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Smythe A, Rathi S, Pavlova N, Littlewood C, Connell D, Haines T, Malliaras P. Self-reported management among people with rotator cuff related shoulder pain: An observational study. Musculoskelet Sci Pract 2021; 51:102305. [PMID: 33249362 DOI: 10.1016/j.msksp.2020.102305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rotator cuff related shoulder pain is the most common cause of shoulder pain. Whilst guidelines recommend conservative management prior to imaging, injection or surgical management, recent findings suggest that patients experience management contrary to guideline recommendations. OBJECTIVES The aim of this study was to investigate self-reported management among people with rotator cuff related shoulder pain (RCRSP) and their beliefs towards management. MATERIALS AND METHODS Cross-sectional survey of people with RCRSP recruited when referred for imaging (n = 120). Electronic survey about demographic factors, management people had had (including imaging, injections, surgery, exercise, adjuncts), and beliefs about treatments. The frequency of various treatments was reported (separately for each cohort and traumatic onset) as well as the timing of interventions related to first-line care. RESULTS Most people had tried exercise (99/120, 82.5%) but only one in five people reported exercise was helpful, and one in six reported it was unhelpful or made their symptoms worse. Approximately a third of the cohort reported not receiving activity modification advice (34.2%, 41/120), those that did received inconsistent information. People with both traumatic (imaging 31/43, 72.1%; injections 13/24, 54.2%, surgery 8/21, 38.1%) and atraumatic onset pain (imaging 43/77, 55.8%; injections 31/51, 60.8%, surgery 4/19, 21.1%) had similarly high rates of intervention prior to trialling conservative management. Patient beliefs in regards to management showed trends towards interventionalist care. CONCLUSION Patient reported management of RCRSP is often inconsistent with guideline recommended management.
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Affiliation(s)
- A Smythe
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia; A-Game Physiotherapy, Somerville, Victoria, 3912, Australia.
| | - S Rathi
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia
| | - N Pavlova
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia
| | - C Littlewood
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, M15 6GX, UK. https://twitter.com/ChrisLittlew00d
| | - D Connell
- Imaging at Olympic Park, AAMI Park, Melbourne, Australia; Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - T Haines
- School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building G, Peninsula Campus, Monash University, Victoria, 3199, Australia
| | - P Malliaras
- Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Building B, Peninsula Campus, Monash University, Victoria, 3199, Australia. https://twitter.com/DrPeteMalliaras
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Guseva O, Guseva O, Mamaeva O, Pavlova N, Pavlov D, Mitusova M, Podlesov A, Evsikova I, Strelyukhina S, Lebedeva S, Scherbak S. P1572 The role of 3D echocardiography in the evaluation of left ventricular remodeling. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
to assess the left ventricular (LV) remodeling with using transthoracic 3D Echo and MRI in young athletes.
Materials
for the period from October 2015 to April 2018, 88 athletes (61 men and 27 women) were examined. Mean age was 20.8 ± 3.9 years. Group A (professionals) – 65 athletes (4 or more training days a week, experience in sports for at least 7 years, the presence of at least the 1st sports category). Group B (Amateurs) – 23 athletes (3 or less training days a week). By types of loads were identified 4 groups: 1st - high-static, low-dynamic (climbing); 2nd - medium-static, medium-dynamic (volleyball, Rugby, sports dancing); 3rd - medium-static, high-dynamic (badminton, orienteering, hockey); 4th - high-static, high-dynamic (triathlon, water polo, rowing).
Methods
2D-, 3D-Echo was performed on Vivid E9 XDclear 4D (GE, USA). With the help of software package for processing 3D arrays (4D auto LVQ and 4D Strain and LV-mass) in automatic and semi-automatic mode was obtained end diastolic and end systolic volumes (EDV, ESV), ejection fraction (EF) and LV mass. The device was used for MRI - Avanto (Siemens) - 1.5 T, using: sensors for breathing and synchronization with ECG, standard surface coil Body Matrix. Visualization of the mobile myocardium was carried out by SSFP protocols in standard two-and four-chamber view, as well as on the short axis. In addition, the black-blood Protocol was performed in axial projection for visualization of mediastinal organs and chest. Evaluation of the results was performed on a workstation Syngo Via VB10B (Siemens) using a worker thread MR Cardiac analisis.
