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Herrstedt J, Clark-Snow R, Ruhlmann CH, Molassiotis A, Olver I, Rapoport BL, Aapro M, Dennis K, Hesketh PJ, Navari RM, Schwartzberg L, Affronti ML, Garcia-Del-Barrio MA, Chan A, Celio L, Chow R, Fleury M, Gralla RJ, Giusti R, Jahn F, Iihara H, Maranzano E, Radhakrishnan V, Saito M, Sayegh P, Bosnjak S, Zhang L, Lee J, Ostwal V, Smit T, Zilic A, Jordan K, Scotté F. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO Open 2024; 9:102195. [PMID: 38458657 PMCID: PMC10937211 DOI: 10.1016/j.esmoop.2023.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 03/10/2024] Open
Abstract
•Nausea and vomiting are considered amongst the most troublesome adverse events for patients receiving antineoplastics. •The guideline covers emetic risk classification, prevention and management of treatment-induced nausea and vomiting. •The Consensus Committee consisted of 34 multidisciplinary, health care professionals and three patient advocates. •Recommendations are based on evidence-based data (level of evidence) and the authors’ collective expert opinion (grade). •All recommendations are for the first course of antineoplastic therapy; modifications may be needed in subsequent courses.
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Affiliation(s)
- J Herrstedt
- Department of Clinical Oncology, Zealand University Hospital Roskilde and Naestved, Roskilde; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - R Clark-Snow
- Oncology Supportive Care Consultant, Overland Park, USA
| | - C H Ruhlmann
- Department of Oncology, Odense University Hospital, Odense; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, UK
| | - I Olver
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - B L Rapoport
- The Medical Oncology Centre of Rosebank, Johannesburg; Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - M Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | - K Dennis
- Division of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Canada
| | - P J Hesketh
- Division of Hematology Oncology, Lahey Hospital and Medical Center, Burlington
| | | | - L Schwartzberg
- William N. Pennington Cancer Institute, University of Nevada, Reno School of Medicine, Reno
| | - M L Affronti
- Department of Neurosurgery, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham; Duke University School of Nursing, Duke University, Durham, USA
| | - M A Garcia-Del-Barrio
- Pharmacy Department, Clínica Universidad de Navarra, Madrid; School of Pharmacy and Nutrition, Universidad de Navarra, Pamplona, Spain
| | - A Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, USA
| | - L Celio
- Independent Medical Oncologist, Milan, Italy
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Fleury
- Department of Oncology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - R J Gralla
- Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, USA
| | - R Giusti
- Medical Oncology Unit, Sant' Andrea Hospital of Rome, Rome, Italy
| | - F Jahn
- Clinic for Internal Medicine IV, Oncology - Hematology - Hemostaseology, University Hospital Halle (Saale), Halle, Germany
| | - H Iihara
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | | | - V Radhakrishnan
- Department of Medical Oncology, Cancer Institute (WIA), Adyar, Chennai, India
| | - M Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - P Sayegh
- Department of Pharmacy, OU Health Stephenson Cancer Center, Oklahoma City, USA
| | - S Bosnjak
- Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - L Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - V Ostwal
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - T Smit
- The Medical Oncology Centre of Rosebank, Johannesburg
| | - A Zilic
- Department of Supportive Oncology and Palliative Care, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - K Jordan
- Department of Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - F Scotté
- ∗Interdisciplinary Patient Pathway Division, Gustave Roussy, Villejuif, France.
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Herrstedt J, Celio L, Hesketh PJ, Zhang L, Navari R, Chan A, Saito M, Chow R, Aapro M. 2023 updated MASCC/ESMO consensus recommendations: prevention of nausea and vomiting following high-emetic-risk antineoplastic agents. Support Care Cancer 2023; 32:47. [PMID: 38127246 PMCID: PMC10739516 DOI: 10.1007/s00520-023-08221-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE This systematic review updates the MASCC/ESMO recommendations for high-emetic-risk chemotherapy (HEC) published in 2016-2017. HEC still includes cisplatin, carmustine, dacarbazine, mechlorethamine, streptozocin, and cyclophosphamide in doses of > 1500 mg/m2 and the combination of cyclophosphamide and an anthracycline (AC) in women with breast cancer. METHODS A systematic review report following the PRISMA guidelines of the literature from January 1, 2015, until February 1, 2023, was performed. PubMed (Ovid), Scopus (Google), and the Cochrane Database of Systematic Reviews were searched. The literature search was limited to randomized controlled trials, systematic reviews, and meta-analyses. RESULTS Forty-six new references were determined to be relevant. The main topics identified were (1) steroid-sparing regimens, (2) olanzapine-containing regimens, and (3) other issues such as comparisons of antiemetics of the same drug class, intravenous NK1 receptor antagonists, and potentially new antiemetics. Five updated recommendations are presented. CONCLUSION There is no need to prescribe steroids (dexamethasone) beyond day 1 after AC HEC, whereas a 4-day regimen is recommended in non-AC HEC. Olanzapine is now recommended as a fixed part of a four-drug prophylactic antiemetic regimen in both non-AC and AC HEC. No major differences between 5-HT3 receptor antagonists or between NK1 receptor antagonists were identified. No new antiemetic agents qualified for inclusion in the updated recommendations.
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Affiliation(s)
- Jørn Herrstedt
- Department of Clinical Oncology, Zealand University Hospital, Sygehusvej 10, DK-4000, Roskilde, Denmark.
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | | | - P J Hesketh
- Division of Hematology Oncology, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - L Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - R Navari
- World Health Organization, Birmingham, Alabama, USA
| | - A Chan
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA, USA
| | - M Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Aapro
- Genolier Cancer Center, Genolier, Switzerland
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Salek M, Li N, Chou HP, Saini K, Jovic A, Jacobs KB, Johnson C, Lu V, Lee EJ, Chang C, Nguyen P, Mei J, Pant KP, Wong-Thai AY, Smith QF, Huang S, Chow R, Cruz J, Walker J, Chan B, Musci TJ, Ashley EA, Masaeli MM. Author Correction: COSMOS: a platform for real-time morphology-based, label-free cell sorting using deep learning. Commun Biol 2023; 6:1023. [PMID: 37813962 PMCID: PMC10562360 DOI: 10.1038/s42003-023-05415-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023] Open
Affiliation(s)
- Mahyar Salek
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA.
| | - Nianzhen Li
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Hou-Pu Chou
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Kiran Saini
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Andreja Jovic
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Kevin B Jacobs
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | | | - Vivian Lu
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Esther J Lee
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | | | - Phuc Nguyen
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Jeanette Mei
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Krishna P Pant
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | | | | | | | - Ryan Chow
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Janifer Cruz
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Jeff Walker
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Bryan Chan
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Thomas J Musci
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Euan A Ashley
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
- Department of Medicine, Genetics, & Biomedical Data Science, Stanford University, Stanford, CA, USA
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Gutierrez E, Navarro I, Chow R, Zhou K, Ramotar M, Sanchez-Rodriguez IE, Ruiz V, Weersink RA, Glicksman R, Helou J, Berlin A, Chung P, Raman S, Fazelzad R. Focal Brachytherapy for Localized Prostate Cancer: Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e388. [PMID: 37785306 DOI: 10.1016/j.ijrobp.2023.06.2509] [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) Advances in image-guided brachytherapy have increased the interest in focal brachytherapy (F-BT) approaches to optimize disease control, while reducing the toxicities associated whole gland treatments for prostate cancer (PCa). In this study we performed a systematic review to report biochemical control (BC), and genitourinary (GU) and gastrointestinal (GI) toxicity rates in patients with localized prostate cancer treated with F-BT as a definitive or salvage modality. MATERIALS/METHODS This project was registered in the PROSPERO database (ID CRD42022320921). A comprehensive literature search was conducted in Cochrane Central databases, Cochrane Database of Systematic Reviews, Embase Classic +Embase, and Medline ALL, all from the OvidSP platform and Web of Science from Clarivate, from each database's inception to July 2022. Search was restricted to English and included terms: focal brachytherapy/prostate cancer, partial brachytherapy/prostate cancer. In total, 14862 articles were identified. Manuscripts that not related to focal or partial prostate brachytherapy, review papers and studies not reporting BC were excluded. After eliminating duplicates, and studies deemed irrelevant by consensus among three independent reviewers, 44 articles remained for in-depth review and data extraction. RESULTS Thirty studies that included BC outcomes were included for this analysis, comprising 1556 patients treated with F-BT for PCa. Of these, 1094 (70%) and 462 (30%) underwent F-BT as definitive monotherapy or salvage, respectively; while 585 (38%) and 971 (62%) received HDR or LDR, respectively. For F-BT as monotherapy, the most commonly prescribed dose for HDR was 19 Gy in 1 fraction (range 19-24 Gy), and for LDR, 145 Gy (90-160Gy). Whereas for salvage F-BT, most common dose schedule of HDR was 19Gy in 1 fraction (19-27GY) and LDR 145Gy (144-145Gy). BC random effects estimate for F-BT monotherapy at 1-, 2-, 3-, and 5-years were 100% (P = 1.0), 96% (P = 0.45), 91% (P = 0.45) and 87% (P< 0.01), respectively. Whereas BC random effects estimate for salvage at 1-, 2-, 3-, and 5-years were 91% (P = 0.86), 68% (0.17), and 57% (P = 0.20), respectively. GI and GU grade 3-4 crude toxicity rates for monotherapy and salvage ranged from 0-3.33% and 0-17%, respectively. CONCLUSION Over the last decade, there has been increasing interest in F-BT approaches, both as monotherapy and in the salvage setting. BC and toxicity profiles of F-BT appear favorable, and future studies directly comparing with whole-gland treatments are warranted.
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Affiliation(s)
- E Gutierrez
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - I Navarro
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - K Zhou
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - M Ramotar
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | | | - V Ruiz
- University of Guadalajara, Guadalajara, Mexico
| | - R A Weersink
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - R Glicksman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - J Helou
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - A Berlin
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - P Chung
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - S Raman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - R Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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Chow R, Biswas T, Liu H, Pryor DI, Chu W, Swaminath A, Chung HT, Schellenberg D, Grindrod N, Lee YY, Gaede S, Sachdeva R, Lock MI. Radiotherapy for Liver Cancer: An International Multi-Centre Pooled Analysis of 925 Cases. Int J Radiat Oncol Biol Phys 2023; 117:e319-e320. [PMID: 37785141 DOI: 10.1016/j.ijrobp.2023.06.2358] [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) Primary and secondary liver cancer incidence is growing and has a poor prognosis. The standard use of radiation has been hampered by studies with a wide range of patients, different management protocols and varied outcomes. To overcome this heterogeneity in the literature, larger and higher-level trials are warranted, but, so far, have been difficult to implement. Therefore, pooled analyses may offer the best way to determine the benefit of radiation, identify treatment parameters needed to optimize treatment techniques, and identify patient factors that allow for better patient selection. MATERIALS/METHODS Patients with liver cancer treated by radiotherapy at centers in Canada, United States and Australia was pooled. Patient and treatment characteristics were noted, as well as the clinical outcomes of local control within 1 year, recurrence and mortality. Stepwise Cox proportional hazards models were used to identify significant predictors for recurrence and mortality. Patients were stratified by center, and primary versus metastatic disease. RESULTS A total of 925 patients were included in this study. Mean age was 67 years, and 45% had a primary diagnosis of hepatocellular carcinoma. 1-year local control rate was 80%. Median survival was 1.8 years (1.9 years for primary liver cancer, and 1.4 years for metastatic liver cancer). Higher total dose and BED was associated with better survival. Median time to recurrence was 1.5 years. Higher total dose was associated with lower risk of recurrence CONCLUSION: As one of the largest pooled analyses in hepatic cancer, this international multi-center study provides pragmatic data on clinical outcomes of patients receiving radiotherapy for liver cancer. This database may assist in better selection of patients for future studies and answer questions such as what is the optimal dose and which patients benefit from treatment.
