A I Ghanem
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI; Alexandria Clinical Oncology Department, Alexandria University, Alexandria, Egypt
| | - F Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - K Thind
- Henry Ford Health Systems, Detroit, MI
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Ghanem AI, Gilbert M, Li P, Vance S, Tam S, Ghanem T, Siddiqui F. Disease Characteristics, Treatment and Survival for Oropharyngeal Squamous Cell Carcinoma of Elderly. Int J Radiat Oncol Biol Phys 2023; 117:e584. [PMID: 37785771 DOI: 10.1016/j.ijrobp.2023.06.1925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Incidence of oropharyngeal cancers (OP) has been increasing over the past few decades, mainly driven by human papilloma virus (HPV) associated cancers in younger men. However, a large number of OP patients in recent years are ≥65 years of age. We wanted to determine if there is a difference in outcomes in elderly patients with OP as compared to younger patients. MATERIALS/METHODS We queried our institutional prospectively maintained head and neck cancer database for patients with non-metastatic OP treated between 1/2009-6/2020. We excluded patients who did not receive any definitive treatment. We analyzed clinicopathological and treatment characteristics for elderly (age at diagnosis ≥65 years) compared to young (<65 years) across HPV subtypes. We also studied survival endpoints among age groups using Kaplan-Meier curves and log-rank test. Independent predictors were estimated using multivariate (MVA) Cox regression models for each HPV subtype. RESULTS We identified 340 patients who met our inclusion criteria: elderly 123 (36%) and young 213 (64%). The proportion of elderly HPV+ve patients showed an increasing trend over the years studied. Median age was 70 years (range 65-91) in elderly and 56 years (38-64) in young (p<0.001); and HPV+ve/-ve were 73.2/26.8% vs 74.6/25.3% for both age groups respectively (p = 0.86). Elderly patients had higher Charlson Comorbidity Index (CCI) and included more divorcees (p<0.05). There were more elderly current/former smokers (97% vs 82%; p = 0.007) within HPV-ve cases. Definitive radiotherapy (RT) +/- systemic therapy (CRT) was utilized in 73.2% (n = 249), while the remainder had surgery +/- adjuvant RT/CRT. There was no difference with age for OP subsite, 8th edition AJCC stage and treatment received except for more use of cetuximab (22.5% vs 10.2%; p<0.001) and weekly cisplatin (32.4% vs 25.8%; p<0.001) among elderly patients. After a median follow up of 5.24 years (IQR: 3.53), 3-year overall (OS) (HPV+ve: 85 vs 81%; HPV-ve: 39 vs 52%), locoregional free (LRFS) (HPV+ve: 86 vs 90%; HPV-ve: 67 vs 69%) and distant metastasis free (DMFS) survival (HPV+ve: 91 vs 90%; HPV-ve: 79 vs 81%) were all non-significant for elderly vs young respectively. On MVA, CCI and AJCC stage for HPV+ve; and smoking, T-stage and lymphovascular space invasion for HPV- were associated with OS. For HPV+ve, AJCC stage, adjuvant vs definitive RT and treatment in later years were predictive of better LRFS, whereas smoking index and extracapsular space invasion were deterministic for DMFS. Interestingly, outcomes among those who received cetuximab was similar to those who received concurrent cisplatin for all endpoints. CONCLUSION We did not note any significant difference in outcomes among elderly patients treated for OP when compared to the younger patients when multi-disciplinary head and neck cancer care is provided. This was noted even though a significantly larger proportion of elderly patients received cetuximab concurrent with RT as opposed to standard of care cisplatin.
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Affiliation(s)
- A I Ghanem
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI; Alexandria Clinical Oncology Department, Alexandria University, Alexandria, Egypt
| | - M Gilbert
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - P Li
- Department of Public Health Sciences, Henry Ford Cancer Institute, Detroit, MI
| | - S Vance
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
| | - S Tam
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - T Ghanem
- Department of Otolaryngology, Henry Ford Cancer Institute, Detroit, MI
| | - F Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI
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Gilbert M, Mohamed M, Choong SS, Baqi A, Kumaran JV, Sani I, Noralidin A, Manaf A, Reduan FH, Tan LP, Jusoh M. Presence of SARS-CoV-2-like coronaviruses in bats from east coast Malaysia. Trop Biomed 2023; 40:273-280. [PMID: 37897158 DOI: 10.47665/tb.40.3.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
Most of the public health importance coronaviruses, such as Severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2 are likely originated from bats and spread to humans through intermediate hosts; civet cats, dromedary camel and Malayan pangolin, respectively. SARS-CoV-2-like coronaviruses were detected in Thailand, which is neighbouring with Kelantan in East Coast Malaysia. To date, there is no report on the presence of public health concerns (SARS-CoV, SARS-CoV-2 and MERS-CoV) coronaviruses in bats from Malaysia. This study was aimed to elucidate the presence of these coronaviruses in bat samples from East Coast, Malaysia. A total of hundred seventy oropharyngeal swab samples were collected from three states of East Coast Malaysia. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was conducted based on partial 3' Untranslated region (3'UTR) or ORF10 gene and the products were sequenced. The sequences were compared with all coronavirus sequences from the National Center for Biotechnology Information-GenBank (NCBI-GenBank) using NCBI-Basic Local Alignment Search Tool (NCBI-BLAST) software. A phylogenetic tree was constructed to determine the genetic relationship among the detected coronaviruses with the reference coronaviruses from the NCBI-GenBank. Our results showed that SARSCoV-2-like viruses were present in 3% (5/170) of the bats from East Coast Malaysia that have 98-99% sequence identities and are genetically related to SARS-CoV-2 from humans. This finding indicates the presence of SARS-CoV-2-like viruses in bats from East Coast Malaysia that may become a public health concern in the future.
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Affiliation(s)
- M Gilbert
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - M Mohamed
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - S S Choong
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - A Baqi
- Faculty of Earth Science, Universiti Malaysia Kelantan (UMK), Jeli Campus, 17600, Jeli, Kelantan, Malaysia
| | | | - I Sani
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - A Noralidin
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - A Manaf
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - F H Reduan
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - L P Tan
- Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Pengkalan Chepa, 16100 Kota Bharu, Kelantan, Malaysia
| | - M Jusoh
- Faculty of Science and Marine Environment, Universiti Malaysia Terengganu, 21030 Kuala Nerus, Terengganu, Malaysia
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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Parrado RH, Foster L, Gilbert M, Movtchan N, Sayrs L, Khoury E, Ballan W, Schaub T. Clinical Characteristics and Treatment Patterns of Open Hand Fractures in the Pediatric Population. J Pediatr Orthop 2023; 43:e358-e362. [PMID: 36882896 DOI: 10.1097/bpo.0000000000002379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND Open hand fractures are one of the most common injuries in the pediatric population. These injuries are at higher risk of infection, especially in cases of frank contamination. Several studies on adult hand fractures are available in the literature; however, pediatric open hand fractures have yet to be extensively studied. This study aimed to define pediatric open hand fracture's demographics, clinical characteristics, and treatment patterns. METHODS Using the Protected Health Information database, pediatric patients (<18 y old) with the diagnosis of open hand fracture from June 2016 to June 2018 were extracted. Demographic, treatment, and follow-up data were collected. Clinical outcomes included readmission and postoperative infection rates. RESULTS There were a total of 4516 patients who met the inclusion criteria; the median age was 7 years (interquartile range: 3 to 11); 60% males; 60% white. Displaced fractures occurred in 74% of patients, with the right hand (52%) and middle finger (27%) predominance. The most common mechanism of injury was a crushing injury in-between objects (56%). Associated nerve injury occurred in 78 patients (4%) and vascular injury in 43 patients (2%). Open reduction and internal fixation were performed in 30% of patients. Cephalosporins were the most commonly prescribed antibiotics (73%), followed by aminopenicillins (7%). Nine patients had complications related to surgical intervention (0.2%), and postoperative infection occurred in 44 patients (1%). CONCLUSIONS Pediatric open hand fractures most often occur during childhood and more frequently in males. These fractures tend to be more distal and displaced; reduction and fixation are required in one-third of the cases. Despite the absence of treatment guidelines and variability, this injury exhibits low complication rates. LEVEL OF EVIDENCE Level III, retrospective study.
