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Schwartz T. At the Speed of SOUND: The Pace of Change for Axillary Management in Breast Cancer. Ann Surg Oncol 2024; 31:2801-2803. [PMID: 38347331 DOI: 10.1245/s10434-024-15010-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/22/2024] [Indexed: 04/10/2024]
Affiliation(s)
- Theresa Schwartz
- Department of Surgery, Henry Ford Cancer Institute, Detroit, MI, USA.
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Goldfarb DG, Prezant DJ, Zeig-Owens R, Hall CB, Schwartz T, Liu Y, Kavouras IG. Association of firefighting exposures with lung function using a novel job exposure matrix (JEM). Occup Environ Med 2024; 81:84-91. [PMID: 38233128 DOI: 10.1136/oemed-2023-109155] [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: 08/10/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Characterisation of firefighters' exposures to dangerous chemicals in smoke from non-wildfire incidents, directly through personal monitoring and indirectly from work-related records, is scarce. The aim of this study was to evaluate the association between smoke particle exposures (P) and pulmonary function. METHODS The study period spanned from January 2010 through September 2021. Routine firefighting P were estimated using fire incident characteristics, response data and emission factors from a novel job exposure matrix. Linear mixed effects modelling was employed to estimate changes in pulmonary function as measured by forced expiratory volume in one second (FEV1). Models controlled for age, race/ethnicity, height, smoking and weight. RESULTS Every 1000 kg P was associated with 13 mL lower FEV1 (β=-13.34; 95% CI=-13.98 to -12.70) over the entire 12-year follow-up period. When analysing exposures within 3 months before PFT measurements, 1000 kg P was associated with 27 mL lower FEV1 (β=-26.87; 95% CI=-34.54 to -19.20). When evaluating P estimated within 3 months of a pulmonary function test (PFT), stronger associations were observed among those most highly exposed to the World Trade Center (WTC) disaster (β=-12.90; 95% CI=-22.70 to -2.89); the association of cumulative exposures was similar for both highly and less highly exposed individuals. DISCUSSION Smoke particle exposures were observed to have modest short-term and long-term associations with pulmonary function, particularly in those who, previously, had high levels of WTC exposure. Future work examining the association between P and pulmonary function among non-WTC exposed firefighters will be essential for disentangling the effects of ageing, routine firefighting and WTC exposures.
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Affiliation(s)
- David G Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Environmental and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York city, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David J Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Theresa Schwartz
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Yang Liu
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Ilias G Kavouras
- Department of Environmental and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York city, New York, USA
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Hembach N, Drechsel V, Sobol M, Kaster AK, Köhler HR, Triebskorn R, Schwartz T. Effect of glyphosate, its metabolite AMPA, and the glyphosate formulation Roundup ® on brown trout ( Salmo trutta f. fario) gut microbiome diversity. Front Microbiol 2024; 14:1271983. [PMID: 38298542 PMCID: PMC10829098 DOI: 10.3389/fmicb.2023.1271983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
Glyphosate is used worldwide as a compound of pesticides and is detectable in many environmental compartments. It enters water bodies primarily through drift from agricultural areas so that aquatic organisms are exposed to this chemical, especially after rain events. Glyphosate is advertised and sold as a highly specific herbicide, which interacts with the EPSP synthase, an enzyme of the shikimate metabolism, resulting in inhibition of the synthesis of vital aromatic amino acids. However, not only plants but also bacteria can possess this enzyme so that influences of glyphosate on the microbiomes of exposed organisms cannot be excluded. Those influences may result in subtle and long-term effects, e.g., disturbance of the symbiotic interactions of bionts with microorganisms of their microbiomes. Mechanisms how the transformation product aminomethylphosphonic acid (AMPA) of glyphosate might interfere in this context have not understood so far. In the present study, molecular biological fingerprinting methods showed concentration-dependent effects of glyphosate and AMPA on fish microbiomes. In addition, age-dependent differences in the composition of the microbiomes regarding abundance and diversity were detected. Furthermore, the effect of exposure to glyphosate and AMPA was investigated for several fish pathogens of gut microbiomes in terms of their gene expression of virulence factors associated with pathogenicity. In vitro transcriptome analysis with the fish pathogen Yersinia ruckeri revealed that it is questionable whether the observed effect on the microbiome is caused by the intended mode of action of glyphosate, such as the inhibition of EPSP synthase activity.
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Affiliation(s)
- N. Hembach
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces, Karlsruhe, Germany
| | - V. Drechsel
- Institute of Evolution and Ecology, Animal Physiological Ecology, University of Tübingen, Tübingen, Germany
| | - M. Sobol
- Karlsruhe Institute of Technology (KIT), Institute for Biological Interfaces, Karlsruhe, Germany
| | - A.-K. Kaster
- Karlsruhe Institute of Technology (KIT), Institute for Biological Interfaces, Karlsruhe, Germany
| | - H.-R. Köhler
- Institute of Evolution and Ecology, Animal Physiological Ecology, University of Tübingen, Tübingen, Germany
| | - R. Triebskorn
- Institute of Evolution and Ecology, Animal Physiological Ecology, University of Tübingen, Tübingen, Germany
| | - T. Schwartz
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces, Karlsruhe, Germany
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Godsi M, Golombek A, Balasubrahmaniyam M, Schwartz T. Exploring the nature of high-order cavity polaritons under the coupling-decoupling transition. J Chem Phys 2023; 159:134307. [PMID: 37800643 DOI: 10.1063/5.0167945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023] Open
Abstract
Recently, we predicted theoretically that in cavities that support several longitudinal modes, strong coupling can occur in very different manners, depending on the system parameters. Distinct longitudinal cavity modes are either entangled with each other via the material or independently coupled to the exciton mode. Here, we experimentally demonstrate the transition between those two regimes as the cavity thickness is gradually increased while maintaining fixed coupling strength. We study the properties of the system using reflection and emission spectroscopy and show that even though the coupling strength is constant, different behavior in the spectral response is observed along the coupling-decoupling transition. In addition, we find that in such multimode cavities, pronounced upper polariton emission is observed, in contrast to the usual case of a single-mode cavity. Furthermore, we address the ultrafast dynamics of the multimode cavities by pump-probe spectroscopic measurements and observe that the transient spectra significantly change through the transition.
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Affiliation(s)
- M Godsi
- School of Chemistry, Raymond and Beverly Sackler Faculty of Exact Sciences and Center for Light-Matter Interaction, Tel Aviv University, Tel Aviv 6997801, Israel
| | - A Golombek
- School of Chemistry, Raymond and Beverly Sackler Faculty of Exact Sciences and Center for Light-Matter Interaction, Tel Aviv University, Tel Aviv 6997801, Israel
| | - M Balasubrahmaniyam
- School of Chemistry, Raymond and Beverly Sackler Faculty of Exact Sciences and Center for Light-Matter Interaction, Tel Aviv University, Tel Aviv 6997801, Israel
| | - T Schwartz
- School of Chemistry, Raymond and Beverly Sackler Faculty of Exact Sciences and Center for Light-Matter Interaction, Tel Aviv University, Tel Aviv 6997801, Israel
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Schwartz T, Marumoto AD, Giuliano AE. ASO Author Reflections: The Evolution of Axillary Management in Breast Cancer. Ann Surg Oncol 2023; 30:1014-1015. [PMID: 36245054 DOI: 10.1245/s10434-022-12677-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 01/10/2023]
Affiliation(s)
- Theresa Schwartz
- Department of Surgery, Henry Ford Cancer Institute, Detroit, MI, USA
| | - Ashley D Marumoto
- Department of Surgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA
| | - Armando E Giuliano
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Schwartz T, Marumoto AD, Giuliano AE. ASO Visual Abstract: Surgical Management of the Axilla in Breast Cancer-Evolving but Still Necessary. Ann Surg Oncol 2023; 30:1016. [PMID: 36335269 DOI: 10.1245/s10434-022-12685-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Theresa Schwartz
- Department of Surgery, Henry Ford Cancer Institute, Detroit, MI, USA
| | - Ashley D Marumoto
- Department of Surgery, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI, USA
| | - Armando E Giuliano
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Goldfarb DG, Prezant DJ, Zeig-Owens R, Schwartz T, Liu Y, Kavouras IG. Development of a job-exposure matrix (JEM) for exposure to smoke particle mass among firefighters of the Fire Department of the City of New York (FDNY). Occup Environ Med 2023; 80:104-110. [PMID: 36635097 DOI: 10.1136/oemed-2022-108549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/29/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES A refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from 2010 to 2021. METHODS The cohort included a subset of 3237 Fire Department of the City of New York firefighters who responded to at least one incident between 2010 and 2021, prior to retirement. Fire incident data included dates, type, severity (alarm level) and location. Response data included dates worked, firehouse, position titles and shift lengths for each firefighter. The quantity of smoke particle mass generated during structural and non-structural fires adjusted by individual firefighter engagement was computed using the United States Environmental Protection Agency AP-42 emissions framework. Correlations between years of employment, fire responses and career total particle mass concentration by firefighter were examined. Linear regression models were fit and corresponding R2 values were calculated. RESULTS Firefighters responded to a median of 424.7 (IQR=202.3-620.0) annual incidents/person; 17.6% were fire incidents (median=77.1; IQR=40.4-114.0). Structural fires were the most common type of fire incident (72.5% of annual incidents/person; median=55.9; IQR=29.6-85.5). Incident severity (alarm level) and firefighter engagement (position title) appeared to differentiate between high and low exposure regimes (R2=0.43). Incident severity explained most of the variability of particle exposures (R2=0.90). CONCLUSIONS Using the JEM, job-related smoke particle concentrations were estimated to vary by incident type, incident severity and firefighter engagement, highlighting the importance of using refined measures, so that future studies can more accurately evaluate associations between firefighting and health outcomes.
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Affiliation(s)
- David G Goldfarb
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA .,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Theresa Schwartz
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA
| | - Yang Liu
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Ilias G Kavouras
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
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Schwartz T, Marumoto AD, Giuliano AE. Surgical Management of the Axilla in Breast Cancer: Evolving but Still Necessary. Ann Surg Oncol 2023; 30:1008-1013. [PMID: 36194309 DOI: 10.1245/s10434-022-12605-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/14/2022] [Indexed: 01/10/2023]
Affiliation(s)
- Theresa Schwartz
- Department of Surgery, Henry Ford Cancer Institute, Detroit, MI, USA
| | - Ashley D Marumoto
- Department of Surgery, University of Hawai'i John A. Burns School of Medicine, Honolulu, HI, USA
| | - Armando E Giuliano
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Cleven KL, Zeig-Owens R, Goldfarb DG, Schwartz T, Prezant DJ. Risk Factors for COVID-19 in a Retired FDNY WTC-Exposed Cohort. IJERPH 2022; 19:ijerph19158891. [PMID: 35897262 PMCID: PMC9331420 DOI: 10.3390/ijerph19158891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
We evaluated the incidence and risk factors for COVID-19 in a prospectively followed cohort of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers, thus reducing the potential for selection bias, a limitation in published studies of hospitalized individuals. Participants were retired FDNY WTC-exposed rescue/recovery workers with ≥1 medical visit between 1 March 2020 and 1 August 2021. The cumulative incidence was calculated using self-reported COVID-19 diagnoses. Cox regression was performed to evaluate the association of WTC-exposure and COVID-19, adjusting for history of comorbidities, age, race, work assignment (emergency medical service providers vs. firefighter), and sex. The cumulative incidence of COVID-19 was 130 per 1000. The adjusted models showed the risk of infection was greater in those with highest WTC exposure versus less exposure (hazard ratio (HR) = 1.14 (95% CI 1.00–1.31)). Older age was associated with a lower risk of infection HR = 0.97 (95% CI 0.96–0.98). WTC-associated diseases (obstructive airways disease and interstitial lung disease) were not COVID-19 risk factors. This study is the first to show an association between WTC exposure and the risk of COVID-19. While participants are retired from FDNY work, the youngest individuals may still be in the workforce, explaining why younger age was a significant risk for COVID-19.