Results
There were significant differences in the types of loads (p < 0.001): 22% of men in Group B had 1st type, 2nd type - 78% of men and 93% of women in group B, 3rd type - 45% of men and 36% of women in group A, 4th type - 39% of men and 21% of women in group A. In the evaluation of LV remodeling and its relationship with the type of loads revealed significant differences (p < 0.01): 87.5% had LV remodeling (95.4% - aggregate type load 1, 2, 3), 6.8% - concentric remodeling (21.7% of all type 4), and 4.5% eccentric hypertrophy (8.7% of all type 4), 1.1 per cent of concentric hypertrophy (4.4% of all type 4). Consequently, most athletes with loads of type 4 had different types of LV remodeling. Comparing 3D Echo and MRI, high-grade positive correlations were obtained in indicators: EDV (R 0.82, p < 0.0001), ESV (R 0.80, p < 0.0001), LV mass (R 0.85, p < 0.0001), as well as moderate positive the index of EDV (R 0.54, p < 0.037) and unreliable for the EF.
Conclusions
three-dimensional visualization allows to carry out a reliable assessment of the volumetric parameters of the heart chambers, comparable with MRI data and to identify the signs and type of LV remodeling.
Requires further study of the performance of 3D Echo in athletes, given the lack of normative data on the modern stage.
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Affiliation(s)
- O Guseva
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - O Guseva
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - O Mamaeva
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - N Pavlova
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - D Pavlov
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - M Mitusova
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - A Podlesov
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - I Evsikova
- City Hospital 40, Saint-Petersburg, Russian Federation
| | | | - S Lebedeva
- City Hospital 40, Saint-Petersburg, Russian Federation
| | - S Scherbak
- City Hospital 40, Saint-Petersburg, Russian Federation
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Pavlova N. P870 The role of transthoracic doppler echocardiography in chronic total occlusion diagnosis in a patient with stable angina and cerebral atherosclerosis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The issue of sudden cardiac death (SCD) remains one of the most actual problem in healthcare. Several reports underscores that about 50-80% of SCD is linked to ischemic heart disease (IHD). The usage of contemporary risk-stratification criteria of SCD and implementation of new noninvasive ultrasound methods allow to improve patient’s prognosis through early start of optimal medical therapy and surgical treatment.
Material and methods: 63 years-old male with moderate class II stable angina. Patient undergone eversion endarterectomy 2 years prior to initial admittance due to an 80% left internal carotid stenosis and received appropriate optimal medical therapy provided by the modern dyslipidemia guidelines. We’ve used ECG (MAC 1600, GE); transthoracic doppler echocardiography, stress-echo, triplex scanning (VIVID E9, E95, GE); ergometry stress test (eBike, GE), quantitative coronary angiography (Innova 3100, GE).
Results
ECG (sinus rhythm, 62bpm, left ventricular hypertrophy) and brachiocephalic arteries triplex scan were unremarkable. Patient had dyslipidemia with low HDL. Transthoracic echocardiography revealed no region wall motion abnormalities, concentric remodeling, mild diastolic dysfunction, preserved ejection fraction (57%, Simpson). Transthoracic doppler echocardiography showed retrograde mid-LAD flow and patient was scheduled for noninvasive stress-echocardiography (Level III, 100W 2:00 min). Stress-echo was positive with apical anterior and lateral akinesia, septal and mid-lateral hypokinesia, GLS rest 15 %, GLS peak 13% and dynamic ST-segment changes in V4-V6. Invasive coronary angiography showed LAD CTO and subtotal LCx lesion. Then LAD and LCx PTCA with stenting were performed with good clinical outcome.
Conclusion
Novel methods of cardiac and coronary visualization are feasible in coronary flow reserve assessment and chronic total occlusions identification, especially in patients with multifocal atherosclerosis.