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Affiliation(s)
| | - Lukas Foster
- Division of Trauma Surgery, Department of Surgery
| | | | | | - Lois Sayrs
- Division of Trauma Surgery, Department of Surgery
| | - Emily Khoury
- Division of Trauma Surgery, Department of Surgery
| | - Wassim Ballan
- Division of Infectious Diseases, Department of Pediatrics
| | - Timothy Schaub
- Division of Plastic Surgery, Department of Surgery, Phoenix Children's Hospital
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8
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Liu L, Mendoza-Espinosa D, Quiroz-Guzmán M, Rheingold AL, Hanna TA, Saha G, Tang L, Chen Y, Gilbert M, Dutta A, Asandei AD. Radical and Ring-Opening Polymerizations with Aryl-Substituted Methylene-Bridged Titanium Bisphenolates. Organometallics 2023. [DOI: 10.1021/acs.organomet.3c00053] [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: 03/05/2023]
Affiliation(s)
- Lihua Liu
- Department of Chemistry, Texas Christian University, Box 298860, Fort Worth, Texas 76129, United States
| | - Daniel Mendoza-Espinosa
- Department of Chemistry, Texas Christian University, Box 298860, Fort Worth, Texas 76129, United States
| | - Mauricio Quiroz-Guzmán
- Department of Chemistry, Texas Christian University, Box 298860, Fort Worth, Texas 76129, United States
| | - Arnold L. Rheingold
- Department of Chemistry, UC San Diego, 9500 Gilman Drive, La Jolla, California 92093-0021, United States
| | - Tracy A. Hanna
- Department of Chemistry, Texas Christian University, Box 298860, Fort Worth, Texas 76129, United States
| | - Gobinda Saha
- Institute of Materials Science, Polymer Program and Department of Chemistry, University of Connecticut, Storrs, Connecticut 06062-3136, United States
| | - Liming Tang
- Institute of Materials Science, Polymer Program and Department of Chemistry, University of Connecticut, Storrs, Connecticut 06062-3136, United States
| | - Yanhui Chen
- Institute of Materials Science, Polymer Program and Department of Chemistry, University of Connecticut, Storrs, Connecticut 06062-3136, United States
| | - Megan Gilbert
- Institute of Materials Science, Polymer Program and Department of Chemistry, University of Connecticut, Storrs, Connecticut 06062-3136, United States
| | - Abhirup Dutta
- Institute of Materials Science, Polymer Program and Department of Chemistry, University of Connecticut, Storrs, Connecticut 06062-3136, United States
| | - Alexandru D. Asandei
- Institute of Materials Science, Polymer Program and Department of Chemistry, University of Connecticut, Storrs, Connecticut 06062-3136, United States
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Tamzali Y, Scemla A, Bonduelle T, Garandeau C, Gilbert M, Randhawa S, De Nattes T, Hachad H, Pourcher V, Taupin P, Kaminski H, Hazzan M, Moal V, Matignon M, Fihman V, Levi C, Le Quintrec M, Chemouny JM, Rondeau E, Bertrand D, Thervet E, Tezenas Du Montcel S, Savoye E, Barrou B, Kamar N, Tourret J. Specificities of Meningitis and Meningo-Encephalitis After Kidney Transplantation: A French Retrospective Cohort Study. Transpl Int 2023; 36:10765. [PMID: 36744053 PMCID: PMC9889366 DOI: 10.3389/ti.2023.10765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/03/2023] [Indexed: 01/20/2023]
Abstract
Kidney transplant recipients develop atypical infections in their epidemiology, presentation and outcome. Among these, meningitis and meningoencephalitis require urgent and adapted anti-infectious therapy, but published data is scarce in KTRs. The aim of this study was to describe their epidemiology, presentation and outcome, in order to improve their diagnostic and management. We performed a retrospective, multicentric cohort study in 15 French hospitals that included all 199 cases of M/ME in KTRs between 2007 and 2018 (0.9 case per 1,000 KTRs annually). Epidemiology was different from that in the general population: 20% were due to Cryptococcus neoformans, 13.5% to varicella-zoster virus, 5.5% to Mycobacterium tuberculosis, and 4.5% to Enterobacteria (half of which produced extended spectrum beta-lactamases), and 5% were Post Transplant Lymphoproliferative Disorders. Microorganisms causing M/ME in the general population were infrequent (2%, for Streptococcus pneumoniae) or absent (Neisseria meningitidis). M/ME caused by Enterobacteria, Staphylococci or filamentous fungi were associated with high and early mortality (50%-70% at 1 year). Graft survival was not associated with the etiology of M/ME, nor was impacted by immunosuppression reduction. Based on these results, we suggest international studies to adapt guidelines in order to improve the diagnosis and the probabilistic treatment of M/ME in SOTRs.
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Affiliation(s)
- Y. Tamzali
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France,Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Infectious and Tropical Diseases, Paris, France,*Correspondence: Y. Tamzali,
| | - A. Scemla
- Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology and Kidney Transplantation, Hôpital Necker, Paris, France
| | - T. Bonduelle
- Neurology Department, Epilepsy Unit, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - C. Garandeau
- Nephrology Department, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - M. Gilbert
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - S. Randhawa
- Aix-Marseille Université, Hôpitaux Universitaires de Marseille, Hôpital Conception, Center of Nephrology and Kidney Transplantation, Marseille, France
| | - T. De Nattes
- Department of Nephrology Dialysis and Kidney Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - H. Hachad
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France
| | - V. Pourcher
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Infectious and Tropical Diseases, Paris, France
| | - P. Taupin
- University Paris-Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Biostatistics, Necker Hospital, Paris, France
| | - H. Kaminski
- Department of Nephrology, Transplantation, Dialysis and Apheresis, CHU Bordeaux, Bordeaux, France
| | - M. Hazzan
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - V. Moal
- Aix-Marseille Université, Hôpitaux Universitaires de Marseille, Hôpital Conception, Center of Nephrology and Kidney Transplantation, Marseille, France
| | - M. Matignon
- Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire, Innovative Therapy for Immune Disorders, Créteil, France
| | - V. Fihman
- Bacteriology and Infection Control Unit, Department of Prevention, Diagnosis, and Treatment of Infections, Henri-Mondor University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Créteil, France,EA 7380 Dynamyc, EnvA, Paris-Est University (UPEC), Créteil, France
| | - C. Levi
- Department of Nephrology Immunology and Kidney Transplantation, Centre Hospitalier Univeristaire Edouard Herriot, Lyon, France
| | - M. Le Quintrec
- Department of Nephrology Dialysis and Kidney Transplantation, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - J. M. Chemouny
- Université de Rennes, CHU Rennes, INSERM, EHESP, IRSET—UMR_S 1085, CIC‐P 1414, Rennes, France
| | - E. Rondeau
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology, SINRA, Hôpital Tenon, GHEP, Paris, France
| | - D. Bertrand
- Department of Nephrology Dialysis and Kidney Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - E. Thervet
- Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology, Hôpital Europeen Georges Pompidou, Paris, France
| | - S. Tezenas Du Montcel
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute, Assistance Publique-Hopitaux de Paris (AP-HP), Medical Information Department, Pitié Salpêtrière-Charles Foix University Hospital, Paris, France
| | - E. Savoye
- Agence de la Biomédecine, Saint Denis, France
| | - B. Barrou
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, INSERM, UMR 1082, Paris, France
| | - N. Kamar
- Department of Nephrology and Organ, INFINITY-INSERM U1291-CNRS U5051, Université Paul Sabatier, Toulouse, France
| | - J. Tourret
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, INSERM, UMR 1138, Paris, France
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Zhu S, Gilbert M, Chetty I, Siddiqui F. Landscape of Oncology-Specific, FDA-Approved, Artificial Intelligence and Machine Learning-Enabled Medical Devices. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Beyer AK, Schlack R, Neuperdt L, Kuhnert R, Hölling H, Romanos M, Jans T, Berner A, Hetzke L, Weyrich S, Emser T, Hauer D, Scholz V, Ulsamer S, Wallau C, Ravens-Sieberer U, Kaman A, Gilbert M, Greiner W, Witte J, Seck K, Heuschmann PU, Fiessler C, Widmann J, Riederer C. Das Projekt INTEGRATE-ADHD: Vergleich und Integration administrativer
und epidemiologischer ADHS-Diagnosedaten durch klinisches Assessment bei Kindern
und Jugendlichen in Deutschland. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753801] [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: 12/12/2022]
Affiliation(s)
- A-K Beyer
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - R Schlack
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - L Neuperdt
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - R Kuhnert
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - H Hölling
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - M Romanos
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - T Jans
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - A Berner
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - L Hetzke
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - S Weyrich
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - T Emser
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - D Hauer
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - V Scholz