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Affiliation(s)
- R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - T Biswas
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH
| | - H Liu
- Princess Alexandra Hospital, Woolloongabba, Australia
| | - D I Pryor
- Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - W Chu
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - A Swaminath
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - H T Chung
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | | | | | - Y Y Lee
- Princess Alexandra Hospital, Greenslopes, QLD, Australia
| | - S Gaede
- Department of Medical Physics, Western University, London, ON, Canada
| | - R Sachdeva
- London Regional Cancer Program, London, ON, Canada
| | - M I Lock
- London Health Sciences Centre, London, ON, Canada
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Liu BL, Chow R, Meyers BM, Grindrod N, Boldt G, Malik A, Jairam M, Brahmania M, Leite LC, Freiburger S, Lock MI. Treatment Modalities to Manage Hepatocellular Carcinoma Patients with Portal Vein Thrombus: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e319. [PMID: 37785143 DOI: 10.1016/j.ijrobp.2023.06.2357] [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) Patients with hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT) have poor outcomes and an effective treatment strategy has not been established. The aim of this review is to compare the effectiveness of available treatment options in preventing mortality. MATERIALS/METHODS A search was conducted in PubMed, EMBASE and Cochrane CENTRAL from 2007 to 2022. Articles were screened to identify studies of HCC patients with PVT that reported on all-cause mortality using radical intent treatments. Study quality was assessed using the Cochrane Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS-1). Mortality rates at prespecified timepoints between 6 and 24 months were extracted and summarized using a random-effects DerSimonian-Laird model. This review was registered a priori on PROSPERO (CRD42022290708). RESULTS The impact of radiotherapy (RT) on overall survival (OS) is similar to all other treatments including sorafenib. When comparing sorafenib to local modalities (Y90 and RT), the local treatments had a better OS (OR 2.20, 95% CI: 1.11 - 4.39), but this difference disappeared after 6-months. Indeed, within 6 months, Y90 provided the best OS. No significant differences were noticed from 12 to 24 months. Combination treatments appeared to provide a significant additional OS benefit with TACE+RT having an improved OS over TACE alone and RT alone, with the benefit extending to 24 months. CONCLUSION this analysis of HCC patients with PVT reports on six cohorts, with a total sample size of 2,356 patients. The addition of localized treatment to systemic treatment appears to improve survival. Combining TACE and RT was also better than either modality alone. Further investigations should be conducted, to further understand the role of localized treatments.
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Affiliation(s)
- B L Liu
- McMaster University, Hamilton, ON, Canada
| | - R Chow
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - B M Meyers
- Division of Medical Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada
| | | | - G Boldt
- Western University, London, ON, Canada
| | - A Malik
- University of Toronto, Toronto, ON, Canada
| | - M Jairam
- Harvard Medical School, Boston, MA
| | | | - L C Leite
- Western University, London, ON, Canada
| | | | - M I Lock
- Western University, London, ON, Canada; London Health Sciences Centre, London, ON, Canada
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Salek M, Li N, Chou HP, Saini K, Jovic A, Jacobs KB, Johnson C, Lu V, Lee EJ, Chang C, Nguyen P, Mei J, Pant KP, Wong-Thai AY, Smith QF, Huang S, Chow R, Cruz J, Walker J, Chan B, Musci TJ, Ashley EA, Masaeli MM. COSMOS: a platform for real-time morphology-based, label-free cell sorting using deep learning. Commun Biol 2023; 6:971. [PMID: 37740030 PMCID: PMC10516940 DOI: 10.1038/s42003-023-05325-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/06/2023] [Indexed: 09/24/2023] Open
Abstract
Cells are the singular building blocks of life, and a comprehensive understanding of morphology, among other properties, is crucial to the assessment of underlying heterogeneity. We developed Computational Sorting and Mapping of Single Cells (COSMOS), a platform based on Artificial Intelligence (AI) and microfluidics to characterize and sort single cells based on real-time deep learning interpretation of high-resolution brightfield images. Supervised deep learning models were applied to characterize and sort cell lines and dissociated primary tissue based on high-dimensional embedding vectors of morphology without the need for biomarker labels and stains/dyes. We demonstrate COSMOS capabilities with multiple human cell lines and tissue samples. These early results suggest that our neural networks embedding space can capture and recapitulate deep visual characteristics and can be used to efficiently purify unlabeled viable cells with desired morphological traits. Our approach resolves a technical gap in the ability to perform real-time deep learning assessment and sorting of cells based on high-resolution brightfield images.
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Affiliation(s)
- Mahyar Salek
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA.
| | - Nianzhen Li
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Hou-Pu Chou
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Kiran Saini
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Andreja Jovic
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Kevin B Jacobs
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | | | - Vivian Lu
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Esther J Lee
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | | | - Phuc Nguyen
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Jeanette Mei
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Krishna P Pant
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | | | | | | | - Ryan Chow
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Janifer Cruz
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Jeff Walker
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Bryan Chan
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Thomas J Musci
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
| | - Euan A Ashley
- Deepcell Inc; 4025 Bohannon Dr., Menlo Park, CA, 94025, USA
- Department of Medicine, Genetics, & Biomedical Data Science, Stanford University, Stanford, CA, USA
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Willis JV, Cobey KD, Ramos J, Chow R, Ng JY, Alayche M, Moher D. Limited online training opportunities exist for scholarly peer reviewers. J Clin Epidemiol 2023; 161:65-73. [PMID: 37421994 DOI: 10.1016/j.jclinepi.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVES To create a comprehensive list of all openly available online trainings in scholarly peer review and to analyze their characteristics. STUDY DESIGN AND SETTING A systematic review of online training material in scholarly peer review openly accessible between 2012 and 2022. Training characteristics were presented in evidence tables and summarized narratively. A risk of bias tool was purpose-built for this study to evaluate the included training material as evidence-based. RESULTS Fourty-two training opportunities in manuscript peer review were identified, of which only twenty were openly accessible. Most were online modules (n = 12, 60%) with an estimated completion time of less than 1 hour (n = 13, 65%). Using our ad hoc risk of bias tool, four sources (20%) met our criteria of evidence-based. CONCLUSION Our comprehensive search of the literature identified 20 openly accessible online training materials in manuscript peer review. For such a crucial step in the dissemination of literature, a lack of training could potentially explain disparities in the quality of scholarly publishing.
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Affiliation(s)
- Jessie V Willis
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Kelly D Cobey
- University of Ottawa Heart Institute, Ottawa, Canada; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Janina Ramos
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Biology, Faculty of Science, University of Ottawa, Ottawa, Canada
| | - Ryan Chow
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Jeremy Y Ng
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Mohsen Alayche
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
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Son JS, Chow R, Kim H, Lieu T, Xiao M, Kim S, Matuszewska K, Pereira M, Nguyen DL, Petrik J. Liposomal delivery of gene therapy for ovarian cancer: a systematic review. Reprod Biol Endocrinol 2023; 21:75. [PMID: 37612696 PMCID: PMC10464441 DOI: 10.1186/s12958-023-01125-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE To systematically identify and narratively synthesize the evidence surrounding liposomal delivery of gene therapy and the outcome for ovarian cancer. METHODS An electronic database search of the Embase, MEDLINE and Web of Science from inception until July 7, 2023, was conducted to identify primary studies that investigated the effect of liposomal delivery of gene therapy on ovarian cancer outcomes. Retrieved studies were assessed against the eligibility criteria for inclusion. RESULTS The search yielded 564 studies, of which 75 met the inclusion criteria. Four major types of liposomes were identified: cationic, neutral, polymer-coated, and ligand-targeted liposomes. The liposome with the most evidence involved cationic liposomes which are characterized by their positively charged phospholipids (n = 37, 49.3%). Similarly, those with neutrally charged phospholipids, such as 1,2-dioleoyl-sn-glycero-3-phosphatidylcholine, were highly researched as well (n = 25, 33.3%). Eight areas of gene therapy research were identified, evaluating either target proteins/transcripts or molecular pathways: microRNAs, ephrin type-A receptor 2 (EphA2), interleukins, mitogen-activated protein kinase (MAPK), human-telomerase reverse transcriptase/E1A (hTERT/EA1), suicide gene, p53, and multidrug resistance mutation 1 (MDR1). CONCLUSION Liposomal delivery of gene therapy for ovarian cancer shows promise in many in vivo studies. Emerging polymer-coated and ligand-targeted liposomes have been gaining interest as they have been shown to have more stability and specificity. We found that gene therapy involving microRNAs was the most frequently studied. Overall, liposomal genetic therapy has been shown to reduce tumor size and weight and improve survivability. More research involving the delivery and targets of gene therapy for ovarian cancer may be a promising avenue to improve patient outcomes.
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Affiliation(s)
- Jin Sung Son
- Faculty of Health Sciences, University of McMaster, Hamilton, ON, Canada
| | - Ryan Chow
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Helena Kim
- Faculty of Health Sciences, University of McMaster, Hamilton, ON, Canada
| | - Toney Lieu
- Faculty of Health Sciences, University of McMaster, Hamilton, ON, Canada
| | - Maria Xiao
- Faculty of Health Sciences, University of McMaster, Hamilton, ON, Canada
| | - Sunny Kim
- Faculty of Health Sciences, University of McMaster, Hamilton, ON, Canada
| | - Kathy Matuszewska
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Madison Pereira
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - David Le Nguyen
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jim Petrik
- Faculty of Health Sciences, University of McMaster, Hamilton, ON, Canada.
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada.
- Department of Obstetrics and Gynecology, University of McMaster, Hamilton, ON, Canada.
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10
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Fabre C, Doppler T, Chow R, Fenicia F, Scheidegger R, Dietzel A, Stamm C. Challenges of spatially extrapolating aquatic pesticide pollution for policy evaluation. Sci Total Environ 2023; 875:162639. [PMID: 36889390 DOI: 10.1016/j.scitotenv.2023.162639] [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] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Aquatic pesticide pollution is an important issue worldwide. Countries rely on monitoring programs to observe water bodies quality and on models to evaluate pesticide risks for entire stream networks. Measurements are typically sparse and discontinuous which lead to issues in quantifying pesticide transport at the catchment scale. Therefore, it is essential to assess the performance of extrapolation approaches and provide guidance on how to extend monitoring programs to improve predictions. Here we present a feasibility study to predict pesticide levels in a spatially explicit manner in the Swiss stream network based on the national monitoring program quantifying organic micropollutants at 33 sites and spatially distributed explanatory variables. Firstly, we focused on a limited set of herbicides used on corn crops. We observed a significant relationship between herbicide concentrations and the areal fraction of hydrologically connected cornfields. Neglecting connectivity revealed no influence of areal corn coverage on the herbicide levels. Considering chemical properties of the compounds slightly improved the correlation. Secondly, we analysed a set of 18 pesticides widely used on different crops and monitored across the country. In this case, the areal fractions of arable or crop lands showed significant correlations with average pesticide concentrations. Similar results were found with average annual discharge or precipitation if two outlier sites were neglected. The correlations found in this paper explained only about 30 % of the observed variance leaving most of the variability unexplained. Accordingly, extrapolating the results from the existing monitoring sites to the Swiss river network comes with substantial uncertainty. Our study highlights possible reasons for weak matches, such as missing pesticide application data, limited set of compounds in the monitoring program, or a limited understanding of factors differentiating the loss rates from different catchments. Improving the data on pesticide applications will be essential to progress in this regard.