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Affiliation(s)
- Krystal L. Cleven
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- Correspondence: ; Tel.: +1-718-403-4416
| | - Rachel Zeig-Owens
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - David G. Goldfarb
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
| | - Theresa Schwartz
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
| | - David J. Prezant
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Ferastraoaru D, Zeig-Owens R, Goldfarb DG, Mueller AK, Hall CB, Weiden MD, Schwartz T, Prezant DJ, Rosenstreich D. Relationship between low serum IgE levels and malignancies in 9/11 World Trade Center responders. Ann Allergy Asthma Immunol 2022; 129:769-775. [PMID: 35872243 DOI: 10.1016/j.anai.2022.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/21/2022] [Accepted: 07/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Individuals with very low immunoglobulin E-(IgE)-levels have a high risk of developing malignancy. Previous studies have shown that World Trade Center (WTC)-responders exposed to carcinogens have an elevated risk of some cancers. OBJECTIVE To evaluate the association between low-serum IgE levels and cancer development in WTC-exposed-responders. METHODS IgE-levels were measured in 1,851 WTC-responders after 9/11/2001. This is the first pilot study in humans comparing the odds of developing cancer in this high-risk population, between the "low-IgE" (IgE in the lowest 3 rd percentile) versus "non-low IgE" participants. RESULTS A significantly higher proportion of hematologic malignancies was found in low-IgE (4/55, 7.3%) compared with non-low IgE (26/1,796, 1.5%, p<0.01) responders. The proportion of solid tumors were similar in both groups (5.5% vs 11.4%, p>0.05). After adjustment for relevant confounders (race, sex, age at blood draw, WTC-arrival time, smoking status), the low-IgE-participants had 7.81 times greater odds (95% CI=1.77-29.35) of developing hematologic cancer when compared with non-low-IgE-participants. The hematologic cancers found in this cohort were leukemia (n=1), multiple myeloma (n=1) and lymphoma (n=2). No statistical significance was found when estimating the odds-ratio for solid tumors in relation to IgE levels. CONCLUSION WTC-responders with low serum IgE levels had the highest odds of developing hematologic malignancies. This hypothesis-generating study suggests that low serum IgE levels might be associated with the development of specific malignancies in at-risk individuals exposed to carcinogens. Larger, multicenter studies with adequate follow up of individuals with different IgE levels are needed to better evaluate this relationship.
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Affiliation(s)
| | - Rachel Zeig-Owens
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY; Fire Department of the City of New York (FDNY), Brooklyn, NY
| | - David G Goldfarb
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY; Fire Department of the City of New York (FDNY), Brooklyn, NY
| | - Alexandra K Mueller
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY; Fire Department of the City of New York (FDNY), Brooklyn, NY
| | - Charles B Hall
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY
| | - Michael D Weiden
- Fire Department of the City of New York (FDNY), Brooklyn, NY; New York University Grossman School of Medicine, New York, NY
| | - Theresa Schwartz
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY; Fire Department of the City of New York (FDNY), Brooklyn, NY
| | - David J Prezant
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY; Fire Department of the City of New York (FDNY), Brooklyn, NY
| | - David Rosenstreich
- Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY
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Schwartz T. Personal Systemic Therapy Decision-Making has Officially Arrived for Node-Positive Breast Cancer. Ann Surg Oncol 2022; 29:4659-4662. [DOI: 10.1245/s10434-022-11689-9] [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] [Received: 02/17/2022] [Accepted: 03/16/2022] [Indexed: 11/18/2022]
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Gmurek M, Borowska E, Schwartz T, Horn H. Does light-based tertiary treatment prevent the spread of antibiotic resistance genes? Performance, regrowth and future direction. Sci Total Environ 2022; 817:153001. [PMID: 35031375 DOI: 10.1016/j.scitotenv.2022.153001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 10/05/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
The common occurrence of antibiotic-resistance genes (ARGs) originating from pathogenic and facultative pathogenic bacteria pose a high risk to aquatic environments. Low removal of ARGs in conventional wastewater treatment processes and horizontal dissemination of resistance genes between environmental bacteria and human pathogens have made antibiotic resistance evolution a complex global health issue. The phenomenon of regrowth of bacteria after disinfection raised some concerns regarding the long-lasting safety of treated waters. Despite the inactivation of living antibiotic-resistant bacteria (ARB), the possibility of transferring intact and liberated DNA containing ARGs remains. A step in this direction would be to apply new types of disinfection methods addressing this issue in detail, such as light-based advanced oxidation, that potentially enhance the effect of direct light interaction with DNA. This study is devoted to comprehensively and critically review the current state-of-art for light-driven disinfection. The main focus of the article is to provide an insight into the different photochemical disinfection methods currently being studied worldwide with respect to ARGs removal as an alternative to conventional methods. The systematic comparison of UV/chlorination, UV/H2O2, sulfate radical based-AOPs, photocatalytic processes and photoFenton considering their mode of action on molecular level, operational parameters of the processes, and overall efficiency of removal of ARGs is presented. An in-depth discussion of different light-dependent inactivation pathways, influence of DBP and DOM on ARG removal and the potential bacterial regrowth after treatment is presented. Based on presented revision the risk of ARG transfer from reactivated bacteria has been evaluated, leading to a future direction for research addressing the challenges of light-based disinfection technologies.
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Affiliation(s)
- M Gmurek
- Department of Molecular Engineering, Faculty of Process and Environmental Engineering, Lodz University of Technology, 90-924 Lodz, Poland; Karlsruhe Institute of Technology, Engler-Bunte-Institut, Water Chemistry and Water Technology, 76131 Karlsruhe, Germany; Karlsruhe Institute of Technology, Institute of Functional Interfaces, Microbiology/Molecular Biology Department, Eggenstein-Leopoldshafen, Germany.
| | - E Borowska
- Karlsruhe Institute of Technology, Engler-Bunte-Institut, Water Chemistry and Water Technology, 76131 Karlsruhe, Germany
| | - T Schwartz
- Karlsruhe Institute of Technology, Institute of Functional Interfaces, Microbiology/Molecular Biology Department, Eggenstein-Leopoldshafen, Germany
| | - H Horn
- Karlsruhe Institute of Technology, Engler-Bunte-Institut, Water Chemistry and Water Technology, 76131 Karlsruhe, Germany; DVGW German Technical and Scientific Association for Gas and Water Research Laboratories, Water Chemistry and Water Technology, 76131 Karlsruhe, Germany
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Lisee C, Spang JT, Loeser R, Longobardi L, Lalush D, Nissman D, Schwartz T, Hu D, Pietrosimone B. Tibiofemoral articular cartilage composition differs based on serum biochemical profiles following anterior cruciate ligament reconstruction. Osteoarthritis Cartilage 2021; 29:1732-1740. [PMID: 34536530 DOI: 10.1016/j.joca.2021.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/31/2021] [Accepted: 09/08/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Biochemical joint changes contribute to posttraumatic osteoarthritis (PTOA) development following anterior cruciate ligament reconstruction (ACLR). The purpose of this longitudinal cohort study was to compare tibiofemoral cartilage composition between ACLR patients with different serum biochemical profiles. We hypothesized that profiles of increased inflammation (monocyte chemoattractant protein-1 [MCP-1]), type-II collagen turnover (type-II collagen breakdown [C2C]:synthesis [CPII]), matrix degradation (matrix metalloproteinase-3 [MMP-3] and cartilage oligomeric matrix protein [COMP]) preoperatively to 6-months post-ACLR would be associated with greater tibiofemoral cartilage T1ρ relaxation times 12-months post-ACLR. DESIGN Serum was collected from 24 patients (46% female, 22.1 ± 4.2 years old, 24.0 ± 2.6 kg/m2 body mass index [BMI]) preoperatively (6.4 ± 3.6 days post injury) and 6-months post-ACLR. T1ρ Magnetic Resonance Imaging (MRI) was collected for medial and lateral tibiofemoral articular cartilage at 12-months post-ACLR. A k-means cluster analysis was used to identify profiles based on biomarker changes over time and T1ρ relaxation times were compared between cluster groups controlling for sex, age, BMI, concomitant injury (either meniscal or chondral pathology), and Marx Score. RESULTS One cluster exhibited increases in MCP-1 and COMP while the other demonstrated decreases in MCP-1 and COMP preoperatively to 6-months post-ACLR. The cluster group with increases in MCP-1 and COMP demonstrated greater lateral tibial (adjusted mean difference = 3.88, 95% confidence intervals [1.97-5.78]) and femoral (adjusted mean difference = 12.71, 95% confidence intervals [0.41-23.81]) T1ρ relaxation times. CONCLUSION Profiles of increased serum levels of inflammation and matrix degradation markers preoperatively to 6-months post-ACLR are associated with MRI changes consistent with lesser lateral tibiofemoral cartilage proteoglycan density 12-months post-ACLR.
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Affiliation(s)
- C Lisee
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC, USA.
| | - J T Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R Loeser
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA
| | - L Longobardi
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Lalush
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC, USA
| | - D Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill NC, USA
| | - T Schwartz
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA
| | - D Hu
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - B Pietrosimone
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC, USA
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14
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Kwon S, Lee M, Crowley G, Schwartz T, Zeig-Owens R, Prezant DJ, Liu M, Nolan A. Dynamic Metabolic Risk Profiling of World Trade Center Lung Disease: A Longitudinal Cohort Study. Am J Respir Crit Care Med 2021; 204:1035-1047. [PMID: 34473012 DOI: 10.1164/rccm.202006-2617oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Metabolic syndrome (MetSyn) increases the risk of World Trade Center (WTC) lung injury (LI). However, the temporal relationship of MetSyn, exposure intensity, and lung dysfunction is not well understood. Objective: To model the association of longitudinal MetSyn characteristics with WTC lung disease to define modifiable risk. Methods: Firefighters, for whom consent was obtained (N = 5,738), were active duty on September 11, 2001 (9/11). WTC-LI (n = 1,475; FEV1% predicted <lower limit of normal [LLN]) and non-WTC-LI (n = 4,263; FEV1% predicted ⩾LLN at all exams) was the primary outcome, and FVC% predicted <LLN and FEV1/FVC <0.70 were secondary outcomes. We assessed 1) the effect of concurrent MetSyn on longitudinal lung function by linear mixed models, 2) the temporal effect of MetSyn and exposure by Weibull proportional hazards, 3) the effects of MetSyn's rate of change by two-stage models, and 4) the nonlinear joint effect of longitudinal MetSyn components by a partially linear single-index model (PLSI). Measurements and Main Results: WTC-LI cases were more often ever-smokers, arrived in the morning (9/11), and had MetSyn. Body mass index ⩾30 kg/m2 and high-density lipoprotein <40 mg/dl were most contributory to concurrent loss of FEV1% predicted and FVC% predicted while conserving FEV1/FVC. Body mass index ⩾30 kg/m2 and dyslipidemia significantly predicted WTC-LI, FVC% predicted <LLN in a Weibull proportional hazards model. Dynamic risk assessment of WTC-LI on the basis of MetSyn and exposure showed how reduction of MetSyn factors further reduces WTC-LI likelihood in susceptible populations. PLSI demonstrates that MetSyn has a nonlinear relationship with WTC lung disease, and increases in cumulative MetSyn risk factors exponentially increase WTC-LI risk. An interactive metabolic-risk modeling application was developed to simplify PLSI interpretation. Conclusions: MetSyn and WTC exposure contribute to the development of lung disease. Dynamic risk assessment may be used to encourage treatment of MetSyn in susceptible populations. Future studies will focus on dietary intervention as a disease modifier.
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Affiliation(s)
- Sophia Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Myeonggyun Lee
- Division of Biostatistics, Department of Population Health, and
| | - George Crowley
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Theresa Schwartz
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and
| | - Rachel Zeig-Owens
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and.,Department of Epidemiology and Population Health and
| | - David J Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Mengling Liu
- Division of Biostatistics, Department of Population Health, and.,Department of Environmental Medicine, New York University School of Medicine, New York, New York
| | - Anna Nolan
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.,Department of Environmental Medicine, New York University School of Medicine, New York, New York.,Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and
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15
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Goldfarb DG, Putman B, Lahousse L, Zeig‐Owens R, Vaeth BM, Schwartz T, Hall CB, Prezant DJ, Weiden MD. Lung function decline before and after treatment of World Trade Center associated obstructive airways disease with inhaled corticosteroids and long-acting beta agonists. Am J Ind Med 2021; 64:853-860. [PMID: 34254700 PMCID: PMC9292780 DOI: 10.1002/ajim.23272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/28/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
Background Greater than average loss of one‐second forced expiratory volume (FEV1) is a risk factor for asthma, chronic obstructive pulmonary disease (COPD), and asthma/COPD overlap syndrome in World Trade Center (WTC)‐exposed firefighters. Inhaled corticosteroids and long‐acting beta agonists (ICS/LABA) are used to treat obstructive airways disease but their impact on FEV1‐trajectory in this population is unknown. Methods The study population included WTC‐exposed male firefighters who were treated with ICS/LABA for 2 years or longer (with initiation before 2015), had at least two FEV1 measurements before ICS/LABA initiation and two FEV1 measurements posttreatment between September 11, 2001 and September 10, 2019. Linear mixed‐effects models were used to estimate FEV1‐slope pre‐ and post‐treatment. Results During follow‐up, 1023 WTC‐exposed firefighters were treated with ICS/LABA for 2 years or longer. When comparing intervals 6 years before and 6 years after treatment, participants had an 18.7 ml/year (95% confidence interval [CI]: 11.3–26.1) improvement in FEV1‐slope after adjustment for baseline FEV1, race, height, WTC exposure, weight change, blood eosinophil concentration, and smoking status. After stratification by median date of ICS/LABA initiation (January 14, 2010), earlier ICS/LABA‐initiators had a 32.5 ml/year (95% CI: 19.5–45.5) improvement in slope but later ICS/LABA‐initiators had a nonsignificant FEV1‐slope improvement (7.9 ml/year, 95% CI: −0.5 to 17.2). Conclusions WTC‐exposed firefighters treated with ICS/LABA had improved FEV1 slope after initiation, particularly among those who started earlier. Treatment was, however, not associated with FEV1‐slope improvement if started after the median initiation date (1/14/2010), likely because onset of disease began before treatment initiation. Research on alternative treatments is needed for patients with greater than average FEV1‐decline who have not responded to ICS/LABA.