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
- Radboud University, Donders Institute for Brain, Cognition and
Behaviour, Nijmegen, Niederlande
| | - S Ulsamer
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - C Wallau
- Universitätsklinikum Würzburg, Zentrum für
Psychische Gesundheit, Klinik und Poliklinik für Kinder- und
Jugendpsychiatrie, Psychosomatik und Psychotherapie, Würzburg,
Deutschland
| | - U Ravens-Sieberer
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - A Kaman
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - M Gilbert
- Universitätsklinikum Hamburg-Eppendorf, Klinik für
Kinder- und Jugendpsychiatrie, -psychotherapie und –psychosomatik,
Forschungssektion „Child Public Health", Hamburg,
Deutschland
| | - W Greiner
- Universität Bielefeld, Lehrstuhl für
Gesundheitsökonomie und Gesundheitsmanagement, Bielefeld,
Deutschland
| | - J Witte
- Vandage GmbH, Bielefeld, Deutschland
| | - K Seck
- Vandage GmbH, Bielefeld, Deutschland
| | - PU Heuschmann
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
| | - C Fiessler
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
| | - J Widmann
- Julius-Maximilians-Universität Würzburg, Institut
für Klinische Epidemiologie und Biometrie, Würzburg,
Deutschland
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Ghanem A, Maahs L, Gutta R, Tang A, Gilbert M, Arya S, Saheli Z, Tam S, Sheqwara J, Siddiqui F. Does Cetuximab Reduce the Risk of Anemia in Patients Undergoing Radiation Therapy for Head and Neck Cancers? Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.141] [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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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Ostlie AR, Gilbert M, Lewis C, Ostlie DJ, Hargis-Villanueva A. Fat embolism syndrome with neurological involvement: A case report. Trauma Case Rep 2022; 38:100607. [PMID: 35128021 PMCID: PMC8804199 DOI: 10.1016/j.tcr.2022.100607] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/28/2022] Open
Abstract
Background Fat Embolism Syndrome (FES) occurs when the contents (or some component of) the bone marrow is released into the circulation, generally as the result of long bone fracture. It poses significant challenges in both diagnosis and treatment and, as such, is primarily a diagnosis of exclusion with no definitive treatment. We present a case where heightened awareness of the clinical team allowed for early identification and immediate initiation of supportive care, nitric oxide (NO) for potential mitigation of right heart failure, and pharmacological treatment with atorvastatin. Patient A 16-year-old male with multi-system trauma, including bilateral long-bone fractures, developed Fat Embolism Syndrome with neurological and respiratory symptoms within 24 h of admission. Results Within 24 h of initiation of high dose atorvastatin and inhaled Nitric Oxide our patient showed signs of improvement, including decreasing oxygen requirement's and normalization of mental status. Conclusion We postulate that the combined therapy of high-dose atorvastatin with Nitric Oxide may have played a role in our patients' full recovery in a shortened timeframe. Ideally, further prospective research is needed to determine a universally accepted treatment regimen for pediatric patients with FES.
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Vandenbergen L, Chirita N, Descamps O, Gilbert M, Du Bois M, Ngirabacu M, Petit B, Hanotier P, Bettens S. Does Comprehensive Geriatric Assessment predict treatment interruption in the elderly oncologic and hematologic patients? J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gilbert M, Demarchi S, Urdapilleta I. Risques de violences externes au travail et facteurs de protection. Psychologie du Travail et des Organisations 2021. [DOI: 10.1016/j.pto.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Gilbert M, Ghesquiere L, Drumez E, Subtil D, Fague V, Berveiller P, Garabedian C. How to reduce fetal scalp blood sampling? A retrospective study evaluating the diagnostic value of scalp stimulation to predict fetal wellbeing assessed by scalp blood sampling. Eur J Obstet Gynecol Reprod Biol 2021; 263:153-158. [PMID: 34216939 DOI: 10.1016/j.ejogrb.2021.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Fetal Blood Sample (FBS) is used as an indicator of fetal acidosis during labor. Its place is discussed through the lack of randomized trials, as well as the limitations related to the technical procedure. An alternative could be the Fetal Scalp Stimulation (FSS). AIM Our objective was to describe the FSS diagnostic value to predict fetal wellbeing defined from FBS. METHODS The FSS consisted in a digital scalp stimulation for 15 s. Test was negative when an acceleration and/or a normal variability were elicited in the 2 min following. FSS was performed before each FBS which was classified as normal when pH was > 7.25. The diagnostic value was assessed by sensibility, specificity, positive and negative predictive values. FINDINGS 148 women were included in our center from February to December 2019. Of the 191 FBS procedures, when accelerations were elicited sensibility was 58,3 (36.8-77.1), specificity was 67,5 (59.3-75), positive predictive value was 20,9 (12.5-32.9) and negative predictive value was 91.7 % (95 %CI, 85-95.5). DISCUSSION FBS is considered as the gold standard in our study which could be discussed as it is abandoned in some countries because of its questioned reliability and the lack of controlled randomized trials. CONCLUSION This study suggests that FSS could be an interesting alternative adjunctive test to perform in the first instance as it seems to be reliable, non-invasive and easy to perform in order to limit FBS only to absence of acceleration after FSS.
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Affiliation(s)
- M Gilbert
- CHU Lille, Department of Obstetrics, F-59000, Lille, France.
| | - L Ghesquiere
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - E Drumez
- Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France; CHU Lille, Department of Biostatistics, F-59000, Lille, France
| | - D Subtil
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
| | - V Fague
- CH Valenciennes, Department of Obstetrics, F-59300, Valenciennes, France
| | - P Berveiller
- CH Poissy, Department of Obstetrics, F-78300, Poissy, France
| | - C Garabedian
- CHU Lille, Department of Obstetrics, F-59000, Lille, France; Univ. Lille, ULR 2694 METRICS, Évaluation des Technologies de Santé et des Pratiques Médicales, F-59000, Lille, France
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van Boeckel T, Pires J, Silvester R, Zhao C, Song J, Criscuolo N, Gilbert M, Bonhoeffer S, Laxminarayan R. Global trends in antimicrobial resistance in animals in low- and middle-income countries. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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20
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Chaiban C, Robinson TP, Fèvre EM, Ogola J, Akoko J, Gilbert M, Vanwambeke SO. Early intensification of backyard poultry systems in the tropics: a case study. Animal 2020; 14:2387-2396. [PMID: 32576312 PMCID: PMC7538343 DOI: 10.1017/s175173112000110x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/06/2020] [Accepted: 05/04/2020] [Indexed: 12/24/2022] Open
Abstract
Poultry production is an important way of enhancing the livelihoods of rural populations, especially in low- and middle-income countries (LMICs). As poultry production in LMICs remains dominated by backyard systems with low inputs and low outputs, considerable yield gaps exist. Intensification can increase poultry productivity, production and income. This process is relatively recent in LMICs compared to high-income countries. The management practices and the constraints faced by smallholders trying to scale-up their production, in the early stages of intensification, are poorly understood and described. We thus investigated the features of the small-scale commercial chicken sector in a rural area distant from major production centres. We surveyed 111 commercial chicken farms in Kenya in 2016. We targeted farms that sell the majority of their production, owning at least 50 chickens, partly or wholly confined and provided with feeds. We developed a typology of semi-intensive farms. Farms were found mainly to raise dual-purpose chickens of local and improved breeds, in association with crops and were not specialized in any single product or market. We identified four types of semi-intensive farms that were characterized based on two groups of variables related to intensification and accessibility: (i) remote, small-scale old farms, with small flocks, growing a lot of their own feed; (ii) medium-scale, old farms with a larger flock and well located in relation to markets and (iii) large-scale recently established farms, with large flocks, (iii-a) well located and buying chicks from third-party providers and (iii-b) remotely located and hatching their own chicks. The semi-intensive farms we surveyed were highly heterogeneous in terms of size, age, accessibility, management, opportunities and challenges. Farm location affects market access and influences the opportunities available to farmers, resulting in further diversity in farm profiles. The future of these semi-intensive farms could be compromised by several factors, including the competition with large-scale intensive farmers and with importations. Our study suggests that intensification trajectories in rural areas of LMICs are potentially complex, diverse and non-linear. A better understanding of intensification trajectories should, however, be based on longitudinal data. This could, in turn, help designing interventions to support small-scale farmers.
