26
|
Sutcliffe C, Quinn CH, Shannon C, Glover A, Dunn AM. Exploring the attitudes to and uptake of biosecurity practices for invasive non-native species: views amongst stakeholder organisations working in UK natural environments. Biol Invasions 2017. [DOI: 10.1007/s10530-017-1541-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
27
|
Brew B, Shannon C, Storey L, Boyd A, Mulholland C. A qualitative phenomenological analysis of the subjective experience and understanding of the at risk mental state. Int J Qual Stud Health Well-being 2017; 12:1342504. [PMID: 28689474 PMCID: PMC5510197 DOI: 10.1080/17482631.2017.1342504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Over recent years there has been a growing interest in identifying the early stages of psychosis. The At Risk Mental State (ARMS) is characteristic of the prodromal stages of psychosis and its identification gives rise to a number of clinical and research opportunities including early intervention and prevention of psychosis. This study employs interpretative phenomenological analysis to gain insights into the subjective experience and individuals understanding of the development of their ARMS. Five participants took part and provided information on the experience of symptoms, life prior to onset of their ARMS and their understanding of symptoms and their development through a semi structured interview. From the analysis of transcripts eight themes emerged which were common across participants accounts. Three themes of experience (disturbed world/disturbed self, disconnection with the world, thunderstruck) and five themes of understanding (absence of understanding, use of others, identity, forming links, fragmented understanding) were identified. Themes are explored in detail and discussed in relation to existing literature and theory. Clinical implications, directions for future research, and limitations are discussed within.
Collapse
|
28
|
Mulholland C, Mongan D, Boyd A, Shannon C. CAN WE PREVENT PSYCHOSIS? INNOVATIVE SERVICE OFFERS NEW HOPE. THE ULSTER MEDICAL JOURNAL 2017. [PMID: 29535494 PMCID: PMC5846005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
29
|
Fiore LD, Brophy MT, Ferguson RE, Shannon C, Turek SJ, Pierce‐Murray K, Ajjarapu S, Huang GD, Lee CSE, Lavori PW. Data Sharing, Clinical Trials, and Biomarkers in Precision Oncology: Challenges, Opportunities, and Programs at the Department of Veterans Affairs. Clin Pharmacol Ther 2017; 101:586-589. [PMID: 28182272 PMCID: PMC5414893 DOI: 10.1002/cpt.660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 02/07/2017] [Accepted: 02/07/2017] [Indexed: 01/05/2023]
Abstract
Cancer genomic research reveals that a similar cancer clinical phenotype (e.g., non-small cell lung cancer) can arise from various mutations in tumor DNA. Thus, organ of origin is not a definitive classification. Further, targeted therapy for cancer patients (precision oncology) capitalizes on knowledge of individual patient mutational status to deliver treatment directed against the protein products of these mutations with the goal of reducing toxicity and enhancing efficacy relative to traditional nontargeted chemotherapy.
Collapse
|
30
|
Shannon C, Garmyn A, Miller M. Trends in Consumer Demographics and Willingness to Pay for Perceived Eating Quality Levels of Lamb. MEAT AND MUSCLE BIOLOGY 2017. [DOI: 10.22175/rmc2017.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
31
|
Shannon C, Hanna D, Tumelty L, Waldron D, Maguire C, Mowlds W, Meenagh C, Mulholland C. Reliability of reports of childhood trauma in bipolar disorder: A test-retest study over 18 months. J Trauma Dissociation 2016; 17:511-9. [PMID: 26835747 DOI: 10.1080/15299732.2016.1141147] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to explore the reliability of self-reported trauma histories in a population with a diagnosis of bipolar disorder using the Childhood Trauma Questionnaire. Previous studies in other populations suggest high reliability of trauma histories over time, and it was postulated that a similar high reliability would be demonstrated in this population. A total of 39 patients with a confirmed diagnosis (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, criteria) were followed up and readministered the Childhood Trauma Questionnaire after 18 months. Cohen's kappa scores and intraclass correlations suggested reasonable test-retest reliability over the 18-month time period of the study for all types of childhood abuse, namely, emotional, physical, and sexual abuse and physical and emotional neglect. Intraclass correlations ranged from r = .50 (sexual abuse) to r = .96 (physical abuse). Cohen's kappas ranged from .44 (sexual abuse) to .76 (physical abuse). Retrospective reports of childhood trauma can be seen as reliable and are in keeping with results found with other mental health populations.