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Affiliation(s)
- C Fabre
- Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland; Univ Lyon, UMR 5600 EVS, ENS Lyon, 69342 Lyon Cedex 07, France
| | - T Doppler
- Plattform Wasserqualität, VSA, Dübendorf, Switzerland
| | - R Chow
- Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland; Department of Earth Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - F Fenicia
- Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - R Scheidegger
- Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - A Dietzel
- Plattform Wasserqualität, VSA, Dübendorf, Switzerland
| | - C Stamm
- Eawag: Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.
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11
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Chow R, Spycher S, Scheidegger R, Doppler T, Dietzel A, Fenicia F, Stamm C. Methods comparison for detecting trends in herbicide monitoring time-series in streams. Sci Total Environ 2023:164226. [PMID: 37236458 DOI: 10.1016/j.scitotenv.2023.164226] [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] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/10/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023]
Abstract
An inadvertent consequence of pesticide use is aquatic pesticide pollution, which has prompted the implementation of mitigation measures in many countries. Water quality monitoring programs are an important tool to evaluate the efficacy of these mitigation measures. However, large interannual variability of pesticide losses makes it challenging to detect significant improvements in water quality and to attribute these improvements to the application of specific mitigation measures. Thus, there is a gap in the literature that informs researchers and authorities regarding the number of years of aquatic pesticide monitoring or the effect size (e.g., loss reduction) that is required to detect significant trends in water quality. Our research addresses this issue by combining two exceptional empirical data sets with modelling to explore the relationships between the achieved pesticide reduction levels due to mitigation measures and the length of the observation period for establishing statistically significant trends. Our study includes both a large (Rhine at Basel, ~36,300 km2) and small catchment (Eschibach, 1.2 km2), which represent spatial scales at either end of the spectrum that would be realistic for monitoring programs designed to assess water quality. Our results highlight several requirements in a monitoring program to allow for trend detection. Firstly, sufficient baseline monitoring is required before implementing mitigation measures. Secondly, the availability of pesticide use data helps account for the interannual variability and temporal trends, but such data are usually lacking. Finally, the timing and magnitude of hydrological events relative to pesticide application can obscure the observable effects of mitigation measures (especially in small catchments). Our results indicate that a strong reduction (i.e., 70-90 %) is needed to detect a change within 10 years of monitoring data. The trade-off in applying a more sensitive method for change detection is that it may be more prone to false-positives. Our results suggest that it is important to consider the trade-off between the sensitivity of trend detection and the risk of false positives when selecting an appropriate method and that applying more than one method can provide more confidence in trend detection.
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Affiliation(s)
- R Chow
- Swiss Federal Institute of Aquatic Science and Technology (Eawag), 8600 Dübendorf, Switzerland; Department of Earth Sciences, Stellenbosch University, Stellenbosch, South Africa; Soil Physics and Land Management Group, Wageningen University & Research, P.O. Box 47, 6700 AA Wageningen, the Netherlands.
| | - S Spycher
- EBP Schweiz AG, 8032 Zürich, Switzerland; School of Agricultural, Forest and Food Sciences BFH-HAFL, 3052 Zollikofen, Switzerland
| | - R Scheidegger
- Swiss Federal Institute of Aquatic Science and Technology (Eawag), 8600 Dübendorf, Switzerland; VSA, Swiss Water Association, 8152 Glattbrugg, Switzerland
| | - T Doppler
- VSA, Swiss Water Association, 8152 Glattbrugg, Switzerland
| | - A Dietzel
- VSA, Swiss Water Association, 8152 Glattbrugg, Switzerland
| | - F Fenicia
- Swiss Federal Institute of Aquatic Science and Technology (Eawag), 8600 Dübendorf, Switzerland
| | - C Stamm
- Swiss Federal Institute of Aquatic Science and Technology (Eawag), 8600 Dübendorf, Switzerland
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12
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Spadaro JZ, Chow R, Sinard JH, Watsky K, Habib L. Chronic Lymphocytic Leukemia Presenting as Bilateral Periorbital Edema Treated With Low-dose Radiation Therapy. Ophthalmic Plast Reconstr Surg 2023; 39:e78-e81. [PMID: 36852835 DOI: 10.1097/iop.0000000000002338] [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: 03/01/2023]
Abstract
Ocular manifestations in chronic lymphocytic leukemia (CLL) have been reported in 30% to 40% of patients and may be a result of direct tissue infiltration, concomitant blood dyscrasias, or a result of therapeutic intervention. Leukemia cutis, defined as infiltration of the epidermis or dermis by neoplastic lymphocytes, is rare. Herein, we present a case report of a patient with leukemia who presented with periorbital edema and ecchymosis. This is the first known case to date of periorbital CLL successfully treated with low-dose radiation therapy (4 Gy in 2 fractions). Clinicians should be aware of the possibility of ocular involvement from CLL, given the importance of prompt diagnosis and treatment.
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Affiliation(s)
- Jane Z Spadaro
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Ryan Chow
- Yale School of Medicine, New Haven, Connecticut, U.S.A
| | - John H Sinard
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, U.S.A
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Kalman Watsky
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, U.S.A
| | - Larissa Habib
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, U.S.A
- Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut, U.S.A
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13
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Zhang F, Guangchuan W, Chow R, He E, Majety M, Zhang Y, Chen S. Multiplexed inhibition of immunosuppressive genes with Cas13d for on-demand combinatorial cancer immunotherapy. bioRxiv 2023:2023.03.14.532668. [PMID: 36993222 PMCID: PMC10055084 DOI: 10.1101/2023.03.14.532668] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Checkpoint blockade immunotherapy is a potent class of cancer treatment, however, the complex immunosuppressive tumor microenvironment (TME) often requires multi-agent combinations to be effective. Current cancer immunotherapy combination approaches are cumbersome, usually involving one-drug-at-a-time scheme. Here, we devise Multiplex Universal Combinatorial Immunotherapy via Gene-silencing (MUCIG), as a versatile approach for combinatorial cancer immunotherapy. We harness CRISPR-Cas13d to efficiently target multiple endogenous immunosuppressive genes on demand, allowing us to silence various combinations of multiple immunosuppressive factors in the TME. Intratumoral AAV-mediated administration of MUCIG (AAV-MUCIG) elicits significant anti-tumor activity with several Cas13d gRNA compositions. TME target expression analysis driven optimization led to a simplified off-the-shelf MUCIG targeting a four gene combination (PGGC: Pdl1, Galectin9, Galectin3 and Cd47 ). AAV-PGGC shows significant in vivo efficacy in syngeneic tumor models. Single cell and flow profiling revealed that AAV-PGGC remodeled the TME by increasing CD8 + T cell infiltration and reducing myeloid-derived immunosuppressive cells (MDSCs). MUCIG thus serves as a universal method to silence multiple immune genes in vivo, and can be delivered via AAV as a therapeutic approach.
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14
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Chow R, Curchod L, Davies E, Veludo AF, Oltramare C, Dalvie MA, Stamm C, Röösli M, Fuhrimann S. Seasonal drivers and risks of aquatic pesticide pollution in drought and post-drought conditions in three Mediterranean watersheds. Sci Total Environ 2023; 858:159784. [PMID: 36328263 DOI: 10.1016/j.scitotenv.2022.159784] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/05/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The Western Cape in South Africa has a Mediterranean climate, which has in part led to an abundance of agriculturally productive land supporting the wheat, deciduous fruit, wine, and citrus industries. South Africa is the leading pesticide user in Sub-Saharan Africa. There is limited data on the pesticide pollution of surface water over different seasons in low- and middle-income countries. We evaluated the seasonal drivers of aquatic pesticide pollution in three river catchments (Berg, Krom, and Hex Rivers) from July 2017 to June 2018 and April to July 2019, using 48 passive samplers. Our sampling followed the most severe drought (2015-2018) since recordings in 1960. Thus, our analyses focus on how drought and post-drought conditions may affect in-stream pesticide concentrations and loads. Samples were analyzed for 101 pesticide compounds using liquid chromatography - high-resolution mass spectrometry. Environmental Quality Standards (EQS) were used to assess the risks. We detected 60 pesticide compounds across the sampling periods. Our results indicate that all samples across all three catchments contained at least three pesticides and that the majority (83%) contained five or more pesticides. Approximately half the number of pesticides were detected after the drought in 2018. High concentration sums of pesticides (>1 μg/L) were detected over long time periods in the Hex River Valley (22 weeks) and in Piketberg (four weeks). Terbuthylazine, imidacloprid, and metsulfuron-methyl were detected in the highest concentrations, making up most of the detected mass, and were frequently above EQS. The occurrence of some pesticides in water generally correlated with their application and rainfall events. However, those of imidacloprid and terbuthylazine did not, suggesting that non-rainfall-driven transport processes are important drivers of aquatic pesticide pollution. The implementation of specific, scientifically sound, mitigation measures against aquatic pesticide pollution would require comprehensive pesticide application data as well as a targeted study identifying sources and transport processes for environmentally persistent pesticides.
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Affiliation(s)
- R Chow
- Department of Earth Sciences, Stellenbosch University, Stellenbosch, South Africa; Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland.
| | - L Curchod
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland; Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; University of Basel, 4002 Basel, Switzerland
| | - E Davies
- Department of Earth Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - A F Veludo
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; University of Basel, 4002 Basel, Switzerland
| | - C Oltramare
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland
| | - M A Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, 7925 Cape Town, South Africa
| | - C Stamm
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland
| | - M Röösli
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; University of Basel, 4002 Basel, Switzerland
| | - S Fuhrimann
- Swiss Tropical and Public Health Institute (Swiss TPH), 4123 Allschwil, Switzerland; University of Basel, 4002 Basel, Switzerland.
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15
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Nejstgaard CH, Boutron I, Chan AW, Chow R, Hopewell S, Masalkhi M, Moher D, Schulz KF, Shlobin NA, Østengaard L, Hróbjartsson A. A scoping review identifies multiple comments suggesting modifications to SPIRIT 2013 and CONSORT 2010. J Clin Epidemiol 2023; 155:48-63. [PMID: 36669708 DOI: 10.1016/j.jclinepi.2023.01.003] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To identify, summarize, and analyse comments on the core reporting guidelines for protocols of randomized trials (Standard Protocol Items: Recommendations for Interventional Trials [SPIRIT] 2013) and for completed trials (Consolidated Standards of Reporting Trials [CONSORT] 2010), with special emphasis on suggestions for guideline modifications. METHODS We included documents written in English and published after 2010 that explicitly commented on SPIRIT 2013 or CONSORT 2010. We searched four bibliographic databases (Embase and MEDLINE to June 2022; Web of Science and Google Scholar to April 2022) and other sources (e.g., the EQUATOR Network website, the BMC Blog Network, and the BMJ rapid response section). Two authors independently assessed documents for eligibility and extracted data on basic characteristics and the wording of the main comments. We categorized comments as 'suggestion for modification to the wording of an existing guideline item,' 'suggestion for a new item,' or 'reflections on challenges or strengths.' We provided a summary and examples of the proposed suggestions and categorized comments into those that were directly linked to empirical investigations, were continuations of previous methodological discussions, or reflected new methodological developments. RESULTS We assessed full text of 2,320 potentially eligible documents and included 93 documents with 114 comments. In total, 37 comments suggested modifications to existing guideline items. The participant flow section of CONSORT 2010 received the most comments (eight comments made different suggestions, e.g., one comment suggested to add numbers on nonrandomized screened participants). There were 46 comments suggesting new items. Multiple suggestions were related to trial interventions (eight comments made different suggestions, e.g., one comment suggested to add content on cointerventions), blinding (six comments suggested to add content on risk of unblinding), statistical methods (five comments made different suggestions, e.g., one comment suggested to add content on blinding of statisticians), and participant flow (seven comments made different suggestions, e.g., three comments suggested to add content on missing data). Half (53%) of the suggestions were directly linked to empirical investigations. Six (7%) suggestions were continuations of previous methodological discussions and five (6%) suggestions reflected new methodological developments related to conflicts of interest and funding, data sharing, and patient and public involvement. CONCLUSION The issues raised provide context to authors, peer reviewers, editors, and readers of trials using SPIRIT 2013 and CONSORT 2010 and inform the planned updates of the core guidelines.