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Affiliation(s)
- C. Chaiban
- Georges Lemaître Centre for Earth and Climate Research, Earth and Life Institute, Université catholique de Louvain, UCLouvain, 1348Louvain-la-Neuve, Belgium
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1050Brussels, Belgium
| | - T. P. Robinson
- Livestock Information, Sector Analysis and Policy Branch (AGAL), Food and Agriculture Organization of the United Nations (FAO), Viale delle Terme di Caracalla, 00153Rome, Italy
| | - E. M. Fèvre
- International Livestock Research Institute (ILRI), 00100Nairobi, Kenya
- Institute of Infection and Global Health (IGH), University of Liverpool, LiverpoolL7 3EA, UK
| | - J. Ogola
- International Livestock Research Institute (ILRI), 00100Nairobi, Kenya
- County Directorate of Veterinary Services, Bungoma County 50200, Kenya
| | - J. Akoko
- International Livestock Research Institute (ILRI), 00100Nairobi, Kenya
| | - M. Gilbert
- Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, 1050Brussels, Belgium
- Fonds National de la Recherche Scientifique (FNRS), 1000Brussels, Belgium
| | - S. O. Vanwambeke
- Georges Lemaître Centre for Earth and Climate Research, Earth and Life Institute, Université catholique de Louvain, UCLouvain, 1348Louvain-la-Neuve, Belgium
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21
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Berardis S, Verroken A, Vetillart A, Struyf C, Gilbert M, Gruson D, Gohy S. SARS-CoV-2 seroprevalence in a Belgian cohort of patients with cystic fibrosis. J Cyst Fibros 2020; 19:872-874. [PMID: 32828701 PMCID: PMC7418700 DOI: 10.1016/j.jcf.2020.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Abstract
Background In Belgium, COVID-19 epidemy began on February 4, 2020 with a peak on April 10, 2020. Patients with cystic fibrosis (CF) followed in the Cliniques universitaires Saint-Luc were rapidly isolated before the government lockdown. Methods After the peak of the epidemy, we measured anti-SARS-CoV-2 IgM and IgG antibodies in 149 patients and collected clinical data. Results Only 3 asymptomatic patients presented IgG against the virus. In one patient hospitalized for COVID-19 (positive molecular testing), we did not detect any anti-SARS-CoV-2 antibodies, as in thirty-five other symptomatic patients considered as possible cases. Conclusions Even if respiratory symptoms linked to CF are frequent and compatible with COVID-19, anti-SARS-CoV-2 IgG antibodies were detected only in 3 asymptomatic patients. This reassuring study concerning the risk of COVID-19 in patients with CF illustrates the difficulty to distinguish COVID-19 symptoms from respiratory exacerbations and the need of generalized molecular testing to make a precise diagnosis.
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Affiliation(s)
- S Berardis
- Centre de référence pour la mucoviscidose, Cliniques universitaires Saint-Luc, Brussels, Belgium; Department of Pediatrics, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Verroken
- Department of medical biology and microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Vetillart
- Centre de référence pour la mucoviscidose, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C Struyf
- Centre de référence pour la mucoviscidose, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - M Gilbert
- Centre de référence pour la mucoviscidose, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - D Gruson
- Department of medical biology and microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - S Gohy
- Centre de référence pour la mucoviscidose, Cliniques universitaires Saint-Luc, Brussels, Belgium; Department of Pneumology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Pole of Pneumology, ENT and Dermatology, Institute of Experimental & Clinical Research, Université catholique de Louvain (UCLouvain), Brussels, Belgium.
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Krauze AV, Megan M, Theresa CZ, Peter M, Shih JH, Tofilon PJ, Rowe L, Gilbert M, Camphausen K. The addition of Valproic acid to concurrent radiation therapy and temozolomide improves patient outcome: a Correlative analysis of RTOG 0525, SEER and a Phase II NCI trial. Cancer Stud Ther 2020; 5. [PMID: 34621499 PMCID: PMC8494241 DOI: 10.31038/cst.2020511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE/OBJECTIVES Valproic Acid (VPA) is an antiepileptic agent with HDACi (histone deacetylase inhibitor) activity shown to radiosensitize glioblastoma (GBM) cells. We evaluated the addition of VPA to standard radiation therapy (RT) and temozolomide (TMZ) in an open-label, phase II study (NCI-06-C-0112). The intent of the current study was to compare our patient outcomes with modern era standard of care data (RTOG 0525) and general population data (SEER 2006-2013). MATERIALS/METHODS 37 patients with newly diagnosed GBM were treated in a phase II NCI trial with daily VPA (25 mg/kg) in addition to concurrent RT and TMZ (2006 - 2013) and 411 patients with newly diagnosed GBM were treated in the standard TMZ dose arm of RTOG 0525 (2006 - 2008). Using the SEER database, adult patients (age > 15) with diagnostic codes 9440-9443 (third edition (IDC-O-3) diagnosed between 2006 - 2013 were identified and 6083 were included in the analysis. Kaplan-Meier method was used to estimate OS and PFS. The effect of patient characteristics and clinical factors on OS and PFS was analyzed using univariate analysis and a Cox regression model. A landmark analysis was performed to correlate recurrence to OS and conditional probabilities of surviving an additional 12 months at diagnosis, 6, 12, 18, 24 and 30 months were calculated for both the trial data and the SEER data. RESULTS Updated median OS in the NCI cohort was 30.9m (22.2- 65.6m), compared to RTOG 0525 18.9m (16.8-20.3m) (p= 0.007) and the SEER cohort of 11m. Median PFS in the NCI cohort was 11.1m (6.6 - 49.6m) compared to RTOG 0525 with a median PFS of 7.5m (6.9-8.2m) (p = 0.004). Younger age, class V RPA and MGMT status were significant for PFS in both the NCI cohort and the RTOG 0525 cohort, in addition KPS was also significant for OS. In comparison to RTOG 0525, the population in the NCI cohort had a more favorable KPS and RPA, and a higher proportion of patients receiving bevacizumab after protocol therapy however with the exception of RPA (V) (8% vs 18%) (0.026), the effects of these factors on PFS and OS were not significantly different between the two cohorts. CONCLUSION Previously reported improvements in PFS and OS with the addition of VPA to concurrent RT and TMZ in the NCI phase II study were confirmed by comparison to both a trial population receiving standard of care (RTOG 0525) and a contemporary SEER cohort. These results provide further justification of a phase III trial of VPA/RT/TMZ.
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Affiliation(s)
- A V Krauze
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - Mackey Megan
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - Cooley-Zgela Theresa
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - Mathen Peter
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - J H Shih
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - P J Tofilon
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - L Rowe
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - M Gilbert
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
| | - K Camphausen
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH, 9000 Rockville Pike, Building 10, CRC, Bethesda, MD 20892, USA
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Fleming M, David JC, Rodríguez-Sánchez J, Fiorito L, Gilbert M, Stainer T. The High-Energy Intra-Nuclear Cascade Liège-based Residual (HEIR) nuclear data library. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023920001] [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: 11/14/2022] Open
Abstract
It is standard practice for nuclear data files to include tabulated data for distinct reaction channels for incident energies up to 20-30 MeV. Above these energies, the assumptions implicit in the definition of individual channels break down and event generators are typically used within codes that simulate nuclear observables in applications. These offer robust simulation of the physics but increase the computational burden. So-called ‘high-energy’ nuclear data files have been produced, but the well-known libraries are more than a decade old and rely upon models developed many years before their release. This presentation describes a modern library with a high level of production automation that offers regular updates as the models it is based upon are improved.