Collapse
|
32
|
Cunningham T, Shannon C, Crothers I, Hoy K, Fitzsimmons C, McCann R, O’Hare J, Mulholland C. The perspectives of people with psychosis about participating in trauma-related research. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2016. [DOI: 10.1080/17522439.2016.1145729] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
Cunningham T, Shannon C, Crothers I, Hoy K, Fitzsimmons C, McCann R, O’Hare J, Mulholland C. Enquiring about traumatic experiences in psychosis: A comparison of case notes and self-report questionnaires. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2016. [DOI: 10.1080/17522439.2015.1115542] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Cunningham T, Hoy K, Shannon C. Does childhood bullying lead to the development of psychotic symptoms? A meta-analysis and review of prospective studies. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2015. [DOI: 10.1080/17522439.2015.1053969] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
35
|
Hollander Z, Lam K, Wilson-McManus J, Assadian S, Dai D, Shannon C, Chen V, Tebbutt S, Balshaw R, Borchers C, Davies R, Delgado D, Haddad H, Ignaszewski A, Isaac D, Kim D, Mui A, Rajda M, Ross H, West L, White M, Zieroth S, McMaster R, Keown P, Ng R, McManus B. Blood Test to Monitor for the Absence of Acute Cardiac Rejection: From Discovery to Clinical Implementation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
36
|
McMullen J, O'Callaghan P, Shannon C, Black A, Eakin J. Group trauma-focused cognitive-behavioural therapy with former child soldiers and other war-affected boys in the DR Congo: a randomised controlled trial. J Child Psychol Psychiatry 2013; 54:1231-41. [PMID: 23738530 DOI: 10.1111/jcpp.12094] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled trial for psychologically distressed former child soldiers. METHOD A randomised controlled trial involving 50 boys, aged 13-17, including former child soldiers (n = 39) and other war-affected boys (n = 11). They were randomly assigned to an intervention group, or wait-list control group. The intervention group received a 15-session, group-based, culturally adapted Trauma-Focused Cognitive-Behavioural Therapy (TF-CBT) intervention. Assessment interviews were completed at baseline, postintervention and 3-month follow-up (intervention group). RESULTS Analysis of Covariance (ANCOVA) demonstrated that, in comparison to the wait-list control group, the TF-CBT intervention group had highly significant reductions in posttraumatic stress symptoms, overall psychosocial distress, depression or anxiety-like symptoms, conduct problems and a significant increase in prosocial behaviour (p < .001 for all). Effect sizes were higher when former child soldier scores were separated for sub-analysis. Three-month follow-up of the intervention group found that treatment gains were maintained. CONCLUSIONS A culturally modified, group-based TF-CBT intervention was effective in reducing posttraumatic stress and psychosocial distress in former child soldiers and other war-affected boys.
Collapse
|
37
|
Campbell C, Barrett S, Shannon C, Hoy K, Rushe T, Cooper S, Mulholland C. The relationship between childhood trauma and neuropsychological functioning in first episode psychosis. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2013. [DOI: 10.1080/17522439.2012.660982] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
38
|
Hoy K, Barrett S, Shannon C, Campbell C, Watson D, Rushe T, Shevlin M, Bai F, Cooper S, Mulholland C. Childhood trauma and hippocampal and amygdalar volumes in first-episode psychosis. Schizophr Bull 2012; 38:1162-9. [PMID: 21799213 PMCID: PMC3494041 DOI: 10.1093/schbul/sbr085] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE A history of childhood trauma is common in individuals who later develop psychosis. Similar neuroanatomical abnormalities are observed in people who have been exposed to childhood trauma and people with psychosis. However, the relationship between childhood trauma and such abnormalities in psychosis has not been investigated. This study aimed to explore the association between the experience of childhood trauma and hippocampal and amygdalar volumes in a first-episode psychosis (FEP) population. METHODS The study employed an observational retrospective design. Twenty-one individuals, who had previously undergone magnetic resonance imaging procedures as part of the longitudinal Northern Ireland First-Episode Psychosis Study, completed measures assessing traumatic experiences and were included in the analysis. Data were subject to correlation analyses (r and r (pb)). Potential confounding variables (age at FEP and delay to scan from recruitment) were selected a priori for inclusion in multiple regression analyses. RESULTS There was a high prevalence of lifetime (95%) and childhood (76%) trauma in the sample. The experience of childhood trauma was a significant predictor of left hippocampal volume, although age at FEP also significantly contributed to this model. There was no significant association between predictor variables and right hippocampal volume. The experience of childhood trauma was a significant predictor of right and total amygdalar volumes and the hippocampal/amygdalar complex volume as a whole. CONCLUSIONS The findings indicate that childhood trauma is associated with neuroanatomical measures in FEP. Future research controlling for childhood traumatic experiences may contribute to explaining brain morphology in people with psychosis.