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Affiliation(s)
- David G. Goldfarb
- Fire Department of the City of New York The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn NY USA
- Department of Environmental, Occupational and Geospatial Health Sciences City University of New York Graduate School of Public Health and Health Policy New York NY USA
- Division of Pulmonary Medicine, Department of Medicine Montefiore Medical Center Bronx NY USA
| | - Barbara Putman
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences Ghent University Ghent Belgium
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine and Department of Environmental Medicine New York University School of Medicine New York NY USA
| | - Lies Lahousse
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences Ghent University Ghent Belgium
| | - Rachel Zeig‐Owens
- Fire Department of the City of New York The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn NY USA
- Division of Pulmonary Medicine, Department of Medicine Montefiore Medical Center Bronx NY USA
- Division of Epidemiology, Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY USA
| | - Brandon M. Vaeth
- Fire Department of the City of New York The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn NY USA
- Division of Pulmonary Medicine, Department of Medicine Montefiore Medical Center Bronx NY USA
| | - Theresa Schwartz
- Fire Department of the City of New York The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn NY USA
- Division of Pulmonary Medicine, Department of Medicine Montefiore Medical Center Bronx NY USA
| | - Charles B. Hall
- Division of Biostatistics, Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY USA
| | - David J. Prezant
- Fire Department of the City of New York The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn NY USA
- Division of Pulmonary Medicine, Department of Medicine Montefiore Medical Center Bronx NY USA
- Division of Epidemiology, Department of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY USA
| | - Michael D. Weiden
- Fire Department of the City of New York The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn NY USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine and Department of Environmental Medicine New York University School of Medicine New York NY USA
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16
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Weiden MD, Singh A, Goldfarb DG, Putman B, Zeig‐Owens R, Schwartz T, Cohen HW, Prezant DJ. Serum Th-2 cytokines and FEV 1 decline in WTC-exposed firefighters: A 19-year longitudinal study. Am J Ind Med 2021; 64:845-852. [PMID: 34288008 PMCID: PMC9290799 DOI: 10.1002/ajim.23276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/03/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 01/07/2023]
Abstract
Background Accelerated‐FEV1‐decline, defined as rate of decline in FEV1 > 64 ml/year, is a risk factor for asthma and chronic obstructive pulmonary disease in World Trade Center (WTC)‐exposed firefighters. Accelerated‐FEV1‐decline in this cohort is associated with elevated blood eosinophil concentrations, a mediator of Th‐2 response. We hypothesized that an association exists between Th‐2 biomarkers and FEV1 decline rate in those with accelerated‐FEV1‐decline. Methods Serum was drawn from Fire Department of the City of New York (FDNY) firefighters 1–6 months (early) (N = 816) and 12–13 years (late) (N = 983) after 9/11/2001. Th‐2 biomarkers IL‐4, IL‐13, and IL‐5 were assayed by multiplex Luminex. Individual FEV1 decline rates were calculated using spirometric measurements taken: (1) between 9/11/2001 and 9/10/2020 for the early biomarker group and (2) between late measurement date and 9/10/2020 for the late biomarker group. Associations of early and late Th‐2 biomarkers with subsequent FEV1 decline rates were analyzed using multivariable linear regression controlling for demographics, smoking status, and other potential confounders. Results In WTC‐exposed firefighters with accelerated‐FEV1‐decline, IL‐4, IL‐13, and IL‐5 measured 1–6 months post‐9/11/2001 were associated with greater FEV1 decline ml/year between 9/11/2001 and 9/10/2020 (−2.9 ± 1.4 ml/year per IL‐4 doubling; −8.4 ± 1.2 ml/year per IL‐13 doubling; −7.9 ± 1.3 ml/year per IL‐5 doubling). Among late measured Th‐2 biomarkers, only IL‐4 was associated with subsequent FEV1 decline rate (−4.0 ± 1.6 ml/year per IL‐4 doubling). Conclusions In WTC‐exposed firefighters with accelerated‐FEV1‐decline, elevated serum IL‐4 measured both 1–6 months and 12–13 years after 9/11 is associated with greater FEV1 decline/year. Drugs targeting the IL‐4 pathway may improve lung function in this high‐risk subgroup.
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Affiliation(s)
- Michael D. Weiden
- The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn New York USA
- Fire Department of the City of New York Brooklyn New York USA
- Department of Medicine New York University School of Medicine New York New York USA
- Department of Environmental Medicine, Pulmonary, Critical Care and Sleep Medicine Division New York University School of Medicine New York New York USA
| | - Ankura Singh
- The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn New York USA
- Fire Department of the City of New York Brooklyn New York USA
- Department of Medicine, Pulmonary Medicine Division Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA
| | - David G. Goldfarb
- The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn New York USA
- Fire Department of the City of New York Brooklyn New York USA
- Department of Medicine, Pulmonary Medicine Division Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA
| | - Barbara Putman
- Department of Medicine New York University School of Medicine New York New York USA
- Department of Environmental Medicine, Pulmonary, Critical Care and Sleep Medicine Division New York University School of Medicine New York New York USA
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences Ghent University Ghent Belgium
| | - Rachel Zeig‐Owens
- The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn New York USA
- Fire Department of the City of New York Brooklyn New York USA
- Department of Medicine, Pulmonary Medicine Division Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA
- Department of Epidemiology and Population Health, Division of Epidemiology Albert Einstein College of Medicine Bronx New York USA
| | - Theresa Schwartz
- The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn New York USA
- Fire Department of the City of New York Brooklyn New York USA
- Department of Medicine, Pulmonary Medicine Division Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA
| | - Hillel W. Cohen
- Department of Epidemiology and Population Health, Division of Epidemiology Albert Einstein College of Medicine Bronx New York USA
| | - David J. Prezant
- The Bureau of Health Services and the FDNY World Trade Center Health Program Brooklyn New York USA
- Fire Department of the City of New York Brooklyn New York USA
- Department of Medicine, Pulmonary Medicine Division Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA
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17
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Schwartz T. Just Say No: The Case Against Opioid-Based Postoperative Pain Management Regimens Following Breast Surgery. Ann Surg Oncol 2021; 28:5799-5800. [PMID: 33813672 PMCID: PMC8019348 DOI: 10.1245/s10434-021-09967-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Theresa Schwartz
- Breast Surgical Oncology, Henry Ford Health System, Detroit, USA.
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18
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Van Olden CC, Van de Laar AW, Meijnikman AS, Aydin O, Van Olst N, Hoozemans JB, De Brauw LM, Bruin SC, Acherman YIZ, Verheij J, Pyykkö JE, Hagedoorn M, Sanderman R, Bosma NC, Tremaroli V, Lundqvist A, Olofsson LE, Herrema H, Lappa D, Hjorth S, Nielsen J, Schwartz T, Groen AK, Nieuwdorp M, Bäckhed F, Gerdes VEA. A systems biology approach to understand gut microbiota and host metabolism in morbid obesity: design of the BARIA Longitudinal Cohort Study. J Intern Med 2021; 289:340-354. [PMID: 32640105 PMCID: PMC7984244 DOI: 10.1111/joim.13157] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/01/2020] [Accepted: 05/25/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Prevalence of obesity and associated diseases, including type 2 diabetes mellitus, dyslipidaemia and non-alcoholic fatty liver disease (NAFLD), are increasing. Underlying mechanisms, especially in humans, are unclear. Bariatric surgery provides the unique opportunity to obtain biopsies and portal vein blood-samples. METHODS The BARIA Study aims to assess how microbiota and their metabolites affect transcription in key tissues and clinical outcome in obese subjects and how baseline anthropometric and metabolic characteristics determine weight loss and glucose homeostasis after bariatric surgery. We phenotype patients undergoing bariatric surgery (predominantly laparoscopic Roux-en-Y gastric bypass), before weight loss, with biometrics, dietary and psychological questionnaires, mixed meal test (MMT) and collect fecal-samples and intra-operative biopsies from liver, adipose tissues and jejunum. We aim to include 1500 patients. A subset (approximately 25%) will undergo intra-operative portal vein blood-sampling. Fecal-samples are analyzed with shotgun metagenomics and targeted metabolomics, fasted and postprandial plasma-samples are subjected to metabolomics, and RNA is extracted from the tissues for RNAseq-analyses. Data will be integrated using state-of-the-art neuronal networks and metabolic modeling. Patient follow-up will be ten years. RESULTS Preoperative MMT of 170 patients were analysed and clear differences were observed in glucose homeostasis between individuals. Repeated MMT in 10 patients showed satisfactory intra-individual reproducibility, with differences in plasma glucose, insulin and triglycerides within 20% of the mean difference. CONCLUSION The BARIA study can add more understanding in how gut-microbiota affect metabolism, especially with regard to obesity, glucose metabolism and NAFLD. Identification of key factors may provide diagnostic and therapeutic leads to control the obesity-associated disease epidemic.
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Affiliation(s)
- C C Van Olden
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Experimental Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - A W Van de Laar
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - A S Meijnikman
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - O Aydin
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - N Van Olst
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - J B Hoozemans
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - L M De Brauw
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - S C Bruin
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Y I Z Acherman
- Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - J Verheij
- Department of Pathology, Amsterdam UMC, Amsterdam, The Netherlands
| | - J E Pyykkö
- Department of Health Psychology, Groningen UMC, Groningen, The Netherlands
| | - M Hagedoorn
- Department of Health Psychology, Groningen UMC, Groningen, The Netherlands
| | - R Sanderman
- Department of Health Psychology, Groningen UMC, Groningen, The Netherlands
| | - N C Bosma
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - V Tremaroli
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | - A Lundqvist
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | - L E Olofsson
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Goteborg, Sweden
| | - H Herrema
- Department of Experimental Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - D Lappa
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - S Hjorth
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Kobenhavn, Denmark
| | - J Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - T Schwartz
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Kobenhavn, Denmark
| | - A K Groen
- Department of Experimental Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - M Nieuwdorp
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Experimental Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - F Bäckhed
- Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Goteborg, Sweden.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Kobenhavn, Denmark.,Department of Clinical Physiology, Region Västtra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - V E A Gerdes
- From the, Department of Vascular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
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19
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Lam R, Kwon S, Riggs J, Sunseri M, Crowley G, Schwartz T, Zeig-Owens R, Colbeth H, Halpren A, Liu M, Prezant DJ, Nolan A. Dietary phenotype and advanced glycation end-products predict WTC-obstructive airways disease: a longitudinal observational study. Respir Res 2021; 22:19. [PMID: 33461547 PMCID: PMC7812653 DOI: 10.1186/s12931-020-01596-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/09/2020] [Accepted: 12/03/2020] [Indexed: 01/02/2023] Open
Abstract
Background Diet is a modifier of metabolic syndrome which in turn is associated with World Trade Center obstructive airways disease (WTC-OAD). We have designed this study to (1) assess the dietary phenotype (food types, physical activity, and dietary habits) of the Fire Department of New York (FDNY) WTC-Health Program (WTC-HP) cohort and (2) quantify the association of dietary quality and its advanced glycation end product (AGE) content with the development of WTC-OAD. Methods WTC-OAD, defined as developing WTC-Lung Injury (WTC-LI; FEV1 < LLN) and/or airway hyperreactivity (AHR; positive methacholine and/or positive bronchodilator response). Rapid Eating and Activity Assessment for Participants-Short Version (REAP-S) deployed on 3/1/2018 in the WTC-HP annual monitoring assessment. Clinical and REAP-S data of consented subjects was extracted (7/17/2019). Diet quality [low-(15–19), moderate-(20–29), and high-(30–39)] and AGE content per REAP-S questionnaire were assessed for association with WTC-OAD. Regression models adjusted for smoking, hyperglycemia, hypertension, age on 9/11, WTC-exposure, BMI, and job description. Results N = 9508 completed the annual questionnaire, while N = 4015 completed REAP-S and had spirometry. WTC-OAD developed in N = 921, while N = 3094 never developed WTC-OAD. Low- and moderate-dietary quality, eating more (processed meats, fried foods, sugary drinks), fewer (vegetables, whole-grains),and having a diet abundant in AGEs were significantly associated with WTC-OAD. Smoking was not a significant risk factor of WTC-OAD. Conclusions REAP-S was successfully implemented in the FDNY WTC-HP monitoring questionnaire and produced valuable dietary phenotyping. Our observational study has identified low dietary quality and AGE abundant dietary habits as risk factors for pulmonary disease in the context of WTC-exposure. Dietary phenotyping, not only focuses our metabolomic/biomarker profiling but also further informs future dietary interventions that may positively impact particulate matter associated lung disease.