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Affiliation(s)
- Camilla H Nejstgaard
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Denmark; Open Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark.
| | - Isabelle Boutron
- Université Paris Cité, Centre of Research in Epidemiology and Statistics (CRESS), Inserm, France; Cochrane France, France
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Canada
| | - Ryan Chow
- Faculty of Medicine, University of Ottawa, Canada
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit/Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | | | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lasse Østengaard
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Denmark; Open Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark; University Library of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Denmark; Open Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark
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16
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Xu Y, Chow R, Chandereng T, Murdy K, Sinha R, Lee-Ying R, Abedin T, Cheung W, Nguyen T, Pham T, Lee S. Definitive Chemoradiotherapy vs. Trimodal Therapy for Locally Advanced Esophageal or Junctional Adenocarcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1049] [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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17
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Chow R, Huang E, Fu S, Kim E, Li S, Sodhi J, Tulandi T, Cobey KD, Bacal V, Chen I. Spin in Randomized Controlled Trials in Obstetrics and Gynecology: A Systematic Review. Women's Health Reports 2022; 3:795-802. [PMID: 36204479 PMCID: PMC9531885 DOI: 10.1089/whr.2021.0141] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Ryan Chow
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Eileen Huang
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sarah Fu
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Eileen Kim
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sophie Li
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Jasmine Sodhi
- Faculty of Biology, University of Ottawa, Ottawa, Canada
| | - Togas Tulandi
- Department of Obstetrics & Gynecology, McGill University Health Centre, Montreal, Canada
| | - Kelly D. Cobey
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Vanessa Bacal
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
| | - Innie Chen
- Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, Stickney Z, Suchy H, Tan R, Yordi S, Ahmed I, Aranha M, El Sabawy D, Garwood P, Harnett M, Holohan R, Howard R, Kayyal Y, Krakoski N, Lupo M, McGilberry W, Nepon H, Scoleri Y, Urbina C, Ahmad Fuad MF, Ahmed O, Jaswantlal D, Kelly E, Khan MHT, Naidu D, Neo WX, O'Neill R, Sugrue M, Abbas JD, Abdul-Fattah S, Azlan A, Barry K, Idris NS, Kaka N, Mc Dermott D, Mohammad Nasir MN, Mozo M, Rehal A, Shaikh Yousef M, Wong RH, Curran E, Gardner M, Hogan A, Julka R, Lasser G, Ní Chorráin N, Ting J, Browne R, George S, Janjua Z, Leung Shing V, Megally M, Murphy S, Ravenscroft L, Vedadi A, Vyas V, Bryan A, Sheikh A, Ubhi J, Vannelli K, Vawda A, Adeusi L, Doherty C, Fitzgerald C, Gallagher H, Gill P, Hamza H, Hogan M, Kelly S, Larry J, Lynch P, Mazeni NA, O'Connell R, O'Loghlin R, Singh K, Abbas Syed R, Ali A, Alkandari B, Arnold A, Arora E, Azam R, Breathnach C, Cheema J, Compton M, Curran S, Elliott JA, Jayasamraj O, Mohammed N, Noone A, Pal A, Pandey S, Quinn P, Sheridan R, Siew L, Tan EP, Tio SW, 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Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Jovic A, Saini K, Phelan M, Chow R, Zhang S, Johnson C, Li N, Musci TJ, Salek M, Masaeli M(M. Abstract 1686: Characterizing tumor heterogeneity through label-free, morphology-based live cell sorting. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1686] [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
The complexity of cancer is compounded by the continuous emergence of malignant cell populations that drive tumor heterogeneity and challenges diagnostic and therapeutic advances. Methods to study cancer at the single cell level are important to better understand tumor heterogeneity. Isolation of tumor cells from tissue typically relies on targeting biomarkers overexpressed in tumor cells, such as EpCAM, resulting in cells that may express common markers with morphologic and molecular heterogeneity.
We developed a platform termed Computational Sorting and Mapping of Single cells (COSMOS) that uses high-dimensional morphology analysis of single cells using artificial intelligence, microfluidics and high resolution bright-field imaging to identify and enrich target cells. We used COSMOS to train a deep convolutional neural network (ConvNet) classifier to identify and enrich malignant cells from non-small cell lung cancer (NSCLC) dissociated tumor cell (DTC) samples. The enriched population of NSCLC cells are label-free, unperturbed and viable, making them amenable to many downstream analysis methods but importantly also contain single cell high-dimensional morphology profiles.
We verified enrichment of malignant cells by performing RNA and DNA analysis on the enriched sample. Single cell RNA-seq (scRNA-Seq) analysis shows high levels of EpCAM expression in sorted cells. Copy number variation (CNV) analysis demonstrated increased amplitude of deletion and amplification peaks relative to the pre-sorted DTC sample. Further, mutational analysis show increased allele frequency of mutations including P53 and KRAS in post-sorted compared to pre-sorted samples.
Morphological heterogeneity within the malignant population is observed by UMAP analysis with the presence of multiple clusters of morphologically unique tumor cell populations detected. We further trained the classifier to detect and enrich for each subpopulation; CNV, mutation, bulk RNASeq, and scRNA-Seq analysis revealed molecular differences between the morphology subgroups. Further work is planned to evaluate the link between the morphological, molecular and functional characteristics of each subpopulation.
We demonstrate a platform that can enrich malignant cells based on morphology, yielding a population of cells that are label-free, viable and unperturbed, making them compatible with downstream molecular assays commonly used to study heterogeneity. Additionally the cells can be morphologically profiled at the single cell level yielding a high-dimensional morphological profile that reveals heterogeneous populations of cells that can be further characterized by molecular analysis and could offer a new dimension to understand heterogeneity and biomarker discovery.
Citation Format: Andreja Jovic, Kiran Saini, Michael Phelan, Ryan Chow, Simo Zhang, Chassidy Johnson, Nianzhen Li, Thomas J. Musci, Mahyar Salek, Maddison (Mahdokht) Masaeli. Characterizing tumor heterogeneity through label-free, morphology-based live cell sorting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1686.
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Tehfe H, Chow R, Li S, Kim P, Samari S, Hayawi L, Webster R, Fadel NB. Risk of Bias Assessment in Non-Randomized Studies of Interventions for Premenstrual Syndrome: A Systematic Review. J Family Reprod Health 2022; 16:93-101. [DOI: 10.18502/jfrh.v16i2.9476] [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: 11/24/2022] Open
Abstract
Objective: Premenstrual syndrome (PMS) is a very prevalent condition that affects premenopausal women and can result in monthly debilitating emotional and physical symptoms. The objective of this systematic review was to determine which predictive factors were associated with an increased amount of bias in non-randomized studies (NRSs) of PMS.
Materials and methods: A search of the EMBASE and Medline electronic databases was completed from January 1, 2010 to December 2021. The methodological quality of the included studies was independently evaluated and critically appraised using the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-1) tool. Associations of different factors with the risk of bias levels were assessed using a univariate logistic regression. Odds ratio and 95% confidence interval (CI) were reported.
Results: Of the 1668 studies, 38 were determined to be eligible for inclusion. The ROBINS-1 tool identified that 12 studies were of low/moderate risk of bias (31.6%) and 26 were of serious/critical risk (68.4%). Evidence of relationships between the ROBINS-1 score and impact factor (OR=0.20; 95% CI, 0.07 to 0.57; p= 0.003) and number of authors (OR=0.65; 95% CI, 0.43 to 0.99; p= 0.046) were identified, whereas no relationships were found with the number of citations, the sample size, the funding type, or the conflict-of-interest statement.
Conclusion: The systematic review concludes that the methodological rigor of non-randomized studies of PMS can vary, with fewer authors and a lower impact factor showing evidence of association with a decreased quality of evidence.
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21
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Chow R, Huang E, Fu S, Kim E, Li S, Sodhi J, Tulandi T, Cobey K, Bacal V, Chen I. Spin in Randomized Controlled Trials in Obstetrics and Gynaecology: A Systematic Review. Journal of Obstetrics and Gynaecology Canada 2022. [DOI: 10.1016/j.jogc.2022.02.032] [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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22
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Urban R, Chow R, Pickles T, Chan M, Livergant J, Gerrie AS, Freeman C, Sehn L, Scott DW, Villa D, Farinha P, Gondara L, Savage KJ, Lo AC. The impact of surveillance imaging after curative-intent radiotherapy for limited-stage follicular lymphoma. Br J Haematol 2021; 195:802-805. [PMID: 34734418 DOI: 10.1111/bjh.17684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ryan Urban
- Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Ryan Chow
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tom Pickles
- Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Matthew Chan
- Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan Livergant
- Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Alina S Gerrie
- Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Ciara Freeman
- Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Laurie Sehn
- Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - David W Scott
- Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Diego Villa
- Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Pedro Farinha
- Department of Pathology, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Lovedeep Gondara
- Department of Population Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada
| | - Kerry J Savage
- Department of Medical Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Andrea C Lo
- Department of Radiation Oncology, BC Cancer - Vancouver, Vancouver, BC, Canada.,Department of Surgery, University of British Columbia, Vancouver, BC, Canada.,Department of Lymphoid Cancer Research, BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
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Urban R, Chow R, Pickles T, Chan M, Livergant J, Gerrie A, Freeman C, Sehn L, Scott D, Villa D, Savage K, Slack G, Lo A. The Impact of Surveillance Imaging After Curative Intent Radiotherapy for Limited Stage Follicular Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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24
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Shanmugam S, Haver HL, Knecht SM, Rajjoub R, Ali O, Chow R. Bilateral occipital lobe infarct neglect deficit (BLIND) syndrome. J Community Hosp Intern Med Perspect 2021; 11:678-681. [PMID: 34567463 PMCID: PMC8462920 DOI: 10.1080/20009666.2021.1974730] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Cortical blindness is characterized by loss of vision due to dysfunction of the visual cortices, most commonly secondary to bilateral ischemic infarcts of the occipital lobe. Other causes include surgery such as aortic valve replacement, laryngeal surgery, craniotomy, cerebral angiography, head trauma, and partial seizures. Visual anosognosia is a distinct feature of cortical blindness, wherein patients claim they can see and confabulate visual perceptions, despite loss of sight. We herewith present a rare phenomenon known as Anton Syndrome, an eponym named after the Austrian neurologist and psychiatrist, Gabriel Anton (1858-1933). There are a limited number of cases of Anton's Syndrome in the literature, with only 28 case reports published from 1965-2016. Although he was bestowed a neurologic eponym, Anton was an advocate of eugenics and racial hygiene. He publicly advocated for 'superior breeding' and 'selection' in order to 'build a brave and noble race.' We therefore propose replacing the eponym with Bilateral Occipital Lobe Infarct Neglect Deficit (BLIND) Syndrome, with intention of raising awareness of this unique presentation as well as of the widespread interest in eugenics in the early 1900s amongst physicians, notably Gabriel Anton.