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Affiliation(s)
- N Pavlova
- City Hospital 40, Saint-Petersburg, Russian Federation
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Chegodaev D, Pavlova P, Pavlova N, Gusev V, Lvova O. Impaired GABA transmission is a crucial factor in the genesis of burst suppression electroencephalogram pattern: A hypothesis from neuroanatomical evidences. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pavlova N, Chegodaev D, Pavlova P, Lvova O, Kiselev S, Volodkevich A. Differences in central alpha-rhythm in preterm and full-term infants. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wurth S, Capogrosso M, Raspopovic S, Gandar J, Federici G, Kinany N, Cutrone A, Piersigilli A, Pavlova N, Guiet R, Taverni G, Rigosa J, Shkorbatova P, Navarro X, Barraud Q, Courtine G, Micera S. Long-term usability and bio-integration of polyimide-based intra-neural stimulating electrodes. Biomaterials 2017; 122:114-129. [PMID: 28110171 DOI: 10.1016/j.biomaterials.2017.01.014] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [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: 07/18/2016] [Revised: 12/21/2016] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
Abstract
Stimulation of peripheral nerves has transiently restored lost sensation and has the potential to alleviate motor deficits. However, incomplete characterization of the long-term usability and bio-integration of intra-neural implants has restricted their use for clinical applications. Here, we conducted a longitudinal assessment of the selectivity, stability, functionality, and biocompatibility of polyimide-based intra-neural implants that were inserted in the sciatic nerve of twenty-three healthy adult rats for up to six months. We found that the stimulation threshold and impedance of the electrodes increased moderately during the first four weeks after implantation, and then remained stable over the following five months. The time course of these adaptations correlated with the progressive development of a fibrotic capsule around the implants. The selectivity of the electrodes enabled the preferential recruitment of extensor and flexor muscles of the ankle. Despite the foreign body reaction, this selectivity remained stable over time. These functional properties supported the development of control algorithms that modulated the forces produced by ankle extensor and flexor muscles with high precision. The comprehensive characterization of the implant encapsulation revealed hyper-cellularity, increased microvascular density, Wallerian degeneration, and infiltration of macrophages within the endoneurial space early after implantation. Over time, the amount of macrophages markedly decreased, and a layer of multinucleated giant cells surrounded by a capsule of fibrotic tissue developed around the implant, causing an enlargement of the diameter of the nerve. However, the density of nerve fibers above and below the inserted implant remained unaffected. Upon removal of the implant, we did not detect alteration of skilled leg movements and only observed mild tissue reaction. Our study characterized the interplay between the development of foreign body responses and changes in the electrical properties of actively used intra-neural electrodes, highlighting functional stability of polyimide-based implants over more than six months. These results are essential for refining and validating these implants and open a realistic pathway for long-term clinical applications in humans.
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Affiliation(s)
- S Wurth
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - M Capogrosso
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - S Raspopovic
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - J Gandar
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Federici
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - N Kinany
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - A Cutrone
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - A Piersigilli
- Laboratory Animals Pathology Unit, Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - N Pavlova
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Pavlov Institute of Physiology, St Petersbourg, Russia
| | - R Guiet
- Bioimaging and Optics Platform, Faculty of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Taverni
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - J Rigosa
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; SAMBA Lab, International School for Advanced Studies, Trieste, Italy
| | - P Shkorbatova
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Pavlov Institute of Physiology, St Petersbourg, Russia
| | - X Navarro
- Institute of Neurosciences, Department of Cell Biology, Physiology, and Immunology, Universitat Autònoma de Barcelona, and CIBERNED, Bellaterra, Spain
| | - Q Barraud
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - G Courtine
- International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain Mind Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - S Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
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Makarova K, Slesarev A, Wolf Y, Sorokin A, Mirkin B, Koonin E, Pavlov A, Pavlova N, Karamychev V, Polouchine N, Shakhova V, Grigoriev I, Lou Y, Rohksar D, Lucas S, Huang K, Goodstein DM, Hawkins T, Plengvidhya V, Welker D, Hughes J, Goh Y, Benson A, Baldwin K, Lee JH, Díaz-Muñiz I, Dosti B, Smeianov V, Wechter W, Barabote R, Lorca G, Altermann E, Barrangou R, Ganesan B, Xie Y, Rawsthorne H, Tamir D, Parker C, Breidt F, Broadbent J, Hutkins R, O'Sullivan D, Steele J, Unlu G, Saier M, Klaenhammer T, Richardson P, Kozyavkin S, Weimer B, Mills D. Comparative genomics of the lactic acid bacteria. Proc Natl Acad Sci U S A 2006; 103:15611-6. [PMID: 17030793 PMCID: PMC1622870 DOI: 10.1073/pnas.0607117103] [Citation(s) in RCA: 944] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Lactic acid-producing bacteria are associated with various plant and animal niches and play a key role in the production of fermented foods and beverages. We report nine genome sequences representing the phylogenetic and functional diversity of these bacteria. The small genomes of lactic acid bacteria encode a broad repertoire of transporters for efficient carbon and nitrogen acquisition from the nutritionally rich environments they inhabit and reflect a limited range of biosynthetic capabilities that indicate both prototrophic and auxotrophic strains. Phylogenetic analyses, comparison of gene content across the group, and reconstruction of ancestral gene sets indicate a combination of extensive gene loss and key gene acquisitions via horizontal gene transfer during the coevolution of lactic acid bacteria with their habitats.