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Affiliation(s)
- Rachel Lam
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University, School of Medicine, New York, NY, USA
| | - Sophia Kwon
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University, School of Medicine, New York, NY, USA
| | - Jessica Riggs
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University, School of Medicine, New York, NY, USA
| | - Maria Sunseri
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University, School of Medicine, New York, NY, USA
| | - George Crowley
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University, School of Medicine, New York, NY, USA
| | - Theresa Schwartz
- Fire Department of New York, Bureau of Health Services, Brooklyn, NY, USA
| | - Rachel Zeig-Owens
- Fire Department of New York, Bureau of Health Services, Brooklyn, NY, USA
| | - Hilary Colbeth
- Fire Department of New York, Bureau of Health Services, Brooklyn, NY, USA
| | - Allison Halpren
- Fire Department of New York, Bureau of Health Services, Brooklyn, NY, USA
| | - Mengling Liu
- Division of Biostatistics, Departments of Population Health, New York University School of Medicine, New York, NY, USA.,Department of Environmental Medicine, New York University, School of Medicine, New York, NY, USA
| | - David J Prezant
- Fire Department of New York, Bureau of Health Services, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anna Nolan
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University, School of Medicine, New York, NY, USA. .,Fire Department of New York, Bureau of Health Services, Brooklyn, NY, USA. .,Department of Environmental Medicine, New York University, School of Medicine, New York, NY, USA. .,Department of Medicine, Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New Bellevue, 16 S Room 16 (Office), 16N Room 20 (Lab), 462 1st Avenue, New York, NY, 10016, USA.
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20
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Weiden MD, Zeig-Owens R, Singh A, Schwartz T, Liu Y, Vaeth B, Nolan A, Cleven KL, Hurwitz K, Beecher S, Prezant DJ. Pre-COVID-19 lung function and other risk factors for severe COVID-19 in first responders. ERJ Open Res 2021; 7:00610-2020. [PMID: 33527077 PMCID: PMC7607970 DOI: 10.1183/23120541.00610-2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/06/2020] [Indexed: 01/09/2023] Open
Abstract
Risk factors for #COVID19 infection and severe disease (hospitalisation or death) in NYC first responders: greater pre-pandemic rate of FEV1 decline is associated with severe COVID-19, as is emergency medical service work versus firefighting https://bit.ly/3nZPuZY.
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Affiliation(s)
- Michael D. Weiden
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary, Critical Care and Sleep Medicine Division, Depts of Medicine and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Rachel Zeig-Owens
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Epidemiology, Dept of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ankura Singh
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Theresa Schwartz
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yang Liu
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Brandon Vaeth
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anna Nolan
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary, Critical Care and Sleep Medicine Division, Depts of Medicine and Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Krystal L. Cleven
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karen Hurwitz
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
| | - Shenecia Beecher
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
| | - David J. Prezant
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Dept of the City of New York, Brooklyn, NY, USA
- Pulmonary Medicine Division, Dept of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA
- Office of Medical Affairs, Fire Dept of the City of New York, Brooklyn, NY, USA
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21
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Putman B, Lahousse L, Goldfarb DG, Zeig-Owens R, Schwartz T, Singh A, Vaeth B, Hall CB, Lancet EA, Webber MP, Cohen HW, Prezant DJ, Weiden MD. Factors Predicting Treatment of World Trade Center-Related Lung Injury: A Longitudinal Cohort Study. Int J Environ Res Public Health 2020; 17:E9056. [PMID: 33291671 PMCID: PMC7730939 DOI: 10.3390/ijerph17239056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/20/2020] [Accepted: 12/02/2020] [Indexed: 01/06/2023]
Abstract
The factors that predict treatment of lung injury in occupational cohorts are poorly defined. We aimed to identify patient characteristics associated with initiation of treatment with inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) >2 years among World Trade Center (WTC)-exposed firefighters. The study population included 8530 WTC-exposed firefighters. Multivariable logistic regression assessed the association of patient characteristics with ICS/LABA treatment for >2 years over two-year intervals from 11 September 2001-10 September 2017. Cox proportional hazards models measured the association of high probability of ICS/LABA initiation with actual ICS/LABA initiation in subsequent intervals. Between 11 September 2001-1 July 2018, 1629/8530 (19.1%) firefighters initiated ICS/LABA treatment for >2 years. Forced Expiratory Volume in 1 s (FEV1), wheeze, and dyspnea were consistently and independently associated with ICS/LABA treatment. High-intensity WTC exposure was associated with ICS/LABA between 11 September 2001-10 September 2003. The 10th percentile of risk for ICS/LABA between 11 September 2005-10 Septmeber 2007 was associated with a 3.32-fold increased hazard of actual ICS/LABA initiation in the subsequent 4 years. In firefighters with WTC exposure, FEV1, wheeze, and dyspnea were independently associated with prolonged ICS/LABA treatment. A high risk for treatment was identifiable from routine monitoring exam results years before treatment initiation.
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Affiliation(s)
- Barbara Putman
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium; (B.P.); (L.L.)
- Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Lies Lahousse
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium; (B.P.); (L.L.)
| | - David G. Goldfarb
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
| | - Rachel Zeig-Owens
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Theresa Schwartz
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
| | - Ankura Singh
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
| | - Brandon Vaeth
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
| | - Charles B. Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Elizabeth A. Lancet
- The Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY 11201, USA;
| | - Mayris P. Webber
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Hillel W. Cohen
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - David J. Prezant
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
- The Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY 11201, USA;
| | - Michael D. Weiden
- Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016, USA
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA; (D.G.G.); (R.Z.-O.); (T.S.); (A.S.); (B.V.); (M.P.W.); (D.J.P.)
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22
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Kwon S, Riggs J, Crowley G, Lam R, Young IR, Nayar C, Sunseri M, Mikhail M, Ostrofsky D, Veerappan A, Zeig-Owens R, Schwartz T, Colbeth H, Liu M, Pompeii ML, St-Jules D, Prezant DJ, Sevick MA, Nolan A. Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE) Protocol: A Randomized Clinical Trial. Int J Environ Res Public Health 2020; 17:E6569. [PMID: 32916985 PMCID: PMC7559064 DOI: 10.3390/ijerph17186569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023]
Abstract
Fire Department of New York (FDNY) rescue and recovery workers exposed to World Trade Center (WTC) particulates suffered loss of forced expiratory volume in 1 s (FEV1). Metabolic Syndrome increased the risk of developing WTC-lung injury (WTC-LI). We aim to attenuate the deleterious effects of WTC exposure through a dietary intervention targeting these clinically relevant disease modifiers. We hypothesize that a calorie-restricted Mediterranean dietary intervention will improve metabolic risk, subclinical indicators of cardiopulmonary disease, quality of life, and lung function in firefighters with WTC-LI. To assess our hypothesis, we developed the Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE), a randomized controlled clinical trial (RCT). Male firefighters with WTC-LI and a BMI > 27 kg/m2 will be included. We will randomize subjects (1:1) to either: (1) Low Calorie Mediterranean (LoCalMed)-an integrative multifactorial, technology-supported approach focused on behavioral modification, nutritional education that will include a self-monitored diet with feedback, physical activity recommendations, and social cognitive theory-based group counseling sessions; or (2) Usual Care. Outcomes include reduction in body mass index (BMI) (primary), improvement in FEV1, fractional exhaled nitric oxide, pulse wave velocity, lipid profiles, targeted metabolic/clinical biomarkers, and quality of life measures (secondary). By implementing a technology-supported LoCalMed diet our FIREHOUSE RCT may help further the treatment of WTC associated pulmonary disease.
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Affiliation(s)
- Sophia Kwon
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Jessica Riggs
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - George Crowley
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Rachel Lam
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Isabel R. Young
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Christine Nayar
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Maria Sunseri
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Mena Mikhail
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Dean Ostrofsky
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Arul Veerappan
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
| | - Rachel Zeig-Owens
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY 11201, USA; (R.Z.-O.); (T.S.); (H.C.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Theresa Schwartz
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY 11201, USA; (R.Z.-O.); (T.S.); (H.C.); (D.J.P.)
| | - Hilary Colbeth
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY 11201, USA; (R.Z.-O.); (T.S.); (H.C.); (D.J.P.)
| | - Mengling Liu
- Department of Population Health, Division of Biostatistics, New York University School of Medicine, New York, NY 10016, USA;
- Department of Environmental Medicine, School of Medicine, New York University, New York, NY 10016, USA
| | - Mary Lou Pompeii
- Department of Population Health, Division of Health and Behavior, Center for Healthful Behavior Change, School of Medicine, New York University, New York, NY 10016, USA; (M.L.P.); (D.S.-J.); (M.A.S.)
| | - David St-Jules
- Department of Population Health, Division of Health and Behavior, Center for Healthful Behavior Change, School of Medicine, New York University, New York, NY 10016, USA; (M.L.P.); (D.S.-J.); (M.A.S.)
| | - David J. Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY 11201, USA; (R.Z.-O.); (T.S.); (H.C.); (D.J.P.)
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mary Ann Sevick
- Department of Population Health, Division of Health and Behavior, Center for Healthful Behavior Change, School of Medicine, New York University, New York, NY 10016, USA; (M.L.P.); (D.S.-J.); (M.A.S.)
- Departments of Medicine, Division of Endocrinology, School of Medicine, New York University, New York, NY 10016, USA
| | - Anna Nolan
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, School of Medicine, New York University, New York, NY 10016, USA; (S.K.); (J.R.); (G.C.); (R.L.); (I.R.Y.); (C.N.); (M.S.); (M.M.); (D.O.); (A.V.)
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, NY 11201, USA; (R.Z.-O.); (T.S.); (H.C.); (D.J.P.)
- Department of Environmental Medicine, School of Medicine, New York University, New York, NY 10016, USA
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23
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Prezant DJ, Zeig-Owens R, Schwartz T, Liu Y, Hurwitz K, Beecher S, Weiden MD. Medical Leave Associated With COVID-19 Among Emergency Medical System Responders and Firefighters in New York City. JAMA Netw Open 2020; 3:e2016094. [PMID: 32706380 PMCID: PMC7382005 DOI: 10.1001/jamanetworkopen.2020.16094] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
This cohort study examines use of medical leave among emergency medical service (EMS) responders and firefighters in New York, New York, during the coronavirus disease 2019 (COVID-19) pandemic compared with earlier periods.