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Affiliation(s)
- S Shanmugam
- University of Maryland Medical Center (Ummc) Midtown Campus, Baltimore, MD, USA
| | - H L Haver
- University of Maryland Medical Center (Ummc) Midtown Campus, Baltimore, MD, USA
| | - S M Knecht
- University of Maryland Medical Center (Ummc) Midtown Campus, Baltimore, MD, USA
| | - R Rajjoub
- University of Maryland Medical Center (Ummc) Midtown Campus, Baltimore, MD, USA
| | - O Ali
- University of Maryland Medical Center (Ummc) Midtown Campus, Baltimore, MD, USA
| | - R Chow
- University of Maryland Medical Center (Ummc) Midtown Campus, Baltimore, MD, USA
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25
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Chow R, Li A, Wu N, Martin M, Wessels JM, Foster WG. Quality appraisal of systematic reviews on methods of labour induction: a systematic review. Arch Gynecol Obstet 2021; 304:1417-1426. [PMID: 34495378 DOI: 10.1007/s00404-021-06228-y] [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: 06/29/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Induction of labour has become more common over the last decade, together with an increase in the number of systematic reviews of the subject. However, with multiple systematic reviews it is necessary to evaluate the methodological rigor to ensure the reliability of conclusions and recommendations for clinical practice. Therefore, the aim of this study was to appraise the quality of systematic reviews that examined the efficacy and/or safety of labour induction methods. METHODS An electronic search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted. Study selection, data extraction and quality assessment were conducted using A Measurement Tool to Assess Systematic Reviews (AMSTAR) by two independent reviewers, in duplicate. RESULTS The search identified 387 publications, of which 48 studies (13%) met the a priori inclusion criteria. No significant relationships were found between study quality and number of citations, journal impact factor, or publication year. CONCLUSION Methodological quality for systematic reviews on the induction of labour were ranked as moderate with no significant changes in quality over the past 2 decades. Publication characteristics are not significantly associated with methodological quality, indicating that healthcare professionals should critically appraise studies before applying them to practice.
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Affiliation(s)
- Ryan Chow
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada.,Department of Obstetrics and Gynecology, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Allen Li
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada
| | - Nicole Wu
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Morgan Martin
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Jocelyn M Wessels
- Department of Obstetrics and Gynecology, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Warren G Foster
- Department of Obstetrics and Gynecology, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
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Sodhi J, Chan L, Chow R, Chen I. P-296 Examining the link between environmental toxin exposure and uterine leiomyoma: a systematic review. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.074] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Is there an association between exposure to certain environmental toxins and the prevalence of uterine leiomyoma in women?
Summary answer
Some evidence was obtained to suggest an association between phthalate esters, bisphenol A, heavy metals, persistent organic pollutants and the prevalence of uterine fibroids.
What is known already
Environmental toxins are naturally occurring, or human made chemicals that can act as endocrine disrupting chemicals (EDCs) by binding and activating estrogen receptors in the body. Uterine fibroids, often called leiomyoma are non-cancerous growths occurring in the uterus. Though often asymptomatic, they can cause pain, infertility, pregnancy complications and are a leading cause for hysterectomy. The aetiology of leiomyoma is not fully understood but both estrogen and progesterone have been implicated in their growth. We aimed to investigate the epidemiological evidence for the association between EDCs and the prevalence of fibroids.
Study design, size, duration
We undertook a systematic review and in keeping with PRISMA guidelines, a structured search of Medline, Embase, Scopus, and Web of Science was conducted (to October 2020). Case-control, cross-sectional, cohort and experimental studies were included.
Participants/materials, setting, methods
The included studies analyzed the association between one or more toxins and the occurrence, or growth of leiomyoma in humans, including human cell lines. The types of toxins, patient characteristics, association and outcome, body concentration of toxin and confounding variables were extracted and analyzed. Quality assessment was performed using the Newcastle-Ottawa Scale.
Main results and the role of chance
In total, 34 studies were included. The majority (76%) of studies revealed a significant association between the exposure studied and the prevalence of uterine leiomyoma. In examining body burden in cases vs controls, phthalate esters showed an association with increased odds of uterine leiomyoma, except in one case where a negative association was observed. In vitro experimental studies examining the effect of alkyl-phenols such as bisphenol A (BPA), octylphenol (OP) and nonylphenol (NP) demonstrated that these environmental estrogens can act to promote the proliferation of leiomyoma cells through a number of mechanisms, typically including the estrogen receptor alpha (ERa) signalling pathway. There were conflicting results for the association between alkyl-phenols and fibroids in case-control studies. A positive association between cadmium was demonstrated in only two studies. There were conflicting results for the association between lead, mercury, arsenic and uterine fibroids. Several metabolites of organophosphate esters, alternative plasticizers, and persistent organic pollutants were associated with an increased risk of uterine fibroids.
Limitations, reasons for caution
Separating these exposures from the multiple other factors that could affect the outcome of leiomyoma is challenging, but an important issue for future research.
Wider implications of the findings
The link between some environmental toxins and uterine fibroids discussed is in agreement with previous literature. However, our review provides a more in depth analysis on specific dosage effects, odds ratios, and potential gene mechanisms of the exposures. This information could contribute to more accurate preventative measures.
Trial registration number
not applicable
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Affiliation(s)
- J Sodhi
- University of Ottawa, Biology, Ottawa, Canada
| | - L Chan
- University of Ottawa, Biology- Toxicology and Environmental Health, Ottawa, Canada
| | - R Chow
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - I Chen
- The Ottawa Hospital Research Institute- University of Ottawa, Clinical Epidemiology Program- Obstetrics and Gynecology, Ottawa, Canada
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27
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Sodhi J, Chan L, Chow R, Chen I. P–296 Examining the link between environmental toxin exposure and uterine leiomyoma: a systematic review. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.295] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Is there an association between exposure to certain environmental toxins and the prevalence of uterine leiomyoma in women?
Summary answer
Some evidence was obtained to suggest an association between phthalate esters, bisphenol A, heavy metals, persistent organic pollutants and the prevalence of uterine fibroids.
What is known already
Environmental toxins are naturally occurring, or human made chemicals that can act as endocrine disrupting chemicals (EDCs) by binding and activating estrogen receptors in the body. Uterine fibroids, often called leiomyoma are non-cancerous growths occurring in the uterus. Though often asymptomatic, they can cause pain, infertility, pregnancy complications and are a leading cause for hysterectomy. The aetiology of leiomyoma is not fully understood but both estrogen and progesterone have been implicated in their growth. We aimed to investigate the epidemiological evidence for the association between EDCs and the prevalence of fibroids.
Study design, size, duration
We undertook a systematic review and in keeping with PRISMA guidelines, a structured search of Medline, Embase, Scopus, and Web of Science was conducted (to October 2020). Case-control, cross-sectional, cohort and experimental studies were included.
Participants/materials, setting, methods
The included studies analyzed the association between one or more toxins and the occurrence, or growth of leiomyoma in humans, including human cell lines. The types of toxins, patient characteristics, association and outcome, body concentration of toxin and confounding variables were extracted and analyzed. Quality assessment was performed using the Newcastle-Ottawa Scale.
Main results and the role of chance
In total, 34 studies were included. The majority (76%) of studies revealed a significant association between the exposure studied and the prevalence of uterine leiomyoma. In examining body burden in cases vs controls, phthalate esters showed an association with increased odds of uterine leiomyoma, except in one case where a negative association was observed. In vitro experimental studies examining the effect of alkyl-phenols such as bisphenol A (BPA), octylphenol (OP) and nonylphenol (NP) demonstrated that these environmental estrogens can act to promote the proliferation of leiomyoma cells through a number of mechanisms, typically including the estrogen receptor alpha (ERa) signalling pathway. There were conflicting results for the association between alkyl-phenols and fibroids in case-control studies. A positive association between cadmium was demonstrated in only two studies. There were conflicting results for the association between lead, mercury, arsenic and uterine fibroids. Several metabolites of organophosphate esters, alternative plasticizers, and persistent organic pollutants were associated with an increased risk of uterine fibroids.
Limitations, reasons for caution
Separating these exposures from the multiple other factors that could affect the outcome of leiomyoma is challenging, but an important issue for future research.
Wider implications of the findings: The link between some environmental toxins and uterine fibroids discussed is in agreement with previous literature. However, our review provides a more in depth analysis on specific dosage effects, odds ratios, and potential gene mechanisms of the exposures. This information could contribute to more accurate preventative measures.
Trial registration number
Not applicable
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Affiliation(s)
- J Sodhi
- University of Ottawa, Biology, Ottawa, Canada
| | - L Chan
- University of Ottawa, Biology- Toxicology and Environmental Health, Ottawa, Canada
| | - R Chow
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - I Chen
- The Ottawa Hospital Research Institute- University of Ottawa, Clinical Epidemiology Program- Obstetrics and Gynecology, Ottawa, Canada
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Chow R, Huang E, Fu S, Kim E, Li S, Tulandi T, Cobey K, Bacal V, Chen I. Spin in randomized controlled trials in obstetrics and gynecology: a systematic review. Journal of Obstetrics and Gynaecology Canada 2021. [DOI: 10.1016/j.jogc.2021.02.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chow R, Huang E, Li A, Li S, Fu SY, Son JS, Foster WG. Appraisal of systematic reviews on interventions for postpartum depression: systematic review. BMC Pregnancy Childbirth 2021; 21:18. [PMID: 33407226 PMCID: PMC7789727 DOI: 10.1186/s12884-020-03496-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions. METHODS An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD. RESULTS Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, - 0.09 to 0.34), or source of funding (p = 0.19). CONCLUSION Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.
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Affiliation(s)
- Ryan Chow
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada
- Department of Obstetrics and Gynecology, HSC-3N52D, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Eileen Huang
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada
| | - Allen Li
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada
| | - Sophie Li
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Sarah Y Fu
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6N5, Canada
| | - Jin S Son
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Warren G Foster
- Department of Obstetrics and Gynecology, HSC-3N52D, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
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Chow R, Wessels JM, Foster WG. Brain-derived neurotrophic factor (BDNF) expression and function in the mammalian reproductive Tract. Hum Reprod Update 2020; 26:545-564. [PMID: 32378708 DOI: 10.1093/humupd/dmaa008] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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: 08/27/2019] [Revised: 12/13/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Neurotrophins of the nerve growth factor family are soluble polypeptides that are best known for their role in nerve growth, survival and differentiation in the central nervous system. A growing body of literature shows that neurotrophins and their receptors are also expressed throughout the reproductive tract. OBJECTIVE AND RATIONALE Neurotrophins are key regulatory proteins in reproductive physiology during development and throughout adult life. Of the neurotrophins, the literature describing the expression and function of brain-derived neurotrophic factor (BDNF) and its high-affinity receptor, neurotrophin receptor kinase-2 (NTRK2), has been expanding rapidly. We therefore conducted a systematic inductive qualitative review of the literature to better define the role of the BDNF in the reproductive tract. We postulate that BDNF and NTRK2 are central regulatory proteins throughout the reproductive system. SEARCH METHODS An electronic search of Medline (PubMed) and Web of Science for articles relating to BDNF and the reproductive system was carried out between January 2018 and February 2019. OUTCOMES In the ovary, BDNF expression and levels have been linked with follicle organisation during ovarian development, follicle recruitment and growth and oocyte maturation. In the endometrium, BDNF is involved in cell proliferation and neurogenesis. In contrast, literature describing the role of BDNF in other reproductive tissues is sparse and BDNF-NTRK2 signalling in the male reproductive tract has been largely overlooked. Whilst estradiol appears to be the primary regulator of BDNF expression, we also identified reports describing binding sites for glucocorticoid and myocyte enhancer factor-2, a calcium-response element through activation of an N-methyl-D-aspartate (NMDA) receptor, and aryl hydrocarbon receptor nuclear transporter protein-4 (ARNT) response elements in promoter regions of the BDNF gene. Expression is also regulated by multiple microRNAs and post-translational processing of precursor proteins and intracellular shuttling. BDNF-NTRK2 signalling is modulated through tissue specific receptor expression of either the full-length or truncated NTRK2 receptor; however, the functional importance remains to be elucidated. Dysregulation of BDNF expression and circulating concentrations have been implicated in several reproductive disorders including premature ovarian failure, endometriosis, pre-eclampsia, intra-uterine growth restriction (IUGR) and several reproductive cancers. WIDER IMPLICATIONS We conclude that BDNF and its receptors are key regulatory proteins central to gonadal development, ovarian regulation and uterine physiology, as well as embryo and placenta development. Furthermore, dysregulation of BDNF-NTRK2 in reproductive diseases suggests their potential role as candidate clinical markers of disease and potential therapeutic targets.