The most recent versions of the intra-nuclear cascade and de-excitation models available within Geant4 were used to generate tabulated data of residual nuclide production. For the first released library, the INCL++5.3 and ABLA version within Geant4 v10.3 were used to calculate over 1012 incident protons over 2095 target isotopes with incident energies up to 1 GeV. These were collated into tabulated data in the international-standard ENDF-6 format. The resulting files were provided as group-wise files and were distributed as HEIR-0.1 with the FISPACT-II version 4.0 release.
A second library, HEIR-0.2, has been generated using the new INCL++6.0 and C++ translation of the ABLA07 model available within Geant4 v10.4. Simulations were performed using incident protons, neutrons, deuterons and π±. An improved agreement is observed in the comparison to experimental data not only between the two versions, but against the other well-known high-energy nuclear data files and models available within Geant4. This benchmark includes mass and isotopic distributions, as well as incident-energy dependent cumulative and independent cross sections from the EXFOR database.
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Al Feghali K, Randall J, Wefel J, Guha-Thakurta N, Grosshans D, Dibej S, McAvoy S, Li J, McGovern S, McAleer M, Ghia A, Paulino A, Sulman E, Penas-Prado M, Wang J, deGroot J, Heimberger A, Armstrong T, Gilbert M, Mahajan A, Brown P, Chung C. Prospective Phase II Randomized Trial Comparing Proton Therapy vs. IMRT for Newly Diagnosed GBM: Secondary Analysis Comparison of Progression Free Survival between Clinical Radiological Assessment vs. Response Assessment in Neuro-Oncology (RANO). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.132] [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: 11/30/2022]
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25
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Herer B, Anllo H, Bocahu Y, Bréfort S, Darné C, Delignières A, Gilbert M, Haniez F, Jaillet H, Maas H, Mach V, Pytlak C, Saada M, Segundo I, Larue F. Effets de l’hypnose dans la dyspnée de la BPCO grave. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2018.10.020] [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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26
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Wilton J, Light L, Gardner S, Rachlis B, Conway T, Cooper C, Cupido P, Kendall CE, Loutfy M, McGee F, Murray J, Lush J, Rachlis A, Wobeser W, Bacon J, Kroch AE, Gilbert M, Rourke SB, Burchell AN. Late diagnosis, delayed presentation and late presentation among persons enrolled in a clinical HIV cohort in Ontario, Canada (1999-2013). HIV Med 2018; 20:110-120. [PMID: 30430742 DOI: 10.1111/hiv.12686] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Timely HIV diagnosis and presentation to medical care are important for treatment and prevention. Our objective was to measure late diagnosis, delayed presentation and late presentation among individuals in the Ontario HIV Treatment Network Cohort Study (OCS) who were newly diagnosed in Ontario. METHODS The OCS is a multi-site clinical cohort study of people living with HIV in Ontario, Canada. We measured prevalence of late diagnosis [CD4 count < 350 cells/μL or an AIDS-defining condition (ADC) within 3 months of HIV diagnosis], delayed presentation (≥ 3 months from HIV diagnosis to presentation to care), and late presentation (CD4 count < 350 cells/μL or ADC within 3 months of presentation). We identified characteristics associated with these outcomes and explored their overlap. RESULTS A total of 1819 OCS participants were newly diagnosed in Ontario from 1999 to 2013. Late diagnosis (53.0%) and presentation (54.0%) were common, and a quarter (23.1%) of participants were delayed presenters. In multivariable models, the participants of delayed presentation decreased over calendar time, but that of late diagnosis/presentation did not. Late diagnosis contributed to the majority (> 87%) of late presentation, and the prevalence of delayed presentation was similar among those diagnosed late versus early (13.4 versus 13.4%, respectively; P = 0.99). Characteristics associated with higher odds of late diagnosis/presentation in multivariable analyses included older age at diagnosis/presentation; African, Caribbean and Black race/ethnicity; Indigenous race/ethnicity; female sex; and being a male who did not report sex with men. There were lower odds of late diagnosis/presentation among participants who had ever injected drugs. In contrast, delayed presentation risk factors included younger age at diagnosis and having ever injected drugs. CONCLUSIONS Late presentation is common in Ontario, as it is in other high-income countries. Our findings suggest that efforts to reduce late presentation should focus on facilitating earlier diagnosis for the populations identified in this analysis.
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Affiliation(s)
- J Wilton
- Ontario HIV Treatment Network, Toronto, Canada
| | - L Light
- Ontario HIV Treatment Network, Toronto, Canada
| | - S Gardner
- Baycrest Health Sciences, Toronto, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - B Rachlis
- Ontario HIV Treatment Network, Toronto, Canada.,Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - T Conway
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Canadian Positive People Network, Ottawa, Canada
| | - C Cooper
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - P Cupido
- Ontario HIV Treatment Network, Toronto, Canada
| | - C E Kendall
- Ottawa Hospital Research Institute, Ottawa, Canada.,Bruyère Research Institute, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - M Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - F McGee
- AIDS Bureau, Ontario Ministry of Health and Long-Term Care, Toronto, Canada
| | - J Murray
- AIDS Bureau, Ontario Ministry of Health and Long-Term Care, Toronto, Canada
| | - J Lush
- AIDS Bureau, Ontario Ministry of Health and Long-Term Care, Toronto, Canada
| | - A Rachlis
- Department of Medicine, University of Toronto, Toronto, Canada.,Sunnybrook Health Science Centre, Toronto, Canada
| | - W Wobeser
- Department of Molecular and Biomedical Sciences, Queen's University, Kingston, Canada.,Department of Public Health, Queen's University, Kingston, Canada
| | - J Bacon
- Ontario HIV Treatment Network, Toronto, Canada
| | - A E Kroch
- Ontario HIV Treatment Network, Toronto, Canada.,Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - M Gilbert
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - S B Rourke
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - A N Burchell
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, St Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Gilbert K, Gilbert M, Chiriboga D, Park N, Molinari V. DEMENTIA-SPECIFIC DAYCARE FOR PATIENTS WITH ALZHEIMER’S DISEASE OR RELATED DISORDERS & THEIR CAREGIVERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Gilbert
- Alzheimer’s Community Care, West Palm Beach, Florida
| | - M Gilbert
- Alzheimer’s Community Care, West Palm Beach, Florida
| | - D Chiriboga
- Dept of Child & Family, College of Behavioral and Community Sciences, University of South Florida
| | - N Park
- University of South Florida
| | - V Molinari
- School of Aging Studies, College of Behavioral and Community Sciences, USF
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Deimling G, Phelps E, Ciaralli S, Gilbert M. LIFE STAISFACTION AND SELF-RATED HEALTH AMONG OLDER ADULT, LONG-TERM CANCER SURVIVORS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2734] [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
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Filset OM, Fredriksen K, Gamst TM, Gilbert M, Hesselberg N, Naesheim T. GUIDELINES FOR MANAGEMENT OF ACCIDENTAL HYPOTHERMIA IN A UNIVERSITY HOSPITAL IN NORTHERN NORWAY. ACTA ACUST UNITED AC 2018; 61:479-482. [PMID: 29894621 DOI: 10.18821/0201-7563-2016-6-479-482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Accidental hypothermia is defined as a trauma. Collaboration on the treatment of victims of accidental hypothermia shouldfollow a communication protocol for the seriously injured. Aim is to establish earliest possible contact with the doctor on duty at the regional University hospital to enable participation in the further communication and decision making process with relevance to technical and logistical issues. Victims of accidental hypothermia with adequate circulation and core temperature < 35⁰C can be treated with active remote heating (hot air blanket) at all hospitals providing emergency surgical care; active external warming should be started during transport to the nearest hospital. Hypothermic patients showing no signs of life, patients with inadequate circulation or hypothermia-induced circulatory arrest with core temperature < 32⁰C and serum K⁺ < 12 mmol-l⁻' should be transported directly to University hospital. Advanced life support in all these cases should be started immediately and continued without interruption during transportation until the patient is connected to a heart-lung machine for rewarming. If core temperature is < 28⁰C and/or the patient has inadequate circulation contact should be taken with the regional University hospital to discuss extracorporeal rewarming.