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Affiliation(s)
- David J. Prezant
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Rachel Zeig-Owens
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Theresa Schwartz
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Yang Liu
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Karen Hurwitz
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
| | - Shenecia Beecher
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
| | - Michael D. Weiden
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, New York
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24
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Singh A, Zeig-Owens R, Hall CB, Liu Y, Rabin L, Schwartz T, Webber MP, Appel D, Prezant DJ. World Trade Center exposure, post-traumatic stress disorder, and subjective cognitive concerns in a cohort of rescue/recovery workers. Acta Psychiatr Scand 2020; 141:275-284. [PMID: 31721141 DOI: 10.1111/acps.13127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine whether World Trade Center (WTC)-exposure intensity and post-traumatic stress disorder (PTSD) are associated with subjective cognitive change in rescue/recovery workers. METHOD The population included 7875 rescue/recovery workers who completed a subjective cognition measure, the Cognitive Function Instrument (CFI), between 3/1/2018 and 2/28/2019 during routine monitoring, indicating whether they had experienced cognitive and functional difficulties in the past year. Higher scores indicated greater self-perceived cognitive change. Probable PTSD, depression, and alcohol abuse were evaluated by validated mental health screeners. Logistic regression assessed the associations of WTC exposure and current PTSD with top-quartile (≥2) CFI score, and of early post-9/11 PTSD with top-quartile CFI in a subpopulation (N = 6440). Models included demographics, smoking, depression, and alcohol abuse as covariates. RESULTS Mean age at CFI completion was 56.7 ± 7.7 (range: 36-81). Participants with high-intensity WTC exposure had an increased likelihood of top-quartile CFI score (odds ratio[OR] vs. low exposure: 1.32, 95%CI: 1.07-1.64), controlling for covariates. Current and early PTSD were both associated with top-quartile CFI (OR: 3.25, 95%CI: 2.53-4.19 and OR: 1.56, 95%CI: 1.26-1.93) respectively. CONCLUSIONS High-intensity WTC exposure was associated with self-reported cognitive change 17 years later in rescue/recovery workers, as was PTSD. Highly WTC-exposed subgroups may benefit from additional cognitive evaluation and monitoring of cognition over time.
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Affiliation(s)
- A Singh
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - R Zeig-Owens
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - C B Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.,Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Y Liu
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - L Rabin
- Department of Psychology, Brooklyn College and The Graduate Center of CUNY, Brooklyn, NY, USA
| | - T Schwartz
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - M P Webber
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - D Appel
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - D J Prezant
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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25
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Voigt AM, Zacharias N, Timm C, Wasser F, Sib E, Skutlarek D, Parcina M, Schmithausen RM, Schwartz T, Hembach N, Tiehm A, Stange C, Engelhart S, Bierbaum G, Kistemann T, Exner M, Faerber HA, Schreiber C. Association between antibiotic residues, antibiotic resistant bacteria and antibiotic resistance genes in anthropogenic wastewater - An evaluation of clinical influences. Chemosphere 2020; 241:125032. [PMID: 31622887 DOI: 10.1016/j.chemosphere.2019.125032] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 06/19/2019] [Revised: 09/12/2019] [Accepted: 09/30/2019] [Indexed: 06/10/2023]
Abstract
The high use of antibiotics in human and veterinary medicine has led to a wide spread of antibiotics and antimicrobial resistance into the environment. In recent years, various studies have shown that antibiotic residues, resistant bacteria and resistance genes, occur in aquatic environments and that clinical wastewater seems to be a hot spot for the environmental spread of antibiotic resistance. Here a representative statistical analysis of various sampling points is presented, containing different proportions of clinically influenced wastewater. The statistical analysis contains the calculation of the odds ratios for any combination of antibiotics with resistant bacteria or resistance genes, respectively. The results were screened for an increased probability of detecting resistant bacteria, or resistance genes, with the simultaneous presence of antibiotic residues. Positive associated sets were then compared, with regards to the detected median concentration, at the investigated sampling points. All results show that the sampling points with the highest proportion of clinical wastewater always form a distinct cluster concerning resistance. The results shown in this study lead to the assumption that ciprofloxacin is a good indicator of the presence of multidrug resistant P. aeruginosa and extended spectrum β-lactamase (ESBL)-producing Klebsiella spec., Enterobacter spec. and Citrobacter spec., as it positively relates with both parameters. Furthermore, a precise relationship between carbapenemase genes and meropenem, regarding the respective sampling sites, could be obtained. These results highlight the role of clinical wastewater for the dissemination and development of multidrug resistance.
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Affiliation(s)
- A M Voigt
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany.
| | - N Zacharias
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - C Timm
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - F Wasser
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - E Sib
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - D Skutlarek
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - M Parcina
- Institute of Immunology, Medical Microbiology and Parasitology, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - R M Schmithausen
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - T Schwartz
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces (IFG), Microbiology/Molecular Biology Department, Hermann-von-Helmholtz Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - N Hembach
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces (IFG), Microbiology/Molecular Biology Department, Hermann-von-Helmholtz Platz 1, 76344, Eggenstein-Leopoldshafen, Germany
| | - A Tiehm
- DVGW-Technologiezentrum Wasser (TZW), Karlsruher Straße 84, 76139, Karlsruhe, Germany
| | - C Stange
- DVGW-Technologiezentrum Wasser (TZW), Karlsruher Straße 84, 76139, Karlsruhe, Germany
| | - S Engelhart
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - G Bierbaum
- Institute of Immunology, Medical Microbiology and Parasitology, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - T Kistemann
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - M Exner
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - H A Faerber
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
| | - C Schreiber
- Institute for Hygiene and Public Health, University Hospital Bonn, Medical Faculty University of Bonn, Venusberg-Campus 1, Building 63, 53127, Bonn, Germany
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26
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Abstract
The evolution in axillary management for patients with breast cancer has resulted in multiple dramatic changes over the past several decades. The end result has been an overall deescalation of surgery in the axilla. Landmark trials that have formed the basis for the current treatment guidelines are reviewed herein.
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Affiliation(s)
- Carla S Fisher
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Julie A Margenthaler
- Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
| | - Kelly K Hunt
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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27
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Putman B, Lahousse L, Zeig-Owens R, Singh A, Hall CB, Liu Y, Schwartz T, Goldfarb D, Webber MP, Prezant DJ, Weiden MD. Low serum IgA and airway injury in World Trade Center-exposed firefighters: a 17-year longitudinal study. Thorax 2019; 74:1182-1184. [PMID: 31611340 DOI: 10.1136/thoraxjnl-2019-213715] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/19/2019] [Accepted: 09/17/2019] [Indexed: 11/04/2022]
Abstract
Serum IgA ≤70 mg/dL (low IgA) is associated with exacerbations of chronic obstructive pulmonary disease. The association of low IgA with longitudinal lung function is poorly defined. This study included 917 World Trade Center (WTC)-exposed firefighters with longitudinal spirometry measured between September 2001 and September 2018 and IgA measured between October 2001 and March 2002. Low IgA, compared with IgA >70 mg/dL, was associated with lower forced expiratory volume in 1 s (FEV1) % predicted in the year following 11 September 2001 (94.1% vs 98.6%, p<0.001), increased risk of FEV1/FVC <0.70 (HR 3.8, 95% CI 1.6 to 8.8) and increased antibiotic treatment (22.5/100 vs 11.6/100 person-years, p=0.002). Following WTC exposure, early IgA ≤70 mg/dL was associated with worse lung function and increased antibiotic treatment.
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Affiliation(s)
- Barbara Putman
- Department of Medicine, New York University School of Medicine, New York, New York, USA
- Department of Bioanalysis, Ghent University, Gent, Belgium
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Gent, Belgium
| | - Rachel Zeig-Owens
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ankura Singh
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Centre, Bronx, New York, USA
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Yang Liu
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Centre, Bronx, New York, USA
| | - Theresa Schwartz
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Centre, Bronx, New York, USA
| | - David Goldfarb
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Centre, Bronx, New York, USA
| | - Mayris P Webber
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David J Prezant
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Centre, Bronx, New York, USA
| | - Michael D Weiden
- Department of Medicine, New York University School of Medicine, New York, New York, USA
- The Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
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Meyer W, Cope R, Behrends E, Patton B, Schwartz T, Branham L, Kellermeier J. Effects of Plum Concentrate, Potato Starch, and Rice Starch as a Phosphate Replacement on Quality and Sensory Attributes of Whole Muscle Hams. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10757] [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: 11/03/2022] Open
Abstract
ObjectivesThe purpose of this study was to evaluate the functionality of potato starch (PS), rice starch (RS), and plum concentrate (PC) as a replacement for phosphates in clean label curing brines, determined by the industry significant attributes of smokehouse yields, sensory analysis, and color scores.Materials and MethodsFresh inside ham pieces (Semimembranosus + Adductor) (n = 80), USDA-IMPS # 402F, were denuded and split into halves. Inside ham pieces were randomly assigned to one of four treatments including: a control containing traditional curing ingredients (CON), and three treatments with natural curing alternatives containing either plum concentrate (PC), potato starch (PS), or rice starch (RS) as phosphate replacement. Clean label treatment hams (CLT) were evaluated in conjunction with a traditional processed ham control (CON). The control brine was made with the addition of phosphate; whereas, the three clean label treatment brines received phosphate replacement inclusion via the vacuum tumbler. The ham pieces from all treatments were injected to approximately 125% of their fresh weight using a multi- needle injector. Hams were vacuum tumbled with a target post tumble weight of 130%. Inclusion rates for treatments included 2.25% (PS, RS) and 1.1% (PC) of the projected final meat block weight. Hams were then tumbled for 2 h at –15 mm Hg and 12 RPM (industry standard). Hams were cooked to an internal temperature of 62.7°C without the addition of smoke and chilled in accordance with USDA-FSIS Appendix B. They were then vacuum packaged and held under refrigeration (4°C) for 21d. Hams were evaluated for smokehouse yields, sensory analysis, and color scores. Ham samples were evaluated for: initial and sustained juiciness, initial and sustained tenderness, off flavors, ham flavor intensity, and mouth feel. Ham slices were held vacuum packaged, under refrigeration for an additional 7d, and then evaluated for L*, a*, b* color space values at 28d post cooking to simulate a retail setting. Differences in treatment results were analyzed using the MIXED models procedure of SAS.ResultsHams treated with PS had the highest cooking and overall yield (P < 0.05), PC hams had the lowest cooking and overall yield (P < 0.05), and RS hams were comparable to CON. The CLT were darker and less red than CON (P < 0.05). Similarly, CON had the highest a* value (P < 0.05) indicating a significant redder color compared to PS, RS, and PC; additionally, CON had a higher b* (P < 0.05) compared to clean label treatments. The CON had decreased tenderness compared to CLT (P < 0.05). For all other sensory attributes CLT was comparable to CON. Trained sensory analysis determined all phosphate replacements maintained or improved sensory attributes over the control. Cooking yields were improved by PS, held similar by RS, and decreased significantly by PC when compared to the control. Both PS and RS should be considered acceptable phosphate replacements in natural curing brines.ConclusionBased on research presented, PS and RS are suitable replacement for phosphates in natural curing brines based on similar or improved yields, and similar or improved sensory attributes. Due to its extreme cooking loss PC is not a recommended phosphate replacement.
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Affiliation(s)
- W. Meyer
- Angelo State University Department of Agriculture
| | - R. Cope
- Angelo State University Department of Agriculture
| | - E. Behrends
- Angelo State University Department of Agriculture
| | - B. Patton
- Angelo State University Department of Agriculture
| | - T. Schwartz
- Angelo State University Department of Agriculture
| | - L. Branham
- Angelo State University Department of Agriculture
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Schwartz T, Cope R, Behrends E, Patton B, Branham L, Kellermeier J. The Effect of Brine Temperature on Smokehouse Yield, Sensory Characteristics, and Color Scores of Bacon. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10717] [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: 11/03/2022] Open
Abstract
ObjectivesThe objective of this study was to determine if an increased brine temperature could impact smokehouse yield, sensory characteristics, and color scores of bacon.Materials and MethodsFresh pork bellies (n = 30) were randomly assigned to one of three brine temperatures: –1°C (COLD), 10°C (MED), and 21°C (WARM). Bellies were injected using a multi-needle injector at 13% of the green weight containing a 1.5% salt inclusion level. All bellies were heat treated in a smokehouse to 50°C. Bellies were chilled for 24 h to an internal temperature of 4°C. After chilling, weights were measured to calculate smokehouse yield. Bellies were tempered to –4°C, sliced 4 mm in thickness, and vacuum packaged into 0.22 kg packages. Samples from each treatment were placed under UV lighting to mimic a retail setting. Trained sensory and color panels were conducted on d 1, 7, 14, 21, 28, and 35. Panelists evaluated sliced bacon packages for cured color intensity, cured color characterization, cured color fading, and off odor. Samples were cooked in a convection oven for 15 min at 177°C and were evaluated for saltiness, oxidized flavor, and flavor intensity. Data were analyzed using the MIXED models procedure of SAS. Least-squares means were computed for each dependent variable, and statistically separated by a pair-wise t-test with predetermined α = 0.05.ResultsGreen weight pump percentage, smokehouse weight percentage, and chilled weight percentage for all treatments were similar (P > 0.05). Trained sensory panel results revealed no significant differences (P > 0.05) for salt flavor between treatments on d 1, 28, and 35. The MED brine was more acceptable than the COLD and WARM brines for salt flavor on d 7 and 14 (P < 0.05). Oxidized flavor on d 1, 7, 14, 21, and 28 were similar for all treatments (P > 0.05), but by d 35 the COLD treatment had significantly less oxidized flavor than the MED and WARM treatments. No significant differences (P > 0.05) were found for flavor intensity between treatments for each day. No differences (P > 0.05) were found between treatments on d 1, 7, or 14 for cured color intensity and characterization. However, on d 21 and 35 the MED brine temperature had the most intense cured color (P < 0.05). On d 35, cured color characterization for the MED brine revealed a darker cured color (P < 0.05) compared to the COLD treatment but was similar to the WARM treatment. Cured color fading showed no differences (P > 0.05) between treatments on d 1, 7, 14, 21, and 28. On d 35 the COLD brine exhibited significantly (P < 0.05) higher levels of cured color fading compared to both the MED and WARM brines. No significant differences were found between treatments for all days for off odor (P > 0.05); however, d 35 was significantly higher than all other days within treatments (P < 0.05).ConclusionProcessing yields were not significantly affected by brine temperature. Salt flavor and flavor intensity were not affected by brine temperature. In conclusion, cured meat color and oxidized flavor can be affected by brine temperature.