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Affiliation(s)
- R Chow
- Department of Obstetrics & Gynaecology, McMaster University, Hamilton, Ontario, Canada
| | - J M Wessels
- Department of Obstetrics & Gynaecology, McMaster University, Hamilton, Ontario, Canada
| | - W G Foster
- Department of Obstetrics & Gynaecology, McMaster University, Hamilton, Ontario, Canada
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Chow R, Scheidegger R, Doppler T, Dietzel A, Fenicia F, Stamm C. A review of long-term pesticide monitoring studies to assess surface water quality trends. Water Res X 2020; 9:100064. [PMID: 32995734 PMCID: PMC7501075 DOI: 10.1016/j.wroa.2020.100064] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 05/05/2023]
Abstract
Aquatic pesticide pollution from both agricultural and urban pest control is a concern in many parts of the world. Making an accurate assessment of pesticide exposure is the starting point to protecting aquatic ecosystems. This in turn requires the design of an effective monitoring program. Monitoring is also essential to evaluate the efficacy of mitigation measures aimed to curb pesticide pollution. However, empirical evidence for their efficacy can be confounded by additional influencing factors, most prominently variable weather conditions. This review summarizes the experiences gained from long-term (>5 years) pesticide monitoring studies for detecting trends and provides recommendations for their improvement. We reviewed articles published in the scientific literature, with a few complements from selected grey literature, for a total of 20 studies which fulfill our search criteria. Overall, temporal trends of pesticide use and hydrological conditions were the two most common factors influencing aquatic pesticide pollution. Eighteen studies demonstrated observable effects to surface water concentrations from changes in pesticide application rates (e.g., use restriction) and sixteen studies from interannual variability in hydrological conditions during the application period. Accounting for seasonal- and streamflow-related variability in trend analysis is important because the two factors can obscure trends caused by changes in pesticide use or management practices. Other mitigation measures (e.g., buffer strips) were only detectable in four studies where concentrations or loads were reduced by > 45%. Collecting additional agricultural (e.g., pesticide use, mitigation measures) and environmental (e.g., precipitation, stream flow) data, as well as establishing a baseline before the implementation of mitigation measures have been consistently reported as prerequisites to interpret water quality trends from long-term monitoring studies, but have rarely been implemented in the past.
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Affiliation(s)
- R Chow
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland
| | - R Scheidegger
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland
| | - T Doppler
- VSA, Swiss Water Association, 8152 Glattbrugg, Switzerland
| | - A Dietzel
- VSA, Swiss Water Association, 8152 Glattbrugg, Switzerland
| | - F Fenicia
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland
| | - C Stamm
- Swiss Federal Institute of Aquatic Science and Technology (eawag), 8600 Dübendorf, Switzerland
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Dharamsi A, Hayman K, Yi S, Chow R, Yee C, Gaylord E, Tawadrous D, Chartier LB, Landes M. Enhancing departmental preparedness for COVID-19 using rapid-cycle in-situ simulation. J Hosp Infect 2020; 105:604-607. [PMID: 32540462 PMCID: PMC7292952 DOI: 10.1016/j.jhin.2020.06.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/10/2020] [Indexed: 01/25/2023]
Abstract
In response to coronavirus disease 2019 (COVID-19), a rapid-cycle in-situ simulation (ISS) programme was developed to facilitate identification and resolution of systems-based latent safety threats. The simulation involved a possible COVID-19 case in respiratory failure, using a mannequin modified to aerosolize phosphorescent secretions. Thirty-six individuals participated in five ISS sessions over 6 weeks, and a further 20 individuals observed these sessions. Debriefing identified latent safety threats from four domains: personnel, personal protective equipment, supply/environment and communication. These threats were addressed and resolved in later iterations. Ninety-four percent of participants felt more prepared to care for a potential case of COVID-19 after the ISS.
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Affiliation(s)
- A Dharamsi
- Emergency Department, University Health Network, Toronto, Canada; Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada.
| | - K Hayman
- Emergency Department, University Health Network, Toronto, Canada; Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada
| | - S Yi
- Emergency Department, University Health Network, Toronto, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - R Chow
- The Michener Institute of Education at University Health Network, Toronto, Canada
| | - C Yee
- Emergency Department, University Health Network, Toronto, Canada
| | - E Gaylord
- Emergency Department, University Health Network, Toronto, Canada
| | - D Tawadrous
- Emergency Department, University Health Network, Toronto, Canada; Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada
| | - L B Chartier
- Emergency Department, University Health Network, Toronto, Canada; Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada
| | - M Landes
- Emergency Department, University Health Network, Toronto, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Canada
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Lee JG, Telford JJ, Galorport C, Yonge J, Macdonnell CA, Gillies A, Chow R, Enns RA. A149 COMPARING THE REAL-WORLD EFFECTIVENESS OF 4L VERSUS 2L SPLIT COLONOSCOPY PREPARATIONS: PRELIMINARY DATA OF A SINGLE CENTRE EXPERIENCE THROUGH THE BRITISH COLUMBIA COLONOSCOPY SCREENING PROGRAM. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.148] [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: 11/14/2022] Open
Abstract
Abstract
Background
The British Columbia Colon Screening Program (CSP) is a population-based program offering biennial fecal immunochemical test (FIT) to individuals age 50–74 years with follow-up colonoscopy for a positive FIT as well as individuals with a personal history of neoplastic polyps or a high risk family history of colorectal cancer. Over 20,000 colonoscopies are performed annually. In December 2018, program colonoscopists in Vancouver, Canada agreed to switch from a 2L polyethylene glycol (PEG) preparation to a 4L PEG preparation after studies suggested superiority of the higher volume preparation in achieving adequate bowel cleansing and improving adenoma detection rates (ADR). High quality bowel cleansing is critical to minimize repeat procedures and maximize neoplasia detection.
Aims
To compare the quality of bowel preparation and neoplasia detection rates using the 4L high volume split preparation (HVSP) versus the 2L low volume split preparation (LVSP) in patients undergoing colonoscopy in the BC CSP.
Methods
A retrospective review of consecutive patients undergoing colonoscopy through the CSP at St. Paul’s Hospital from Dec 2017-Apr 2018 and Dec 2018-Apr 2019 was conducted. Inclusion criteria included: age 50–74, patients undergoing colonoscopy for any reason through the BC CSP. Variables collected included: patient demographics, bowel preparation qualty and pathologic findings. ADR and sessile serrated polyp detection rate (SSDR) were analyzed.
Results
462 colonoscopies were included, 280 in the LVSP group and 182 in the HVSP group. 8/280 (2.9%) had poor bowel preparation in the LVSP group, while 10/182 (5.5%) had poor bowel preparation in the HVSP group. The ADR and SSDR were 53.6% in LVSP vs. 50.0% in HVSP and 8.2% in LVSP vs. 8.8% in HVSP, respectively.
Conclusions
In this preliminary evaluation, the high volume PEG-based split preparation did not reduce the proportion of inadequate bowel preparations. Further evaluation of a larger number of colonoscopies is planned.
Funding Agencies
None
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Affiliation(s)
- J G Lee
- University of British Columbia, Vancouver, BC, Canada
| | - J J Telford
- University of British Columbia, Vancouver, BC, Canada
| | - C Galorport
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - J Yonge
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - C A Macdonnell
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - A Gillies
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - R Chow
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - R A Enns
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
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Smith BC, Yonge J, Macdonnell CA, Poon J, Galorport C, Gillies A, Chow R, Enns RA, Telford JJ. A168 IS ROUTINE SCREENING FOR HEREDITARY COLORECTAL CANCER FEASIBLE IN AN OUTPATIENT GASTROENTEROLOGY PRACTICE? J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.167] [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: 11/14/2022] Open
Abstract
Abstract
Background
Lynch syndrome (LS) is the most common cause of hereditary colorectal cancer (CRC), with a reported prevalence of 2–5% of all CRC cases. A study by Kastrinos et al. found that a simple 3 item survey identified 77% of individuals at high risk for hereditary CRC. Implementation of this questionnaire at a gastroenterology office may help identify patients at risk for LS and other hereditary CRC.
Aims
To assess whether implementation of a validated questionnaire to screen for hereditary CRC is feasible in an outpatient gastroenterology clinic.
Methods
Adult gastroenterology outpatients who consented to participate in the study completed the screening questionnaire. Those who had previously been assessed by the Hereditary Cancer Program were excluded. Each subject was asked the following three questions: (1) Do you have a first-degree relative with CRC or LS-related cancer diagnosed before age 50? (2) Have you had CRC or polyps diagnosed before age 50? (3) Do you have ≥3 relatives with CRC?. Answering yes to any question was considered a positive screen.
Results
A total of 288 patients were screened, with 12 (4.2%) screening positive for question 1, 28 (9.7%) screening positive for question 2, and 8 (2.8%) screening positive for question 3. In total, 14.2% of individuals surveyed screened positive.
Conclusions
Utilization of a simple 3-question survey as part of regular patient intake in a gastroenterology office resulted in 14.2% of individuals screening high-risk for hereditary CRC. This is similar to the 15% screen positive rate in the original study of individuals with CRC. Further research is needed to determine whether a physician’s knowledge of the questionnaire results will change management and whether a positive screen leads to a confirmed diagnosis of LS and other hereditary colorectal cancers.
Funding Agencies
None
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Affiliation(s)
- B C Smith
- Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J Yonge
- University of British Columbia, Vancouver, BC, Canada
| | - C A Macdonnell
- Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J Poon
- Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - C Galorport
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - A Gillies
- Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - R Chow
- McGill University, Vancouver, BC, Canada
| | - R A Enns
- Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - J J Telford
- University of British Columbia, Vancouver, BC, Canada
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Chow R, Gillies A, Enns RA, Telford JJ, Galorport C. A165 ASSESSING ATTENDANCE OF SUBSTANCE USER ENDOSCOPIES (A.S.U.R.E). J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.164] [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
Background
In Canada, British Columbia (BC) is the leading province in opioid deaths with 30.6 per 100,000 population. Since substance users are stigmatized in health care, patient care requires specific, individualized management strategies, which often creates a gap between the patient and health care service. Diagnostic studies remain a challenge due to lack of funding and the unique requirements necessary to treat this patient population efficiently. Thus, new methods of prevention must be cultivated to ensure ideal patient care.
Aims
To investigate the proportion of patients on restricted narcotics that failed to attend scheduled gastroenterology and hepatology appointments at our center.
Methods
A retrospective chart review from 01/05 – 07/19 and data analysis of patients (≥ 19 yrs.) referred to a Downtown Gastroenterology office was performed. Data was collected from an electronic medical record system and filtered through a keyword search for ‘Methadone’, ‘Suboxone’, ‘Dilaudid’, and ‘Morphine’ to create a sample size of patients with recent/ongoing use of narcotic agents. Patients with chronic pain, or terminal illness prescribed these drugs were not included. Demographic information, type of appointment scheduled and failure to attend were recorded.