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Affiliation(s)
- K. Makarova
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894
| | - A. Slesarev
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - Y. Wolf
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894
| | - A. Sorokin
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894
| | - B. Mirkin
- School of Information Systems and Computer Science, Birkbeck College, University of London, Malet Street, London WC1E 7HX, United Kingdom
| | - E. Koonin
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD 20894
- To whom correspondence may be addressed. E-mail:
, , , or
| | - A. Pavlov
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - N. Pavlova
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - V. Karamychev
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - N. Polouchine
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - V. Shakhova
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - I. Grigoriev
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - Y. Lou
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - D. Rohksar
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - S. Lucas
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - K. Huang
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - D. M. Goodstein
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - T. Hawkins
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - V. Plengvidhya
- Department of Food Science, North Carolina State University, Raleigh, NC 27695
- North Carolina Agricultural Research Service, U.S. Department of Agriculture, Raleigh, NC 27695; Departments of
| | | | | | - Y. Goh
- Department of Food Science and Technology, University of Nebraska, Lincoln, NE 68583
| | - A. Benson
- Department of Food Science and Technology, University of Nebraska, Lincoln, NE 68583
| | - K. Baldwin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108
| | - J.-H. Lee
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108
| | - I. Díaz-Muñiz
- Department of Food Science, University of Wisconsin, Madison, WI 53706
| | - B. Dosti
- Department of Food Science, University of Wisconsin, Madison, WI 53706
| | - V. Smeianov
- Department of Food Science, University of Wisconsin, Madison, WI 53706
| | - W. Wechter
- Department of Food Science, University of Wisconsin, Madison, WI 53706
| | - R. Barabote
- Department of Biology, University of California at San Diego, La Jolla, CA 92093
| | - G. Lorca
- Department of Biology, University of California at San Diego, La Jolla, CA 92093
| | - E. Altermann
- Department of Food Science, North Carolina State University, Raleigh, NC 27695
| | - R. Barrangou
- Department of Food Science, North Carolina State University, Raleigh, NC 27695
| | - B. Ganesan
- Center for Integrated BioSystems, Utah State University, Logan, UT 84322
| | - Y. Xie
- Nutrition and Food Science and
- Center for Integrated BioSystems, Utah State University, Logan, UT 84322
| | - H. Rawsthorne
- Department of Viticulture and Enology, University of California, Davis, CA 95616; and
| | | | | | - F. Breidt
- Department of Food Science, North Carolina State University, Raleigh, NC 27695
- North Carolina Agricultural Research Service, U.S. Department of Agriculture, Raleigh, NC 27695; Departments of
| | | | - R. Hutkins
- Department of Food Science and Technology, University of Nebraska, Lincoln, NE 68583
| | - D. O'Sullivan
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108
| | - J. Steele
- Department of Food Science, University of Wisconsin, Madison, WI 53706
| | - G. Unlu
- Department of Food Science and Toxicology, University of Idaho, Moscow, ID 83844
| | - M. Saier
- Department of Biology, University of California at San Diego, La Jolla, CA 92093
| | - T. Klaenhammer
- Department of Food Science, North Carolina State University, Raleigh, NC 27695
- To whom correspondence may be addressed. E-mail:
, , , or
| | - P. Richardson
- U.S. Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA 94598
| | - S. Kozyavkin
- Fidelity Systems Inc., 7961 Cessna Avenue, Gaithersburg, MD 20879
| | - B. Weimer
- Nutrition and Food Science and
- Center for Integrated BioSystems, Utah State University, Logan, UT 84322
- To whom correspondence may be addressed. E-mail:
, , , or
| | - D. Mills
- Department of Viticulture and Enology, University of California, Davis, CA 95616; and
- To whom correspondence may be addressed. E-mail:
, , , or
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Damyanov C, Tonchev Z, Pavlova N, Ivanov A. Treatment of advanced bladder cancer by submucosal injection of methotrexate in the anorectal area. Eur Urol 1992; 21:211-5. [PMID: 1499627 DOI: 10.1159/000474840] [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: 12/27/2022]
Abstract
In 1988, Shafik et al. presented their first attempt to apply cytostatics in the treatment of pelvic malignancies. Experimentally and clinically, they studied the anal route for administration of methotrexate, and their first results showed that higher concentration of drugs can be achieved in the bladder wall compared to that in serum. Since December 1988, we have been engaged in experimental and clinical investigations of the possibilities this method might reveal. Experiments with animals have proven that submucosal injection of the cytostatic agent does not induce local changes. The clinical trial on 20 patients with tumors of stage T2-T4 has not shown side effects, either local or systemic. The treatment was well tolerated by the patients. Anorexia has been reported in 3, elevated temperature in 2 and leukopenia in 4 of 20 patients. Complete response has been documented in 3 (15%), partial response in 3 (15%), stabilization in 5 (25%) and progression of the disease in 9 (45%) of the patients. Mean duration of remissions was 10.3 months (range 9-12). The distribution of submucously injected contrast medium into the anorectal area has been studied by computerized tomography in 4 of the patients. Although our results do not support the original estimates of the inventors of the method, its ease of application, the possibility of out-patient administration and negligible side effects are sufficient arguments for performing further experimental and clinical studies.
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Affiliation(s)
- C Damyanov
- Clinic of Urology, Higher Medical Institute, Sofia, Bulgaria
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