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Affiliation(s)
- T. Schwartz
- Angelo State University Department of Agriculture
| | - R. Cope
- Angelo State University Department of Agriculture
| | - E. Behrends
- Angelo State University Department of Agriculture
| | - B. Patton
- Angelo State University Department of Agriculture
| | - L. Branham
- Angelo State University Department of Agriculture
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30
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Kwon S, Crowley G, Mikhail M, Lam R, Clementi E, Zeig-Owens R, Schwartz T, Liu M, Prezant D, Nolan A. METABOLIC SYNDROME BIOMARKERS OF WORLD TRADE CENTER AIRWAY HYPERREACTIVITY: A 16-YEAR PROSPECTIVE COHORT STUDY. Chest 2019. [DOI: 10.1016/j.chest.2019.08.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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31
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Cohen SM, Sekigami Y, Schwartz T, Losken A, Margenthaler JA, Chatterjee A. Lipofilling after Breast Conserving Surgery: A Comprehensive Literature Review Investigating Its Oncologic Safety. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Hiller CX, Hübner U, Fajnorova S, Schwartz T, Drewes JE. Antibiotic microbial resistance (AMR) removal efficiencies by conventional and advanced wastewater treatment processes: A review. Sci Total Environ 2019; 685:596-608. [PMID: 31195321 DOI: 10.1016/j.scitotenv.2019.05.315] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [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: 03/23/2019] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 05/27/2023]
Abstract
The World Health Organization (WHO) has identified the spread of antibiotic resistance as one of the major risks to global public health. An important transfer route into the aquatic environment is the urban water cycle. In this paper the occurrence and transport of antibiotic microbial resistance in the urban water cycle are critically reviewed. The presence of antibiotic resistance in low impacted surface water is being discussed to determine background antibiotic resistance levels, which might serve as a reference for treatment targets in the absence of health-based threshold levels. Different biological, physical and disinfection/oxidation processes employed in wastewater treatment and their efficacy regarding their removal of antibiotic resistant bacteria and antibiotic resistance geness (ARGs) were evaluated. A more efficient removal of antibiotic microbial resistance abundances from wastewater effluents can be achieved by advanced treatment processes, including membrane filtration, ozonation, UV-irradiation or chlorination, to levels typically observed in urban surface water or low impacted surface water.
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Affiliation(s)
- C X Hiller
- Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany
| | - U Hübner
- Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany
| | - S Fajnorova
- Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany; Department of Water Technology and Environmental Engineering, University of Chemistry and Technology, Prague, Technická 5, 166 28 Praha, Czech Republic
| | - T Schwartz
- Karlsruhe Institute of Technology (KIT) - Campus North, Institute of Functional Interfaces (IFG), Microbiology at Natural and Technical Interfaces Department, 76021 Karlsruhe, Germany
| | - J E Drewes
- Urban Water Systems Engineering, Technical University of Munich, Am Coulombwall 3, 85748 Garching, Germany.
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33
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Cohen S, Sekigami Y, Schwartz T, Losken A, Margenthaler J, Chatterjee A. Lipofilling after breast conserving surgery: a comprehensive literature review investigating its oncologic safety. Gland Surg 2019; 8:569-580. [PMID: 31741888 DOI: 10.21037/gs.2019.09.09] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lipofilling has regenerative properties used to improve deformities after breast conserving surgery. Our hypothesis is that there is inadequate data to ensure that lipofilling does not increase locoregional cancer recurrence after breast conserving surgery. A PRISMA comprehensive literature review was conducted of articles published prior to October 2019 investigating recurrence in patients who underwent lipofilling after breast conserving surgery. All forms of breast conserving surgery, fat grafting, and injection intervals were included. Patients undergoing mastectomy were excluded. Requirements to define lipofilling as "safe" included (I) a defined interval between resection and lipofilling; (II) a minimum follow-up period of 6 years from tumor resection; (III) a minimum follow-up period of 3 years from lipofilling; (IV) presence of a control group; (V) controls matched for ER/PR/Her-2; (VI) a sub-group analysis focusing on ER/PR/Her-2; (VII) adequate powering. Nineteen studies met inclusion criteria. The range in time from breast conserving surgery to fat injection was 0-76 months. The average time to follow-up after lipofilling was 23 days-60 months. Two studies had a sufficient follow-up time from both primary resection and from lipofilling. Seventeen of the nineteen studies specified the interval between resection and lipofilling, but there is currently no consensus regarding how soon lipofilling can be performed following BCS. Eight studies performed a subgroup analysis in cases of recurrence and found recurrence after lipofilling was associated with number of positive axillary nodes, intraepithelial neoplasia, high grade histology, Luminal A subtype, age <50, Ki-67 expression, and lipofilling within 3 months of primary resection. Of the eleven studies that included a comparison group, one matched patient for Her-2 and there was a statistically significant difference in Her-2 positive cancers in the study arms of two articles. Several studies deemed lipofilling "safe," two showed association of lipofilling and local recurrence, and most studies concluded that further research was needed. Insufficient and contradictory data exists to demonstrate the safety of lipofilling after breast conserving surgery. A multicentered, well designed study is needed to verify the safety of this practice.
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Affiliation(s)
- Stephanie Cohen
- Division of Plastic Surgery, Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, MA, USA
| | - Yurie Sekigami
- Division of Plastic Surgery, Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, MA, USA
| | - Theresa Schwartz
- Division of Surgical Oncology, Department of Surgery, St. Louis University Hospital, St. Louis, MO, USA
| | - Albert Losken
- Division of Plastic Surgery, Department of Surgery, Emory University Hospital, Atlanta, GA, USA
| | - Julie Margenthaler
- Division of Endocrine and Oncologic Surgery, Department of Surgery, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Abhishek Chatterjee
- Division of Plastic Surgery, Division of Surgical Oncology, Department of Surgery, Tufts Medical Center, Boston, MA, USA
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34
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Schwartz T, Margenthaler J. Flipping a Coin? Predicting Nodal Status After Neoadjuvant Chemotherapy. Ann Surg Oncol 2019; 26:4168-4170. [PMID: 31555938 DOI: 10.1245/s10434-019-07868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Theresa Schwartz
- Department of Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA.
| | - Julie Margenthaler
- Department of Surgery, Washington University in Saint Louis, St. Louis, MO, USA
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35
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Landgren O, Zeig-Owens R, Giricz O, Goldfarb D, Murata K, Thoren K, Ramanathan L, Hultcrantz M, Dogan A, Nwankwo G, Steidl U, Pradhan K, Hall CB, Cohen HW, Jaber N, Schwartz T, Crowley L, Crane M, Irby S, Webber MP, Verma A, Prezant DJ. Multiple Myeloma and Its Precursor Disease Among Firefighters Exposed to the World Trade Center Disaster. JAMA Oncol 2019; 4:821-827. [PMID: 29710195 PMCID: PMC6145680 DOI: 10.1001/jamaoncol.2018.0509] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Question Are environmental exposures from the World Trade Center disaster site associated with multiple myeloma and its precursor disease, monoclonal gammopathy of undetermined significance (MGUS), in New York City firefighters? Findings In this case series, 16 participants were diagnosed with multiple myeloma after September 11, 2001, with a median age of disease onset of 57 years, and in subsets with relevant data, a high proportion of the cases had light-chain myeloma, and plasma cells were CD20 positive. In the screening study, World Trade Center exposure was found to be statistically significantly associated with light-chain MGUS and overall MGUS. Meaning World Trade Center disaster exposures are associated with myeloma precursor disease (MGUS) and may be a risk factor for the development of multiple myeloma at an earlier age. Importance The World Trade Center (WTC) attacks on September 11, 2001, created an unprecedented environmental exposure to known and suspected carcinogens suggested to increase the risk of multiple myeloma. Multiple myeloma is consistently preceded by the precursor states of monoclonal gammopathy of undetermined significance (MGUS) and light-chain MGUS, detectable in peripheral blood. Objective To characterize WTC-exposed firefighters with a diagnosis of multiple myeloma and to conduct a screening study for MGUS and light-chain MGUS. Design, Setting, and Participants Case series of multiple myeloma in firefighters diagnosed between September 11, 2001, and July 1, 2017, together with a seroprevalence study of MGUS in serum samples collected from Fire Department of the City of New York (FDNY) firefighters between December 2013 and October 2015. Participants included all WTC-exposed FDNY white, male firefighters with a confirmed physician diagnosis of multiple myeloma (n = 16) and WTC-exposed FDNY white male firefighters older than 50 years with available serum samples (n = 781). Exposures WTC exposure defined as rescue and/or recovery work at the WTC site between September 11, 2001, and July 25, 2002. Main Outcomes and Measures Multiple myeloma case information, and age-adjusted and age-specific prevalence rates for overall MGUS (ie, MGUS and light-chain MGUS), MGUS, and light-chain MGUS. Results Sixteen WTC-exposed white male firefighters received a diagnosis of multiple myeloma after September 11, 2001; median age at diagnosis was 57 years (interquartile range, 50-68 years). Serum/urine monoclonal protein isotype/free light-chain data were available for 14 cases; 7 (50%) had light-chain multiple myeloma. In a subset of 7 patients, myeloma cells were assessed for CD20 expression; 5 (71%) were CD20 positive. In the screening study, we assayed peripheral blood from 781 WTC-exposed firefighters. The age-standardized prevalence rate of MGUS and light-chain MGUS combined was 7.63 per 100 persons (95% CI, 5.45-9.81), 1.8-fold higher than rates from the Olmsted County, Minnesota, white male reference population (relative rate, 1.76; 95% CI, 1.34-2.29). The age-standardized prevalence rate of light-chain MGUS was more than 3-fold higher than in the same reference population (relative rate, 3.13; 95% CI, 1.99-4.93). Conclusions and Relevance Environmental exposure to the WTC disaster site is associated with myeloma precursor disease (MGUS and light-chain MGUS) and may be a risk factor for the development of multiple myeloma at an earlier age, particularly the light-chain subtype.