Results
Acquired data yielded 2630 patients of which 350 patient were included. Mean age was 47 years (61% male). 35% of the patients were current narcotics users, the rest being previous users of these agents. Scheduled appointments and non-attendance are shown in Tables 2 and 3. Most patients (70%) were referred for various general GI complaints with HCV accounting for 23% of the consults. Despite the use of confirmation lines, 20% of HCV referred patients and 29% of non-HCV referred patients did not attend their first appointment.
Conclusions
Current and prior narcotic users failed to attend more than one quarter of scheduled gastroenterology/hepatology appointments. Ideal management of care for GI disease can’t be obtained without contact with those that provide the service. Creative, innovative management strategies are required to ensure ideal care for this unique group of patients.
Funding Agencies
None
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Affiliation(s)
- R Chow
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - A Gillies
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
| | - R A Enns
- Medicine, St Paul, Vancouver, BC, Canada
| | - J J Telford
- University of British Columbia, Vancouver, BC, Canada
| | - C Galorport
- Medicine, Div. of Gastroenterology, St. Paul’s Hospital, Vancouver, BC, Canada
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Gillies AN, Chow R, Galorport C, Macdonnell CA, Yonge J, Telford JJ, Rosenfeld G, Bressler B, Whittaker S, Lam E, Ramji A, Enns RA. A154 ASSESSING COLON SCREENING PROGRAM COLONOSCOPIES IN A NON-HOSPITAL ENDOSCOPY CLINIC. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.153] [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: 11/12/2022] Open
Abstract
Abstract
Background
Colorectal cancer is the most commonly diagnosed cancer in British Columbia, affecting 1 in 6 persons. The BC Colon Screening Program (CSP) screens individuals 50–74 years of age with biennial FIT (cut-off 10 mcg/g) with follow-up colonoscopy for positive results. In Vancouver, colonoscopies are performed in a hospital environment; however non-hospital endoscopy clinics have been used in other jurisdictions.
Aims
To investigate the quality of procedure, rate of complications and need to repeat procedures in a hospital setting for colonoscopies performed on CSP patients in a non-hospital setting.
Methods
A retrospective chart review for all CSP colonoscopies performed from 04/19 to 07/19 in a non-hospital endoscopy clinic. Data was collected from an electronic medical record system and included adenoma detection rates; any repeat procedures required in a hospital setting and adverse event rates. Criteria for a repeat in hospital colonoscopy were inadequate bowel preparation, body mass index exceeding the allowable threshold for a non-hospital colonoscopy and identification of a difficult to remove polyp such as a polyp > 20 mm or in a difficult location.
Results
801 FIT positive patients (ages 50–74) underwent colonoscopy in the non-hospital endoscopy clinic. The mean age was 60 years (51% female). The mean time between referral date and procedure date was 192 days. The neoplasia detection rate was 60.2%, there was one (0.1%) adverse event (post-polypectomy bleed) and 21 (2.6%) patients required a repeat colonoscopy in a hospital setting.
Conclusions
Colonoscopy to follow-up a positive FIT in an non-hospital endoscopy clinic was safe and effective with a low number of repeat, in hospital colonoscopies required.
Funding Agencies
None
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Affiliation(s)
- A N Gillies
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - R Chow
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - C Galorport
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - C A Macdonnell
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - J Yonge
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - J J Telford
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - G Rosenfeld
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - B Bressler
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - S Whittaker
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - E Lam
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - A Ramji
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - R A Enns
- Division of Gastroenterology, Department of Medicine, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
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Gillies AN, Chow R, Galorport C, Telford JJ, Enns RA. A163 MICROCOSTING: ASSESSING HEALTH ECONOMICS IN GI. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.162] [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
Background
Micro-costing is a method of collecting precise cost measurements and proves effective in determining economic requirements needed to support health interventions. At St. Paul’s GI Clinic, over 12000 procedures are performed yearly, 80% of which are colonoscopies. Specific standards in the form of appropriate documentation are recommended through Global Rating Scale (GRS) and require yearly auditing to ensure appropriate compliance with these standards. These audits require a time commitment of staff to assess charts. The cost of performing these assessments is not known.
Aims
To determine the cost of annual data collection suggested by GRS for documentation of procedures.
Methods
A retrospective chart review and data analysis of patients (≥ 19 years old) admitted to St. Paul’s GI Clinic for a colonoscopy and/or esophagogastroduodenoscopy (EGD). Data is extracted from the St. Paul’s medical database from August 1st 2018 – August 1st 2019. Since it is a ‘time-and-motion’ study, a stopwatch is used to time the collection of data from each chart. The mean time per-case is derived and used to conduct an appropriate economic analysis, such as total working hours, per-minute salary calculations and equipment costs. The purpose is to determine a yearly cost and identify what the main cost drivers were (time/labor).
Results
As per our annual review format suggested by GRS, 260 procedure reports were reviewed, 150 colonoscopies and 110 EGDs (random sampling of 10 per physician for each type of procedure). A spread sheet outlining key data assessment points for mandatory standard reporting points has been used yearly and was used for this study as well. Mean evaluation time (including recording presence or absence of each item on our standard reporting form): 1 minute and 40 seconds to review the report for a colonoscopy and 1 minute and 33 seconds to review the report for an EGD. A total of 2 hours 51 minutes 16 seconds to review all the EGD reports and 4 hours 8 minutes and 46 seconds for the colonoscopy reports.
Conclusions
It would cost $126 annually to pay a research student, who makes $18/ hour, to collect this quality assurance data required for auditing completeness of physician colonoscopy and EGD procedure documentation according to standards.
Funding Agencies
None
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Affiliation(s)
- A N Gillies
- Division of Gastroenterology, Department of Medicine, St Paul’s Hospital, University of British Columbia, Vancouver, BC, West Vancouver, BC, Canada
| | - R Chow
- Division of Gastroenterology, Department of Medicine, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - C Galorport
- Division of Gastroenterology, Department of Medicine, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - J J Telford
- Division of Gastroenterology, Department of Medicine, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
| | - R A Enns
- Division of Gastroenterology, Department of Medicine, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Vancouver, BC, Canada
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Lao N, Mendez L, Rodrigues M, Zhang L, Wronski M, McKenzie E, Chow R, Pidduck W, Yee C, Bosnic S, Leung E, McCann C, Chow E, Lock M. Validation and Inter-Rater Reliability of Two Metrics Used As Predictors of Heart Dose in Patients Treated with Adjuvant Radiotherapy to the Left Breast. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Patel H, Kant S, Chow R. A rare presentation of angioedema with isolated retropharyngeal and supraglottic involvement. J Community Hosp Intern Med Perspect 2019; 9:36-39. [PMID: 30788074 PMCID: PMC6374935 DOI: 10.1080/20009666.2018.1562855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Received: 09/26/2018] [Accepted: 12/18/2018] [Indexed: 11/07/2022] Open
Abstract
Angiotensin converting-enzyme (ACE) inhibitors are commonly prescribed drugs with multiple indications including congestive heart failure, hypertension, and diabetic nephropathy. ACE inhibitor induced angioedema is commonly seen across emergency departments and clinics, with transient swelling of lips, tongue, and other facial structures being the common presentation. Isolated airway obstruction as a result of pharyngeal and laryngeal swelling without facial swelling is a rare presentation. We present a case of a patient on lisinopril therapy for one year who experienced severe airway compromise without the classic symptoms of ACE inhibitor induced angioedema. He required emergent cricothyroidotomy to secure his airway, as fiberoptic laryngoscopy showed 90% obstruction and inability to visualize true vocal cords. His ACE inhibitor therapy was discontinued, and he was discharged home within a few days with no residual symptoms.
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Affiliation(s)
- H Patel
- Department of Medicine, American University of Antigua, New York, USA
| | - S Kant
- Department of Nephrology/Internal Medicine, University of Maryland, Maryland, USA
| | - R Chow
- Department of Nephrology/Internal Medicine, University of Maryland, Maryland, USA
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Wang G, Chow R, Bai Z, Ye L, Chen S. Abstract B095: Mapping the genetic features of immune checkpoint responsiveness using AAV-CRISPR mediated in vivo screen. Cancer Immunol Res 2019. [DOI: 10.1158/2326-6074.cricimteatiaacr18-b095] [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
Immune checkpoint blockade has achieved tremendous clinical success across many tumor types, but fails to induce clinical responses in many patients. The mechanisms underlying checkpoint resistance remain poorly characterized. Recent studies have applied next generation sequencing techniques to catalog the mutational burden of patient tumors, which provides a wealth of data to determine common mutations. To map the genetic features of response to checkpoint blockade immunotherapy as well as correlating the clinical efficacy with certain mutations, we developed a novel direct in vivo CRISPR screening approach for high-throughput profiling of functional cancer drivers in an autochthonous manner by injecting AAVs carrying an sgRNA library targeting the top 50 TCGA pan-cancer recurrently mutated tumor suppressor genes (mTSG) into the immunocompetent Cas9 transgenic mice. All mice that received the AAV-mTSG library developed liver cancer and died within four months. We then utilized MIP sequencing of sgRNA target sites to chart the mutational landscape of these tumors, revealing the functional consequence of multiple variants in driving liver tumorigenesis as well as identifying specific gene pairs that were co-occurring across mice. Using this approach, we also mapped the mutation landscape changes under the pressures of immune checkpoint inhibitors, anti-PD1 or anti-CTLA4. We monitored liver tumor growth in AAV-mTSG injected LSL-Cas9;LSL-Fluc mice by using intravital bioluminescent imaging system (IVIS) in combination with dissection check before drug administration. Using IVIS data, we grouped them into 3 size-matched cohorts to receive anti-PD1 or anti-CTLA4 treatments or PBS control. According to the survival data, the mice with mTSG-induced liver tumor benefit from anti-PD1 or anti-CLTA4 treatment. By comparing the mutation frequencies of liver tumors in the mice receiving either checkpoint inhibitors or PBS treatment, we mapped the mutation landscape changes associated with anti-PD1 or anti-CTLA4 treatment. We are performing validation studies on top targets such as Arid1a, Stk11, and B2M. Using this approach, we systematically mapped the correlation of these top 50 driver mutations with cancer immune evasion and immunotherapy responsiveness, providing a valuable reference for patient stratification when considering immunotherapy as well as novel targets for synergistic interventions.
Citation Format: Guangchuan Wang, Ryan Chow, Zhigang Bai, Lupeng Ye, Sidi Chen. Mapping the genetic features of immune checkpoint responsiveness using AAV-CRISPR mediated in vivo screen [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr B095.