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Chung C, Brown P, Liu D, Grosshans D, Dibaj S, Guha-Thakurta N, Li J, McGovern S, McAleer M, Ghia A, Paulino A, Sulman E, Penas-Prado M, De Groot J, Heimberger A, Wang J, Armstrong T, Gilbert M, Mahajan A, Wefel J. EP-1239: Ph II randomized trial comparing cognitive outcomes of proton vs. photon radiation for glioblastoma. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31549-4] [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: 10/14/2022]
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Bhatnagar D, Rajasekaran K, Gilbert M, Cary J, Magan N. Advances in molecular and genomic research to safeguard food and feed supply from aflatoxin contamination. WORLD MYCOTOXIN J 2018. [DOI: 10.3920/wmj2017.2283] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Worldwide recognition that aflatoxin contamination of agricultural commodities by the fungus Aspergillus flavus is a global problem has significantly benefitted from global collaboration for understanding the contaminating fungus, as well as for developing and implementing solutions against the contamination. The effort to address this serious food and feed safety issue has led to a detailed understanding of the taxonomy, ecology, physiology, genomics and evolution of A. flavus, as well as strategies to reduce or control pre-harvest aflatoxin contamination, including (1) biological control, using atoxigenic aspergilli, (2) proteomic and genomic analyses for identifying resistance factors in maize as potential breeding markers to enable development of resistant maize lines, and (3) enhancing host-resistance by bioengineering of susceptible crops, such as cotton, maize, peanut and tree nuts. A post-harvest measure to prevent the occurrence of aflatoxin contamination in storage is also an important component for reducing exposure of populations worldwide to aflatoxins in food and feed supplies. The effect of environmental changes on aflatoxin contamination levels has recently become an important aspect for study to anticipate future contamination levels. The ability of A. flavus to produce dozens of secondary metabolites, in addition to aflatoxins, has created a new avenue of research for understanding the role these metabolites play in the survival and biodiversity of this fungus. The understanding of A. flavus, the aflatoxin contamination problem, and control measures to prevent the contamination has become a unique example for an integrated approach to safeguard global food and feed safety.
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Affiliation(s)
- D. Bhatnagar
- US Department of Agriculture, Agricultural Research Service, 1100 Robert E. Lee Boulevard, New Orleans, LA 70124, USA
| | - K. Rajasekaran
- US Department of Agriculture, Agricultural Research Service, 1100 Robert E. Lee Boulevard, New Orleans, LA 70124, USA
| | - M. Gilbert
- US Department of Agriculture, Agricultural Research Service, 1100 Robert E. Lee Boulevard, New Orleans, LA 70124, USA
| | - J.W. Cary
- US Department of Agriculture, Agricultural Research Service, 1100 Robert E. Lee Boulevard, New Orleans, LA 70124, USA
| | - N. Magan
- Applied Mycology Group, Cranfield University, MK45 4DT, Cranfield, United Kingdom
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Zimmer AS, Gril B, Steinberg S, Smart D, Gilbert M, Armstrong T, Xiao L, Houston N, Biassou N, Brastianos P, Carter S, Lyden DC, Lipkowitz S, Steeg P. Abstract OT2-06-01: Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-Positive breast cancer brain metastases following stereotactic radiosurgery. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-06-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Brain metastases occur in up to 25-40% of HER2+ breast cancer patients. Standard treatment is limited to surgery or stereotactic radiosurgery (SRS) and/or whole brain radiation therapy (WBRT), with high levels of recurrence or progression, limiting survival and quality of life in most patients. Our group has demonstrated that low doses of temozolomide (TMZ) administered in a prophylactic, metronomic fashion can significantly prevent development of brain metastases in murine models of breast cancer. Based on these findings, we propose a secondary-prevention clinical trial.
Trial Design: Phase I/II open label study. Phase I will follow a standard 3+3 design: T-DM1 3.6 mg/kg IV every 21 days plus TMZ 30, 40 or 50 mg/m2 daily. Phase II: randomization T-DM1 3.6 mg/kg versus T-DM1 3.6mg/kg plus TMZ at recommended phase 2 dose (RP2D). Patients will undergo radiology guided lumbar puncture at baseline and after 6 weeks of treatment (C3D1) for correlative studies, brain MRI, systemic restaging CTs, and questionnaires for evaluation of symptoms and quality of life (MDASI-BT and PROMIS®) every 6 weeks.
Eligibility: HER2+ breast cancer with ≤3 brain metastases, treated with SRS and/or resection ≤6 weeks before enrollment, no leptomeningeal metastases, no previous WBRT, able to complete brain MRI with contrast evaluations, willing to undergo lumbar puncture, ECOG ≤2 and adequate organ and marrow function. HBV, HCV or HIV-positive patients are ineligible.
Specific Aims: Phase I: to identify the maximum tolerated dose (MTD) of TMZ combined with T-DM1. Phase II: to determine if the combination regimen of T-DM1 and TMZ improves the recurrence-free incidence from distant new brain metastases at one year as compared to T-DM1 alone. Biomarkers, including cell free DNA sequencing from CSF, serum and tumor block, serum markers for neuroinflammation, and patient reported outcomes, will be analyzed in an exploratory fashion.
Statistical Methods: Phase I, MTD will be identified based on the dose level at which 0 or 1 patient in 6 has a DLT. Phase II, to test whether TMZ will increase RFS from 50% to 65% at 12 months. RFS Kaplan-Meier curves will be created for each of the randomized arms and compared using a one-tailed log-rank test, with a one-sided 0.10 significance level of interest to be detected. Patients will be stratified for number of brain lesions and status of systemic metastases (controlled or not).
Target Accrual: 49 evaluable patients per arm (total 98), plus 9 to 18 patients during phase I. Trial will open in Summer 2017, at NIH in Bethesda, MD.
Contact Information: Principal Investigator: Alexandra S Zimmer, MD alexandra.zimmer@nih.gov
Citation Format: Zimmer AS, Gril B, Steinberg S, Smart D, Gilbert M, Armstrong T, Xiao L, Houston N, Biassou N, Brastianos P, Carter S, Lyden DC, Lipkowitz S, Steeg P. Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-Positive breast cancer brain metastases following stereotactic radiosurgery [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-06-01.
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Affiliation(s)
- AS Zimmer
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - B Gril
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Steinberg
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - D Smart
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - M Gilbert
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - T Armstrong
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - L Xiao
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - N Houston
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - N Biassou
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - P Brastianos
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Carter
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - DC Lyden
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - S Lipkowitz
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
| | - P Steeg
- Women's Malignancies Branch - NCI/NIH, Bethesda, MD; NCI/NIH, Bethesda, MD; Radiation Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Oncology Branch - NCI/NIH, Bethesda, MD; Neuro-Radiology, Clinical Center - NIH, Bethesda, MD; Massachusetts General Hospital / Harvard Cancer Center, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Weill Cornell Medicine, New York, NY
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Nishijima DK, Gaona SD, Waechter T, Maloney R, Blitz A, Elms AR, Farrales RD, Montoya J, Bair T, Howard C, Gilbert M, Trajano RP, Hatchel KM, Faul M, Bell JM, Coronado VC, Vinson DR, Ballard DW, Tancredi DJ, Garzon H, Mackey KE, Shahlaie K, Holmes JF. The Incidence of Traumatic Intracranial Hemorrhage in Head-Injured Older Adults Transported by EMS with and without Anticoagulant or Antiplatelet Use. J Neurotrauma 2018; 35:750-759. [PMID: 29108469 DOI: 10.1089/neu.2017.5232] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Field triage guidelines recommend transport of head-injured patients on anticoagulants or antiplatelets to a higher-level trauma center based on studies suggesting a high incidence of traumatic intracranial hemorrhage (tICH). We compared the incidence of tICH in older adults transported by emergency medical services (EMS) with and without anticoagulation or antiplatelet use and evaluated the accuracies of different sets of field triage criteria to identify tICH. This was a prospective, observational study at five EMS agencies and 11 hospitals. Older adults (≥55 years) with head trauma and transported by EMS from August 2015 to September 2016 were eligible. EMS providers completed standardized data forms and patients were followed through emergency department (ED) or hospital discharge. We enrolled 1304 patients; 1147 (88%) received a cranial computed tomography (CT) scan and were eligible for analysis. Four hundred thirty-four (33%) patients had anticoagulant or antiplatelet use and 112 (10%) had tICH. The incidence of tICH in patients with (11%, 95% confidence interval [CI] 8%-14%) and without (9%, 95% CI 7%-11%) anticoagulant or antiplatelet use was similar. Anticoagulant or antiplatelet use was not predictive of tICH on adjusted analysis. Steps 1-3 criteria alone were not sensitive in identifying tICH (27%), whereas the addition of anticoagulant or antiplatelet criterion improved sensitivity (63%). Other derived sets of triage criteria were highly sensitive (>98%) but poorly specific (<11%). The incidence of tICH was similar between patients with and without anticoagulant or antiplatelet use. Use of anticoagulant or antiplatelet medications was not a risk factor for tICH. We were unable to identify a set of triage criteria that was accurate for trauma center need.