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Affiliation(s)
- Ola Landgren
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York.,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Orsolya Giricz
- Division of Hemato-Oncology, Department of Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - David Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York.,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
| | - Kaznouri Murata
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Katie Thoren
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lakshmi Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Malin Hultcrantz
- Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ahmet Dogan
- Department of Hematopathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - George Nwankwo
- Division of Hemato-Oncology, Department of Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Ulrich Steidl
- Division of Hemato-Oncology, Department of Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Kith Pradhan
- Division of Hemato-Oncology, Department of Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Charles B Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Hillel W Cohen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Nadia Jaber
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
| | - Theresa Schwartz
- Department of Medicine, Montefiore Medical Center, Bronx, New York.,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
| | | | | | - Shani Irby
- Department of Hematopathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mayris P Webber
- Department of Medicine, Montefiore Medical Center, Bronx, New York.,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Amit Verma
- Division of Hemato-Oncology, Department of Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York.,Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, New York, New York
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36
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Winter AM, Bennett DL, Schwartz T. Sewing needles in the breasts localized intraoperatively with sentimag probe. Breast J 2019; 26:833-834. [PMID: 31513722 DOI: 10.1111/tbj.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea M Winter
- Saint Louis University School of Medicine, St. Louis, Missouri
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37
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Cohen HW, Zeig-Owens R, Joe C, Hall CB, Webber MP, Weiden MD, Cleven KL, Jaber N, Skerker M, Yip J, Schwartz T, Prezant DJ. Long-term Cardiovascular Disease Risk Among Firefighters After the World Trade Center Disaster. JAMA Netw Open 2019; 2:e199775. [PMID: 31490535 PMCID: PMC6735414 DOI: 10.1001/jamanetworkopen.2019.9775] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Published studies examining the association between World Trade Center (WTC) exposure on and after September 11, 2001, and longer-term cardiovascular disease (CVD) outcomes have reported mixed findings. OBJECTIVE To assess whether WTC exposure was associated with elevated CVD risk in Fire Department of the City of New York (FDNY) firefighters. DESIGN, SETTINGS, AND PARTICIPANTS In this cohort study, the association between WTC exposure and the risk of CVD was assessed between September 11, 2001, and December 31, 2017, in FDNY male firefighters. Multivariable Cox regression analyses were used to estimate CVD risk in association with 2 measures of WTC exposure: arrival time to the WTC site and duration of work at the WTC site. Data analyses were conducted from May 1, 2018, to March 8, 2019. MAIN OUTCOMES AND MEASURES The primary CVD outcome included myocardial infarction, stroke, unstable angina, coronary artery surgery or angioplasty, or CVD death. The secondary outcome (all CVD) included all primary outcome events or any of the following: transient ischemic attack; stable angina, defined as either use of angina medication or cardiac catheterization without intervention; cardiomyopathy; and other CVD (aortic aneurysm, peripheral arterial vascular intervention, and carotid artery surgery). RESULTS There were 489 primary outcome events among 9796 male firefighters (mean [SD] age on September 11, 2001, was 40.3 [7.4] years and 7210 individuals [73.6%] were never smokers). Age-adjusted incident rates of CVD were higher for firefighters with greater WTC exposure. The multivariable adjusted hazard ratio (HR) for the primary CVD outcome was 1.44 (95% CI, 1.09-1.90) for the earliest arrival group compared with those who arrived later. Similarly, those who worked at the WTC site for 6 or more months vs those who worked less time at the site were more likely to have a CVD event (HR, 1.30; 95% CI, 1.05-1.60). Well-established CVD risk factors, including hypertension (HR, 1.41; 95% CI, 1.10-1.80), hypercholesterolemia (HR, 1.56; 95% CI, 1.28-1.91), diabetes (HR, 1.99; 95% CI, 1.33-2.98), and smoking (current: HR, 2.13; 95% CI, 1.68-2.70; former: HR, 1.55; 95% CI, 1.23-1.95), were significantly associated with CVD in the multivariable models. Analyses with the all-CVD outcome were similar. CONCLUSIONS AND RELEVANCE The findings of the study suggest a significant association between greater WTC exposure and long-term CVD risk. The findings appear to reinforce the importance of long-term monitoring of the health of survivors of disasters.
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Affiliation(s)
- Hillel W. Cohen
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Rachel Zeig-Owens
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Cynthia Joe
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Charles B. Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mayris P. Webber
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Michael D. Weiden
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary, Critical Care, and Sleep Medicine Division, Department of Medicine, New York University School of Medicine, New York
- Pulmonary, Critical Care, and Sleep Medicine Division, Department of Environmental Medicine, New York University School of Medicine, New York
| | - Krystal L. Cleven
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Nadia Jaber
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
| | - Molly Skerker
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Jennifer Yip
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Theresa Schwartz
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - David J. Prezant
- The Bureau of Health Services and the Fire Department of the City of New York World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
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Kwon S, Clementi E, Crowley G, Schwartz T, Zeig-Owens R, Liu M, Prezant D, Nolan A. CLINICAL BIOMARKERS OF WORLD TRADE CENTER AIRWAY HYPERREACTIVITY: A 16-YEAR LONGITUDINAL STUDY. Chest 2019. [DOI: 10.1016/j.chest.2019.02.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Meyer W, Cope R, Behrends E, Patton B, Schwartz T, Branham L, Kellermeier J. Effects of Plum Concentrate, Potato Starch, and Rice Starch as a Phosphate Replacement on Quality and Sensory Attributes of Whole Muscle Hams. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Schwartz T, Cope R, Behrends E, Patton B, Branham L, Kellermeier J. The Effect of Brine Temperature on Smokehouse Yield, Sensory Characteristics, and Color Scores of Bacon. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Nicks SE, Wray RJ, Peavler O, Jackson S, McClure S, Enard K, Schwartz T. Examining peer support and survivorship for African American women with breast cancer. Psychooncology 2018; 28:358-364. [DOI: 10.1002/pon.4949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/25/2018] [Accepted: 11/21/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Shannon E. Nicks
- College for Public Health & Social Justice, Department of Behavioral Science & Health EducationSaint Louis University St. Louis MO
| | - Ricardo J. Wray
- College for Public Health & Social Justice, Department of Behavioral Science & Health EducationSaint Louis University St. Louis MO
| | - Olivia Peavler
- College for Public Health & Social Justice, Department of Health Management & PolicySaint Louis University St. Louis MO
| | | | - Stephanie McClure
- College for Public Health & Social Justice, Department of Behavioral Science & Health EducationSaint Louis University St. Louis MO
| | - Kimberly Enard
- College for Public Health & Social Justice, Department of Health Management & PolicySaint Louis University St. Louis MO
| | - Theresa Schwartz
- Cancer Center, Department of Surgery, Breast Surgical OncologySaint Louis University St. Louis MO
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Wirth LS, Hinyard L, Keller J, Bucholz E, Schwartz T. Geographic variations in racial disparities in postmastectomy breast reconstruction: A SEER database analysis. Breast J 2018; 25:112-116. [PMID: 30536478 DOI: 10.1111/tbj.13166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to determine whether racial disparities in reconstruction in the United States vary by geographic region. The SEER database years 2000-2013 was queried for all mastectomies in women ages 20-85+. Logistic regression was used to examine the main effects and interaction of race and geographic region on reconstruction. Hot spot Analysis was used to examine clustering of reconstruction across counties by race. We found large regional variation in racial differences in the rate of immediate postmastectomy reconstruction. Understanding how racial disparities vary by region can identify important factors for intervention to reduce disparities in practice.
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Affiliation(s)
| | - Leslie Hinyard
- Saint Louis University Center for Health Outcomes Research, Saint Louis, Missouri
| | - Jennifer Keller
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Eleanor Bucholz
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Theresa Schwartz
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
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Putman B, Zeig-Owens R, Singh A, Hall CB, Schwartz T, Webber MP, Cohen HW, Prezant DJ, Bachert C, Weiden MD. Risk factors for post-9/11 chronic rhinosinusitis in Fire Department of the City of New York workers. Occup Environ Med 2018; 75:884-889. [DOI: 10.1136/oemed-2018-105297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/14/2018] [Accepted: 09/28/2018] [Indexed: 12/12/2022]
Abstract
ObjectivesChronic rhinosinusitis (CRS) has high socioeconomic burden but underexplored risk factors. The collapse of the World Trade Center (WTC) towers on 11 September 2001 (9/11) caused dust and smoke exposure, leading to paranasal sinus inflammation and CRS. We aim to determine which job tasks are risk factors for CRS in WTC-exposed Fire Department of the City of New York (FDNY) firefighters and emergency medical services (EMS) workers.MethodsThis cohort study included a 16-year follow-up of 11 926 WTC-exposed FDNY rescue/recovery workers with data on demographics, WTC exposure, job tasks and first post-9/11 complete blood counts. Using multivariable Cox regression, we assessed the associations of WTC exposure, work assignment (firefighter/EMS), digging and rescue tasks at the WTC site and blood eosinophil counts with subsequent CRS, adjusting for potential confounders.ResultsThe rate of CRS was higher in firefighters than EMS (1.80/100 person-years vs 0.70/100 person-years; p<0.001). The combination of digging and rescue work was a risk factor for CRS (HR 1.54, 95% CI 1.23 to 1.94, p<0.001) independent of work assignment and WTC exposure.ConclusionsCompared with EMS, firefighters were more likely to engage in a combination of digging and rescue work, which was a risk factor for CRS. Chronic irritant exposures associated with digging and rescue work may account for higher post-9/11 CRS rates among firefighters.
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Singh A, Liu C, Putman B, Zeig-Owens R, Hall CB, Schwartz T, Webber MP, Cohen HW, Berger KI, Nolan A, Prezant DJ, Weiden MD. Predictors of Asthma/COPD Overlap in FDNY Firefighters With World Trade Center Dust Exposure: A Longitudinal Study. Chest 2018; 154:1301-1310. [PMID: 30028968 DOI: 10.1016/j.chest.2018.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/31/2018] [Accepted: 07/02/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Previously healthy firefighters with World Trade Center (WTC) dust exposure developed airway disease. Risk factors for irritant-associated asthma/COPD overlap are poorly defined. METHODS This study included 2,137 WTC-exposed firefighters who underwent a clinically indicated bronchodilator pulmonary function test (BD-PFT) between 9/11/2001 and 9/10/2017. A post-BD FEV1 increase of > 12% and 200 mL from baseline defined asthma, and a post-BD FEV1/FVC ratio < 0.7 identified COPD cases. Participants who met both criteria had asthma/COPD overlap. Eosinophil levels were measured on screening blood tests performed shortly after 9/11/2001 and prior to BD-PFT; a subgroup of participants also had serum IgE and 21 cytokines measured (n = 215). Marginal Cox regression models for multiple events assessed the associations of eosinophil levels or serum biomarkers with subsequent diagnosis, with age, race, smoking, WTC exposure, first post-9/11 FEV1/FVC ratio, and BMI included as covariates. RESULTS BD-PFT diagnosed asthma/COPD overlap in 99 subjects (4.6%), isolated-asthma in 202 (9.5%), and isolated-COPD in 215 (10.1%). Eosinophil concentration ≥ 300 cells/μL was associated with increased risk of asthma/COPD overlap (hazard ratio [HR], 1.85; 95% CI, 1.16-2.95) but not with isolated-asthma or isolated-COPD. Serum IL-4 also predicted asthma/COPD overlap (HR, 1.51 per doubling of cytokine concentration; 95% CI, 1.17-1.95). Greater IL-21 concentration was associated with both isolated-asthma and isolated-COPD (HRs of 1.73 [95% CI, 1.27-2.35] and 2.06 [95% CI, 1.31-3.23], respectively). CONCLUSIONS In WTC-exposed firefighters, elevated blood eosinophil and IL-4 levels are associated with subsequent asthma/COPD overlap. Disease-specific T-helper cell type 2 biomarkers present years before diagnosis suggest patient-intrinsic predisposition to irritant-associated asthma/COPD overlap.
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Affiliation(s)
- Ankura Singh
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY
| | - Charles Liu
- Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Barbara Putman
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Rachel Zeig-Owens
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Charles B Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Theresa Schwartz
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY
| | - Mayris P Webber
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Hillel W Cohen
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Kenneth I Berger
- Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Anna Nolan
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - David J Prezant
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY
| | - Michael D Weiden
- Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY; Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY.
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Panuganti B, Chang ES, Helm CW, Schwartz T, Hsueh EC, Piao J, Lai J, Veerapong J. Cytoreductive Surgery and Normothermic Intraperitoneal Chemotherapy for Signet Ring Cell Appendiceal Adenocarcinoma With Peritoneal Metastases in the Setting of Cirrhosis. Gastroenterology Res 2018; 11:247-251. [PMID: 29915638 PMCID: PMC5997481 DOI: 10.14740/gr1029w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/15/2018] [Indexed: 12/15/2022] Open
Abstract
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are combined to treat peritoneal surface malignancies (PSM). The objective of cytoreduction is to eradicate macroscopic disease, while HIPEC addresses residual microscopic disease. Currently, there are no protocols guiding treatment of cirrhotic patients with PSM. We report the case of a cirrhotic patient with signet ring cell (SRC) appendiceal adenocarcinoma who underwent normothermic, as opposed to hyperthermic intraperitoneal chemotherapy (IPC). A 50-year-old woman with compensated class A cirrhosis and chronic hepatitis B and C underwent a right hemicolectomy in 2007 and adjuvant chemotherapy in 2008 for appendiceal SRC adenocarcinoma. In 2011, she was found to have peritoneal disease after a laparotomy. She subsequently experienced intolerance to chemotherapy, with stable disease on serial restaging. In light of her cirrhosis, the decision was made to perform CRS and IPC without hyperthermia to treat her residual disease. In 2012, she underwent CRS (omentectomy, total abdominal hysterectomy, left salpingo-oophorectomy) and IPC with mitomycin C. Thirty-day postoperative morbidity included delayed abdominal closure (Clavien-Dindo Grade IIIb), prolonged ventilator support (IIIa), vasopressor requirements (II), and confusion (II). The patient’s liver function remained stable. Eight months later, she had evidence of recurrence on computed tomography. Twenty-two months later, she developed an extrinsic compression secondary to evolving disease, requiring a palliative endoscopic stent. The patient expired from her disease 29 months after her CRS and IPC. The criteria guiding selection of suitable candidates for CRS continues to evolve. Concomitant compensated cirrhosis in patients with PSM should not constitute a reason independently to exclude CRS with intraperitoneal chemotherapy, given the oncologic benefits of the procedure.