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Affiliation(s)
| | - Ryan Chow
- Yale University School of Medicine, New Haven, CT
| | - Zhigang Bai
- Yale University School of Medicine, New Haven, CT
| | - Lupeng Ye
- Yale University School of Medicine, New Haven, CT
| | - Sidi Chen
- Yale University School of Medicine, New Haven, CT
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41
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Chow R, Hashemi J, Torbey S, Siu J, Glover B, Baranchuk AM, Abdollah H, Simpson C, Akl S, Redfearn DP. Novel frequency analysis of signal-averaged electrocardiograms is predictive of adverse outcomes in implantable cardioverter defibrillator patients. Ann Noninvasive Electrocardiol 2019; 24:e12629. [PMID: 30688396 DOI: 10.1111/anec.12629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/04/2018] [Accepted: 12/16/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Current noninvasive risk stratification methods offer limited prediction of arrhythmic events when selecting patients for ICD implantation. Our laboratory has recently developed a signal processing metric called Layered Symbolic Decomposition frequency (LSDf) that quantifies the percentage of hidden QRS wave frequency components in signal-averaged ECG (SAECG) recordings. The purpose of this pilot study was to determine whether LSDf can be predictive of ventricular arrhythmia or death in an ICD patient cohort. METHODS AND RESULTS Fifty-two ICD patients were recruited from 2008 to 2009. These were followed for a mean of 8.5 ± 0.4 years for the primary outcome of first appropriately treated ventricular arrhythmia (VT/VF) or death. Thirty-four subjects met the primary outcome. LSDf was significantly lower, and 12-lead QRS duration was significantly greater in patients meeting the primary outcome (12.14 ± 3.97% vs. 16.45 ± 3.73%; p = 0.001) and (111.59 ± 14.96 ms vs. 97.69 ± 13.51 ms; p = 0.012) respectively. A 13.25% LSDf threshold (0.74 sensitivity and 0.85 specificity) was selected based on an ROC curve. Kaplan-Meier survival analysis was conducted; patients above the 13.25% threshold demonstrated significantly better survival outcomes (log-rank p < 0.001). In Cox multivariate regression analysis, the LSDf threshold (13.25%) was compared to LVEF (28.5%), 12-lead QRSd (100 ms), age, % male sex, NYHA classification, and antiarrhythmic usage. LSDf was a predictor of the primary outcome (p = 0.005) and an independent predictor for solely ventricular arrhythmia (p = 0.002). CONCLUSION Layered Symbolic Decomposition frequency analysis in SAECG recordings may be a viable predictor of negative ICD survival outcomes.
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Affiliation(s)
- Ryan Chow
- Queen's University, Kingston, Ontario, Canada
| | | | - Sami Torbey
- Queen's University, Kingston, Ontario, Canada
| | - Johnny Siu
- Queen's University, Kingston, Ontario, Canada
| | - Benedict Glover
- Queen's University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Adrian M Baranchuk
- Queen's University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Hoshiar Abdollah
- Queen's University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Christopher Simpson
- Queen's University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Selim Akl
- Queen's University, Kingston, Ontario, Canada
| | - Damian P Redfearn
- Queen's University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Kingston, Ontario, Canada
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Johri AM, Durbin J, Newbigging J, Tanzola R, Chow R, De S, Tam J. Cardiac Point-of-Care Ultrasound: State-of-the-Art in Medical School Education. J Am Soc Echocardiogr 2018; 31:749-760. [DOI: 10.1016/j.echo.2018.01.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Indexed: 11/25/2022]
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43
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Raman S, Ganesh V, Chan S, Chow R, Hoskin P, Lam H, Wan B, Drost L, DeAngelis C, Chow E. A Review of Practice Patterns and Clinical Guidelines in the Palliative Radiation Treatment of Uncomplicated Bone Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1862] [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: 11/30/2022]
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44
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Daugaard I, Sanders KJ, Idica A, Vittayarukskul K, Hamdorf M, Krog JD, Chow R, Jury D, Hansen LL, Hager H, Lamy P, Choi CL, Agalliu D, Zisoulis DG, Pedersen IM. miR-151a induces partial EMT by regulating E-cadherin in NSCLC cells. Oncogenesis 2017; 6:e366. [PMID: 28759022 PMCID: PMC5541717 DOI: 10.1038/oncsis.2017.66] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [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: 01/20/2017] [Revised: 05/15/2017] [Accepted: 06/07/2017] [Indexed: 02/07/2023] Open
Abstract
miR-151a and its host gene, focal adhesion kinase, FAK, are located in a region of chromosome 8q that is frequently amplified in solid tumors, including lung cancer. Lung cancer is the leading cause of cancer deaths worldwide and metastasis remains the major challenge in battling lung cancer mortality. Here, we demonstrate that miR-151a is overexpressed in non-small cell lung cancer (NSCLC) patient specimens, as compared to healthy lung. In addition, miR-151a overexpression promotes proliferation, epithelial-to-mesenchymal transition (EMT) and induces tumor cell migration and invasion of NSCLC cells. Blocking miR-151a expression using anti-miR-151a approaches significantly reduced NCSLC cell proliferative and motility potential. Furthermore, we determined that miR-151a significantly regulates E-cadherin expression. Finally, functional rescue experiments determined that overexpression of E-cadherin in miR-151a NSCLC cell lines potently repressed miR-151a-induced partial EMT and cell migration of NSCLC cells. In conclusion, our findings suggest that miR-151a functions as an oncomiR in NSCLC by targeting E-cadherin mRNA and inducing proliferation, migration and partial EMT.
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Affiliation(s)
- I Daugaard
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - K J Sanders
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - A Idica
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - K Vittayarukskul
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - M Hamdorf
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - J D Krog
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - R Chow
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - D Jury
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - L L Hansen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - H Hager
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.,Department of Pathology, Vejle Hospital, Vejle, Denmark
| | - P Lamy
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - C L Choi
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - D Agalliu
- Departments of Neurology, Pathology and Cell Biology, Pharmacology, Columbia University Medical Center, New York, NY, USA
| | - D G Zisoulis
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
| | - I M Pedersen
- Department of Molecular Biology and Biochemistry, Francisco J. Ayala School of Biological Sciences, University of California, Irvine, CA, USA
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Chow R, Shabsovich D, Schiller G, Kallen M, Tirado CA. A t(17;19)(q22;p13.3) Involving TCF3, a t(1;9)(p13;p13), and a 5' IGH Deletion in a Case of Adult B-cell Acute Lymphoblastic Leukemia. J Assoc Genet Technol 2016; 42:6-14. [PMID: 27183380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
TCF3 (19p13.3) abnormalities are relatively common in B-cell acute lymphoblastic leukemia (B-ALL). The t(1;19)(q23;p13) involving PBX1 is the most common of these rearrangements. The t(17;19)(q22;p13.3), resulting in the TCF3-HLF fusion gene, is also seen in B-ALL and is associated with an extremely poor prognosis. Herein, we present the case of a 25-year-old male diagnosed with B-ALL whose initial karyotype showed a t(17;19)(q22p13.3). FISH confirmed TCF3 involvement and also revealed a 5' IGH deletion. After treatment, the patient relapsed, at which point conventional cytogenetic studies showed a t(17;19), loss of the 5' IGH region, and a t(3;10) not seen in initial studies. After hematopoietic stem cell transplantation, the patient relapsed again, at which point conventional cytogenetic studies showed a complex karyotype with t(17;19), t(1;9)(p13;p13), and structural anomalies involving chromosomes 5, 7, and 14, but no IGH abnormalities by FISH. The t(1;9) has been shown to involve PAX5, which plays numerous regulatory roles in B-cell differentiation. Other PAX5 rearrangements have been detected in B-ALL cases of young adults and adolescents, but with unclear clinical significance. To the best of our knowledge, this is the first reported case of t(17;19)-ALL with concomitant 5' IGH deletion and t(1;9)(p13;p13) potentially involving PAX5, albeit at different time points in disease progression. This case provides insight into the clonal evolution of t(17;19)-ALL and the potential involvement of PAX5 and IGH aberrations in the evolution of this malignancy.
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Affiliation(s)
- R Chow
- Pathology and Laboratory Medicine, UCLA Los Angeles, CA 90024
| | - D Shabsovich
- Pathology and Laboratory Medicine, UCLA Los Angeles, CA 90024
| | - G Schiller
- Medicine, Hematology and Oncology, UCLA, Los Angeles, CA 90024
| | - M Kallen
- Pathology and Laboratory Medicine, UCLA Los Angeles, CA 90024
| | - Carlos A Tirado
- Pathology and Laboratory Medicine, UCLA Los Angeles, CA 90024
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Chow R, Gao M, Chan S, Gin K, Bennett M. The Significance of Early Normalization of the St Segment Depression in the Recovery Period and Its Relationship With the Underlying Coronary Anatomy. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Poon M, Zeng L, Zhang L, Lam H, Emmenegger U, Wong E, Bedard G, Lao N, Chow R, Chow E. Incidence of skeletal-related events over time from solid tumour bone metastases reported in randomised trials using bone-modifying agents. Clin Oncol (R Coll Radiol) 2013; 25:435-44. [PMID: 23582277 DOI: 10.1016/j.clon.2013.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 02/12/2013] [Accepted: 02/13/2013] [Indexed: 11/26/2022]
Abstract
AIMS Skeletal-related events (SREs) in patients with bone metastases decrease a patient's quality of life and functional status. Although bone-modifying agents have been found to reduce the time to first on-trial SRE and decrease the total incidence of SREs in randomised clinical trials, standard practice in the management of bone metastases has changed concurrently. The purpose of this study was to investigate if advances in bone-targeted therapies have decreased the incidence of individual types of SREs and to delineate the trend of SREs. MATERIALS AND METHODS A literature review was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to identify phase III, randomised bisphosphonate and other bone-targeted therapy trials from 1980 to September 2011. For all studies, a mean year of enrolment ([start of enrolment + end of enrolment]/2) was calculated. The incidences of SREs were tabulated and expressed as percentages of on-trial patients. Generalised linear mixed models were used to search for the trends of SREs over time for all placebo and intervention arms. Regression coefficients were interpreted as the odds ratio, which was calculated using the exponential of the slope. Ninety-five per cent confidence intervals were also calculated. RESULTS In total, 20 eligible studies were identified that reported SRE data from phase III trials, of which 11 were suitable for the quantitative analysis. Most of the articles included patients with breast cancer and the remaining involved patients with prostate, renal cell, bladder and lung cancer or other solid tumours. Enrolment periods for all included data ranged from 1990 to 2009. Statistically significant overall downward trends in pathological fractures and the need for surgery were seen over time. Also significant differences between intervention and placebo were seen with all SREs. CONCLUSION The decrease in SREs over time may not only be a result of the development of new generation bone-targeted agents, but also due to better systemic management and awareness of events associated with bone metastases.
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Affiliation(s)
- M Poon
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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48
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Jewett M, Finelli A, Kollmannsberger C, Wood L, Legere L, Basiuk J, Canil C, Heng D, Reaume N, Tanguay S, Atkins M, Bjarnason G, Dancey J, Evans M, Fleshner N, Haider M, Kapoor A, Uzzo R, Maskens D, Soulieres D, Yousef G, Basappa N, Bendali N, Black P, Blais N, Cagiannos I, Care M, Chow R, Chung H, Czaykowski P, Derosa D, Durrant K, Ellard S, Farquharson G, Filion-Brulotte C, Gingerich J, Godbout L, Grant R, Hamilton W, Kassouf W, Kurban G, Lane K, Lattouf J, Lau D, Leveridge M, McCarthy J, Moore R, North S, O'brien P, Pituskin E, Racine P, Rendon R, So A, Sridhar S, Stubbs K, Su Z, Taylor L, Udall T, Venner P, Vogel W, Yap S, Yau P, Cooper M, Giroux N, Miron D, Mosher D, Ross K, Willacy J. Management of kidney cancer: canadian kidney cancer forum consensus update 2011. Can Urol Assoc J 2012; 6:16-22. [PMID: 22396361 DOI: 10.5489/cuaj.11273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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49
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Petz L, Tonai R, Redei I, Li S, Li H, Bryson Y, Regan D, Spellman S, Gragert L, Boo M, Gutman J, Armitage S, Shpall E, Lin A, Rosenthal J, Zaia J, Rossi J, Kurtzberg J, Forman S, Chow R. Cord Blood Transplantation for Long Term Management or Possible Cure of HIV Infection. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.037] [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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50
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Chow R, Tonai R, Klich I, Wang B, Chow M, Ratajczak J, Petz L, Ratajczak M. Optimal Recovery of SSEA-4+/OCT-4+/CD133+/CXCR4+/Lin-/CD45- Very Small Embryonic-Like (VSEL) Stem Cells From Umbilical Cord Blood (CB) Using Plasma Depletion/Reduction (PDR) Compared to Red Cell Reduction (RCR). Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.201] [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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