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Affiliation(s)
- Daniel K Nishijima
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Samuel D Gaona
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Trent Waechter
- City of Sacramento Fire Department, Sacramento, California
| | - Ric Maloney
- Sacramento Metropolitan Fire Department, Sacramento, California
| | - Adam Blitz
- American Medical Response, Sacramento, California
| | - Andrew R Elms
- Kaiser Permanente South Sacramento Medical Center, Sacramento, California
| | | | | | - Troy Bair
- Cosumnes Community Services District Fire Department, Elk Grove, California
| | | | - Megan Gilbert
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Renee P Trajano
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Kaela M Hatchel
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Mark Faul
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeneita M Bell
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Victor C Coronado
- Centers for Disease Control and Prevention, Atlanta, Georgia.,Bridge to Heath, Atlanta, Georgia
| | - David R Vinson
- Kaiser Permanente Division of Research, Oakland, California.,Kaiser Permanente Sacramento Medical Center, Sacramento, California
| | - Dustin W Ballard
- Kaiser Permanente Division of Research, Oakland, California.,Kaiser Permanente San Rafael Medical Center, San Rafael, California
| | - Daniel J Tancredi
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Hernando Garzon
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
| | - Kevin E Mackey
- Kaiser Permanente South Sacramento Medical Center, Sacramento, California
| | - Kiarash Shahlaie
- Department of Neurological Surgery, UC Davis School of Medicine, Sacramento, California
| | - James F Holmes
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
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35
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Fischer U, Bachmann C, Catalan J, Eade T, Flammini D, Gilbert M, Jaboulay JC, Konobeev A, Leichtle D, Lu L, Malouch F, Moro F, Pereslavtsev P, Qiu Y, Sanz J, Sauvan P, Stankunas G, Travleev A, Turner A, Ogando F, Palermo I, Villari R. Methodological approach for DEMO neutronics in the European PPPT programme: Tools, data and analyses. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.01.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Krauze A, Myrehaug S, Chang M, Holdford D, Smith S, Shih J, Tofilon P, Fine H, Rowe L, Gilbert M, Camphausen K. Does the Addition of Valproic Acid to Concurrent Radiation Therapy and Temozolomide Improve Patient Outcome? Correlative Analysis of RTOG 0525, SEER, and a Phase 2 NCI Trial. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rowe L, Butman J, Mackey M, Shih J, Ning H, Cooley-Zgela T, Gilbert M, Smart D, Camphausen K, Krauze A. Response Assessment in Glioblastoma: A Clinical Experience. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.466] [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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Eby D, Molnar L, LeBlanc D, Gilbert M, Bogard S, St. Louis R, Zanier N, Stanciu S. THE OBJECTIVE MEASUREMENT OF DRIVING AMONG OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4599] [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)
- D.W. Eby
- University of Michigan, Ann Arbor, Michigan
| | | | - D. LeBlanc
- University of Michigan, Ann Arbor, Michigan
| | - M. Gilbert
- University of Michigan, Ann Arbor, Michigan
| | - S. Bogard
- University of Michigan, Ann Arbor, Michigan
| | | | - N. Zanier
- University of Michigan, Ann Arbor, Michigan
| | - S. Stanciu
- University of Michigan, Ann Arbor, Michigan
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Islam N, Krajden M, Gilbert M, Gustafson P, Yu A, Kuo M, Chong M, Alvarez M, Wong J, Tyndall MW, Janjua NZ. Role of primary T-cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort. J Viral Hepat 2017; 24:421-429. [PMID: 27885757 DOI: 10.1111/jvh.12650] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/29/2016] [Indexed: 12/13/2022]
Abstract
T-cell host immune response against hepatitis C virus (HCV) has been suggested to play an important role in determining HCV infection outcome. However, data from human studies are not available. This study examined the effect of primary T-cell deficiency along with other factors on the spontaneous clearance of HCV in a large population-based cohort in British Columbia, Canada. The BC Hepatitis Testers Cohort includes all individuals tested for HCV in BC in 1990-2013 linked with data on their medical visits, hospitalizations and prescription drugs. HCV-positive individuals with at least one valid HCV PCR test on/after HCV diagnosis (n=46 783) were included in this study. To examine factors associated with the spontaneous clearance of HCV, multivariable logistic regression was fitted on the full sample, and Cox proportional hazards model on the HCV seroconverters. Spontaneous clearance was observed in 25.1% (n=11 737) of those tested for HCV. After adjusting for potential confounders, the odds of spontaneous clearance of HCV was lower in people with primary T-cell immunodeficiency (adjusted odds ratio [aOR]: 0.55, 95% CI: 0.32-0.94), and higher in females (aOR: 1.61, 95% CI: 1.54-1.68) and in those coinfected with HBV (aOR: 2.31, 95% CI: 1.93-2.77). Similar results were observed in HCV seroconverters except HBV coinfection was not significant. In conclusion, primary T-cell immunodeficiency is associated with a lower spontaneous clearance of HCV while female sex and coinfection with HBV are associated with a higher spontaneous clearance.
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Affiliation(s)
- N Islam
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Krajden
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M Gilbert
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Ontario HIV Treatment Network, Toronto, ON, Canada
| | - P Gustafson
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada
| | - A Yu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Kuo
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Chong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Alvarez
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - J Wong
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M W Tyndall
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - N Z Janjua
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Flowers P, Riddell J, Park C, Ahmed B, Young I, Frankis J, Davis M, Gilbert M, Estcourt C, Wallace L, McDaid LM. Preparedness for use of the rapid result HIV self-test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care. HIV Med 2016; 18:245-255. [PMID: 27492141 PMCID: PMC5347967 DOI: 10.1111/hiv.12420] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 11/30/2022]
Abstract
Objectives The aim of the study was to explore preparedness for the HIV self‐test among men who have sex with men (MSM) and those involved in HIV prevention and care. Methods A mixed methods exploratory research design was employed, detailing awareness and willingness to use the self‐test and the perceived barriers and facilitators to implementation. Quantitative and qualitative data collection and analysis were completed in parallel. Descriptive and inferential analysis of cross‐sectional bar‐based survey data collected from MSM through a self‐completed questionnaire and oral fluid specimen collection (n = 999) was combined with qualitative, thematic, analysis of data collected through 12 expert focus groups (n = 55) consisting of gay men, National Health Service (NHS) staff, community organizations, entrepreneurs and activists. Findings were subsequently combined and assessed for synergies. Results Among MSM, self‐test awareness was moderate (55%). Greater awareness was associated with increased educational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00–2.30; P = 0.05] and previous history of sexually transmitted infection (STI) testing (adjusted odds ratio 1.63; 95% CI 1.11–2.39; P = 0.01). Willingness to use the test was high (89%) and associated with meeting sexual partners online (unadjusted odds ratio 1.96; 95% CI 1.31–2.94; P < 0.001). Experts highlighted the overall acceptability of self‐testing; it was understood as convenient, discreet, accessible, and with a low burden to services. However, some ambivalence towards self‐testing was reported; it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk. Conclusions Self‐testing represents an opportunity to reduce barriers to HIV testing and enhance prevention and access to care. Levels of awareness are moderate but willingness to use is high. Self‐testing may amplify health inequalities.