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Affiliation(s)
- Bharat Panuganti
- Department of Surgery, University of California-San Diego, La Jolla, CA, USA
| | - Ea-Sle Chang
- Department of General Surgery, Saint Louis University, Saint Louis, MO, USA
| | - Cyril W Helm
- Royal Cornwall Hospitals NHS Trust, Treliske, Truro, Cornwall, TR1 3LJ, United Kingdom
| | - Theresa Schwartz
- Division of Surgical Oncology, Department of General Surgery, Saint Louis University, Saint Louis, MO, USA
| | - Eddy C Hsueh
- Division of Surgical Oncology, Department of General Surgery, Saint Louis University, Saint Louis, MO, USA
| | - Jinhua Piao
- Department of Pathology, Saint Louis University, Saint Louis, MO, USA
| | - Jinping Lai
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jula Veerapong
- Division of Surgical Oncology, Department of General Surgery, University of California-San Diego, La Jolla, CA, USA
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Webber MP, Liu Y, Cohen HW, Schwartz T, Weiden MD, Kelly K, Ortiz V, Zeig-Owens R, Jaber N, Colbeth HL, Prezant DJ. Incidence and prevalence of antibody to hepatitis C virus in FDNY first responders before and after work at the World Trade Center disaster site. Am J Ind Med 2018; 61:733-740. [PMID: 29923604 DOI: 10.1002/ajim.22871] [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] [Accepted: 05/21/2018] [Indexed: 12/09/2022]
Abstract
BACKGROUND The goals of this study were to assess the impact of work at the World Trade Center (WTC) site in relation to new, post-9/11/2001 (9/11) antibody to hepatitis C Virus (anti-HCV); and, evaluate secular trends in WTC-exposed male Fire Department of New York City (FDNY) Firefighters and Emergency Medical Services (EMS) responders. METHODS FDNY monitors responder health through physical exams and routine blood work. We used descriptive statistics to compare trans-9/11 and post-9/11 incidence and to assess trends in prevalence from 2000 to 2012. RESULTS Trans-9/11 incidence of new anti-HCV was 0.42 per 100 persons compared with post-9/11 incidence of 0.34 (P = 0.68). Overall seroprevalence was 1.3%; rates declined from 1.79 per 100 to 0.49 per 100 over time (P < 0.0001). CONCLUSIONS Work at the WTC was not associated with new infection. Biennial seroprevalence in responders declined over time, supporting the FDNY decision to discontinue routine annual testing in this cohort.
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Affiliation(s)
- Mayris P Webber
- Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Yang Liu
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Hillel W Cohen
- Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Theresa Schwartz
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Michael D Weiden
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Kerry Kelly
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Viola Ortiz
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Rachel Zeig-Owens
- Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Nadia Jaber
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - Hilary L Colbeth
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
| | - David J Prezant
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York
- Pulmonology Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
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Singh A, Zeig-Owens R, Moir W, Hall CB, Schwartz T, Vossbrinck M, Jaber N, Webber MP, Kelly KJ, Ortiz V, Koffler E, Prezant DJ. Estimation of Future Cancer Burden Among Rescue and Recovery Workers Exposed to the World Trade Center Disaster. JAMA Oncol 2018; 4:828-831. [PMID: 29710126 PMCID: PMC5933461 DOI: 10.1001/jamaoncol.2018.0504] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 12/15/2017] [Indexed: 11/14/2022]
Abstract
Importance Elevated rates of cancer have been reported in individuals exposed to the World Trade Center (WTC) disaster, including Fire Department of the City of New York (FDNY) rescue and recovery workers. Objective To project the future burden of cancer in WTC-exposed FDNY rescue and recovery workers by estimating the 20-year cancer incidence. Design, Setting, and Participants A total of 14 474 WTC-exposed FDNY employees who were cancer-free on January 1, 2012; subgroup analyses were conducted of the cohort's white male population (n = 12 374). In this closed-cohort study, we projected cancer incidence for the January 1, 2012, to December 31, 2031, period. Simulations were run using demographic-specific New York City (NYC) cancer and national mortality rates for each individual, summed for the whole cohort, and performed 1000 times to produce mean estimates. Additional analyses in the subgroup of white men compared case counts produced by using 2007-2011 FDNY WTC Health Program (FDNY-WTCHP) cancer rates vs NYC rates. Average and 20-year aggregate costs of first-year cancer care were estimated using claims data. Exposures World Trade Center disaster exposure defined as rescue and recovery work at the WTC site at any time from September 11, 2001, to July 25, 2002. Main Outcomes and Measures (1) Projected number of incident cancers in the full cohort, based on NYC cancer rates; (2) cancer incidence estimates in the subgroup projected using FDNY-WTCHP vs NYC rates; and (3) estimated first-year treatment costs of incident cancers. Results On January 1, 2012, the cohort was 96.8% male, 87.1% white, and had a mean (SD) age of 50.2 (9.2) years. The projected number of incident cancer cases was 2960 (95% CI, 2883-3037). In our subgroup analyses using FDNY-WTCHP vs NYC cancer rates, the projected number of new cases in white men was elevated (2714 [95% CI, 2638-2786] vs 2596 [95% CI, 2524-2668]). Accordingly, we expect more prostate (1437 [95% CI, 1383-1495] vs 863 [95% CI, 816-910]), thyroid (73 [95% CI, 60-86] vs 57 [95% CI, 44-69]), and melanoma cases (201 [95% CI, 179-223] vs 131 [95% CI, 112-150), but fewer lung (237 [95% CI, 212-262] vs 373 [95% CI, 343-405]), colorectal (172 [95% CI, 152-191] vs 267 [95% CI, 241-292]), and kidney cancers (66 [95% CI, 54-80] vs 132 [95% CI, 114-152]) (P < .001 for all comparisons). The estimated 20-year cost of first-year treatment was $235 835 412 (95% CI, $187 582 227-$284 088 597). Conclusions and Relevance We project that the FDNY-WTCHP cohort will experience a greater cancer burden than would be expected from a demographically similar population. This underscores the importance of cancer prevention efforts and routine screening in WTC-exposed rescue and recovery workers.
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Affiliation(s)
- Ankura Singh
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Rachel Zeig-Owens
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - William Moir
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Charles B. Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Theresa Schwartz
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Madeline Vossbrinck
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Nadia Jaber
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Mayris P. Webber
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Kerry J. Kelly
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Viola Ortiz
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Ellen Koffler
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - David J. Prezant
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
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Zeig-Owens R, Singh A, Aldrich TK, Hall CB, Schwartz T, Webber MP, Cohen HW, Kelly KJ, Nolan A, Prezant DJ, Weiden MD. Blood Leukocyte Concentrations, FEV 1 Decline, and Airflow Limitation. A 15-Year Longitudinal Study of World Trade Center-exposed Firefighters. Ann Am Thorac Soc 2018; 15:173-183. [PMID: 29099614 PMCID: PMC5802620 DOI: 10.1513/annalsats.201703-276oc] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 03/28/2017] [Accepted: 10/19/2017] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Rescue/recovery work at the World Trade Center disaster site (WTC) caused a proximate decline in lung function in Fire Department of the City of New York firefighters. A subset of this cohort experienced an accelerated rate of lung function decline over 15 years of post-September 11, 2001 (9/11) follow-up. OBJECTIVES To determine if early postexposure blood leukocyte concentrations are biomarkers for subsequent FEV1 decline and incident airflow limitation. METHODS Individual rates of forced expiratory volume in 1 second (FEV1) change were calculated for 9,434 firefighters using 88,709 spirometric measurements taken between September 11, 2001, and September 10, 2016. We categorized FEV1 change rates into three trajectories: accelerated FEV1 decline (FEV1 loss >64 ml/yr), expected FEV1 decline (FEV1 loss between 0 and 64 ml/yr), and improved FEV1 (positive rate of change >0 ml/yr). Occurrence of FEV1/FVC less than 0.70 after 9/11 defined incident airflow limitation. Using regression models, we assessed associations of post-9/11 blood eosinophil and neutrophil concentrations with subsequent FEV1 decline and airflow limitation, adjusted for age, race, smoking, height, WTC exposure level, weight change, and baseline lung function. RESULTS Accelerated FEV1 decline occurred in 12.7% of participants (1,199 of 9,434), whereas post-9/11 FEV1 improvement occurred in 8.3% (780 of 9,434). Higher blood eosinophil and neutrophil concentrations were each associated with accelerated FEV1 decline after adjustment for covariates (odds ratio [OR], 1.10 per 100 eosinophils/μl; 95% confidence interval [CI], 1.05-1.15; and OR, 1.10 per 1,000 neutrophils/μl; 95% CI, 1.05-1.15, respectively). Multivariable-adjusted linear regression models showed that a higher blood neutrophil concentration was associated with a faster rate of FEV1 decline (1.14 ml/yr decline per 1,000 neutrophils/μl; 95% CI, 0.69-1.60 ml/yr; P < 0.001). Higher blood eosinophil concentrations were associated with a faster rate of FEV1 decline in ever-smokers (1.46 ml/yr decline per 100 eosinophils/μl; 95% CI, 0.65-2.26 ml/yr; P < 0.001) but not in never-smokers (P for interaction = 0.004). Higher eosinophil concentrations were also associated with incident airflow limitation (adjusted hazard ratio, 1.10 per 100 eosinophils/μl; 95% CI, 1.04-1.15). Compared with the expected FEV1 decline group, individuals experiencing accelerated FEV1 decline were more likely to have incident airflow limitation (adjusted OR, 4.12; 95% CI, 3.30-5.14). CONCLUSIONS Higher post-9/11 blood neutrophil and eosinophil concentrations were associated with subsequent accelerated FEV1 decline in WTC-exposed firefighters. Both higher blood eosinophil concentrations and accelerated FEV1 decline were associated with incident airflow limitation in WTC-exposed firefighters.
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Affiliation(s)
- Rachel Zeig-Owens
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
- Division of Epidemiology and
| | - Ankura Singh
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Thomas K. Aldrich
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Charles B. Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Theresa Schwartz
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Mayris P. Webber
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Epidemiology and
| | | | - Kerry J. Kelly
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
| | - Anna Nolan
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
| | - David J. Prezant
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Michael D. Weiden
- The Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, New York
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, and
- Department of Environmental Medicine, New York University School of Medicine, New York, New York
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Abstract
Biofilm-forming bacteria are ubiquitous in the environment and also include biofilm-forming pathogens. Environmental biofilms may form a reservoir for risk genes and may act as a challenge for human health. Examples of the health relevance of biofilms are the increase in antibiotic resistant bacteria hosted in biofilms in hospital and environment and consequently the interaction of these bacteria with human cells, e.g. in the immune system. Although data concerning the occurrence and spread of resistant bacteria within hospital care units are available, the fate of these bacteria in the environment and especially in the aquatic environment has barely been investigated. Once antibiotic resistant bacteria have entered the environment, a back coupling by ingestion or other possible entry into the host has to be prevented. Therefore a strategy to investigate paths of entry, accumulation and spread of resistant bacteria in environmental compartments has been developed using quantitative determination of genetic resistance determinants. Additionally a bacterial bioassay assessed bioeffectivity thresholds of low antibiotic concentrations. This approach enables an evaluation of the potential of contaminated waters to exert a selection pressure on bacterial communities and thus promote the persistence of resistant organisms. Completed with an indicator system for the identification of sources of multiresistant bacteria a concept for monitoring and evaluation of environmental compartments with respect to their potential of antibiotic resistance dissemination is suggested.
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Affiliation(s)
- U Obst
- Karlsruhe Research Center, Eggenstein-Leopoldshafen, Germany.
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50
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Kispert S, Schwartz T, McHowat J. Cigarette Smoke Regulates Calcium-Independent Phospholipase A2 Metabolic Pathways in Breast Cancer. The American Journal of Pathology 2017; 187:1855-1866. [DOI: 10.1016/j.ajpath.2017.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/24/2017] [Accepted: 04/04/2017] [Indexed: 11/25/2022]
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