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Affiliation(s)
- P Flowers
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - J Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - C Park
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - B Ahmed
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - I Young
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - J Frankis
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - M Davis
- School of Social Sciences, Monash University, Melbourne, Vic., Australia
| | - M Gilbert
- Applied Epidemiology Unit, Ontario HIV Treatment Network, Toronto, ON, Canada
| | - C Estcourt
- Barts and the London School of Medicine and Dentistry, Barts Sexual Health Centre, Blizard Institute, London, UK
| | - L Wallace
- Health Protection Scotland, Glasgow, UK
| | - L M McDaid
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Robinson TP, Bu DP, Carrique-Mas J, Fèvre EM, Gilbert M, Grace D, Hay SI, Jiwakanon J, Kakkar M, Kariuki S, Laxminarayan R, Lubroth J, Magnusson U, Thi Ngoc P, Van Boeckel TP, Woolhouse MEJ. Antibiotic resistance is the quintessential One Health issue. Trans R Soc Trop Med Hyg 2016; 110:377-80. [PMID: 27475987 PMCID: PMC4975175 DOI: 10.1093/trstmh/trw048] [Citation(s) in RCA: 379] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 06/28/2016] [Accepted: 06/30/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- T P Robinson
- International Livestock Research Institute, Nairobi, Kenya
| | - D P Bu
- Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing, China
| | - J Carrique-Mas
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - E M Fèvre
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - M Gilbert
- Université Libre de Bruxelles, Brussels, Belgium
| | - D Grace
- International Livestock Research Institute, Nairobi, Kenya
| | - S I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, UK
| | - J Jiwakanon
- Research Group for Preventive Technology in Livestock, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - M Kakkar
- Public Health Foundation of India, Delhi, India
| | - S Kariuki
- Kenya Medical Research Institute, Nairobi, Kenya
| | - R Laxminarayan
- Center for Disease Dynamics, Economics and Policy, Washington DC, USA
| | - J Lubroth
- Food and Agriculture Organization of the United Nations, Rome, Italy
| | - U Magnusson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - P Thi Ngoc
- National Institute of Veterinary Research, Hanoi, Vietnam
| | - T P Van Boeckel
- Institute of Integrative Biology and Center for Adaptation to a Changing Environment, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - M E J Woolhouse
- Centre for Immunity, Infection & Evolution, University of Edinburgh, Edinburgh, UK
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Magoteaux S, Gilbert M, Langlais CS, Garcia-Filion P, Notrica DM. Should Children with Suspected Nonaccidental Injury Be Admitted to a Surgical Service? J Am Coll Surg 2016; 222:838-43. [DOI: 10.1016/j.jamcollsurg.2015.12.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/29/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
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Shear NH, Hartmann M, Toledo-Bahena ME, Gilbert M, Katsambas A, Yao R, Popmihajlov Z. Health-related quality-of-life improvements during 98 weeks of infliximab therapy in patients with plaque-type psoriasis in real-world practice. Qual Life Res 2016; 25:2031-40. [DOI: 10.1007/s11136-015-1224-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2015] [Indexed: 11/28/2022]
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Bakke HK, Steinvik T, Eidissen S, Gilbert M, Wisborg T. Bystander first aid in trauma - prevalence and quality: a prospective observational study. Acta Anaesthesiol Scand 2015; 59:1187-93. [PMID: 26088860 PMCID: PMC4744764 DOI: 10.1111/aas.12561] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 11/30/2022]
Abstract
Background Bystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out‐of‐hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first‐aid providers, and whether previous first‐aid training affects aid quality. Methods We conducted a prospective 18‐month study in two mixed urban–rural Norwegian counties. The personnel on the first ambulance responding to trauma calls assessed and documented first aid performed by bystanders using a standard form. Results A total of 330 trauma calls were included, with bystanders present in 97% of cases. Securing an open airway was correctly performed for 76% of the 43 patients in need of this first‐aid measure. Bleeding control was provided correctly for 81% of 63 patients for whom this measure was indicated, and prevention of hypothermia for 62% of 204 patients. Among the first‐aid providers studied, 35% had some training in first aid. Bystanders with documented first‐aid training gave better first aid than those where first‐aid training status was unknown. Conclusions A majority of the trauma patients studied received correct pre‐hospital first aid, but still there is need for considerable improvement, particularly hypothermia prevention. Previous first‐aid training seems to improve the quality of first aid provided. The effect on patient survival needs to be investigated.
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Affiliation(s)
- H. K. Bakke
- Mo i Rana Hospital Helgeland Hospital Trust Mo i Rana Norway
- Anaesthesia and Critical Care Research Group Faculty of Health Sciences University of Tromsø Tromsø Norway
| | - T. Steinvik
- Anaesthesia and Critical Care Research Group Faculty of Health Sciences University of Tromsø Tromsø Norway
| | - S.‐I. Eidissen
- Anaesthesia and Critical Care Research Group Faculty of Health Sciences University of Tromsø Tromsø Norway
- Sørlandet Hospital Kristiansand Kristiansand Norway
| | - M. Gilbert
- Anaesthesia and Critical Care Research Group Faculty of Health Sciences University of Tromsø Tromsø Norway
- Clinic of Emergency Medical Services University Hospital of North Norway UNN Hospital Trust Tromsø Norway
| | - T. Wisborg
- Anaesthesia and Critical Care Research Group Faculty of Health Sciences University of Tromsø Tromsø Norway
- Hammerfest Hospital Department of Anaesthesiology and Intensive Care Finnmark Health Trust Hammerfest Norway
- Norwegian National Advisory Unit on Trauma Division of Emergencies and Critical Care Oslo University Hospital Oslo Norway
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Goldmacher GV, Ellingson BM, Boxerman J, Barboriak D, Pope WB, Gilbert M. Standardized Brain Tumor Imaging Protocol for Clinical Trials. AJNR Am J Neuroradiol 2015; 36:E65-6. [PMID: 26359146 DOI: 10.3174/ajnr.a4544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- G V Goldmacher
- Department of Medical and Scientific Affairs ICON Clinical Research Warrington, Pennsylvania
| | - B M Ellingson
- David Geffen School of Medicine University of California, Los Angeles Los Angeles, California
| | - J Boxerman
- Brown Alpert Medical School Brown University Providence, Rhode Island
| | - D Barboriak
- Department of Radiology Duke University School of Medicine Durham, North Carolina
| | - W B Pope
- Department of Radiology UCLA Medical Center Los Angeles, California
| | - M Gilbert
- Center for Cancer Research National Institutes of Health Bethesda, Maryland
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Gilbert M, Wong S, Hottes TS, Haag D, Brownrigg B, Wong J, Ogilvie G. P02.04 Acceptability of online resources for sti partner notification: who would use what in the toolkit? Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.225] [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: 11/03/2022]
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Happold C, Gorlia T, Chinot O, Gilbert M, Nabors L, Wick W, Pugh S, Hegi M, Cloughesy T, Roth P, Reardon D, Perry J, Mehta M, Stupp R, Weller M. 26LBA Does valproic acid improve survival in glioblastoma? A meta-analysis of randomized trials in newly diagnosed glioblastoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(15)30075-7] [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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Gilbert M, Ferlatte O, Michelow W, Martin S, Young I, Donelle L, Rootman I, McDaid L, Flowers P. P02.05 Sexual health literacy – an emerging framework for research and intervention to improve sexual health for gay men. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wong J, Achen M, Holgerson N, Ogilvie G, Gilbert M. P04.06 Partner number and outcomes of partner notification among gay, bisexual, and other men who have sex with men with infectious syphilis in british columbia, canada. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Doull M, Haag D, Bondyra M, Lee C, Dinner K, Wong T, Gilbert M. P04.01 Similarities and differences in perceptions of models for online partner notification for sexually transmitted infections: potential users versus care providers. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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