Collapse
|
39
|
Curran D, Mclaughlin E, Shannon C. The impact of trauma on therapeutic engagement within an addictions population. Appetite 2011. [DOI: 10.1016/j.appet.2011.05.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
40
|
Shannon C, Maguire C, Anderson J, Meenagh C, Mulholland C. Enquiring about traumatic experiences in bipolar disorder: a case note and self- report comparison. J Affect Disord 2011; 133:352-5. [PMID: 21596441 DOI: 10.1016/j.jad.2011.04.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 04/22/2011] [Accepted: 04/23/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study examined: (i) the prevalence of lifetime trauma, childhood trauma and trauma related to civil unrest in a Bipolar Disorder sample, and (ii) the agreement between rates of disclosure of trauma in case notes and self-report questionnaires. METHODS The case notes of sixty participants, recruited from a geographically well-defined mental health service in Northern Ireland, were examined for reports of experiences of lifetime, childhood and traumatic events related to civil conflict. The participants also completed self-report measures of trauma. RESULTS Considerable differences were found between the prevalence of trauma as measured by self-report questionnaires and case notes reports. The prevalence of lifetime trauma as measured by the Trauma History Questionnaire was 61.7% (compared to case notes prevalence of 33.3%). The prevalence of moderate and severe levels of childhood trauma as measured by the Childhood Trauma Questionnaire was 65% (case notes 21.7%). Rates of trauma related to civil unrest were 35% (case notes 3.3%). Poor levels of agreement were found between all self-report trauma measures and case notes reports. Agreement on two categories of trauma (childhood emotional neglect and childhood physical neglect) reached statistical significance but kappa scores suggest this agreement was poor (κ=.14, p<.05; κ=.127, p<.05). CONCLUSIONS It is probable that the increased rate of trauma disclosed in the self-report questionnaire arises because clinicians during initial assessment and subsequent treatment do not consistently enquire about trauma. The need for staff training is discussed.
Collapse
|
41
|
Hanna D, White R, Lyons K, McParland MJ, Shannon C, Mulholland C. The structure of the Beck Hopelessness Scale: A confirmatory factor analysis in UK students. PERSONALITY AND INDIVIDUAL DIFFERENCES 2011. [DOI: 10.1016/j.paid.2011.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
42
|
Shannon C, Douse K, McCusker C, Feeney L, Barrett S, Mulholland C. The association between childhood trauma and memory functioning in schizophrenia. Schizophr Bull 2011; 37:531-7. [PMID: 19752010 PMCID: PMC3080678 DOI: 10.1093/schbul/sbp096] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Both neurocognitive impairments and a history of childhood abuse are highly prevalent in patients with schizophrenia. Childhood trauma has been associated with memory impairment as well as hippocampal volume reduction in adult survivors. The aim of the following study was to examine the contribution of childhood adversity to verbal memory functioning in people with schizophrenia. METHODS Eighty-five outpatients with a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnosis of chronic schizophrenia were separated into 2 groups on the basis of self-reports of childhood trauma. Performance on measures of episodic narrative memory, list learning, and working memory was then compared using multivariate analysis of covariance. RESULTS Thirty-eight (45%) participants reported moderate to severe levels of childhood adversity, while 47 (55%) reported no or low levels of childhood adversity. After controlling for premorbid IQ and current depressive symptoms, the childhood trauma group had significantly poorer working memory and episodic narrative memory. However, list learning was similar between groups. CONCLUSION Childhood trauma is an important variable that can contribute to specific ongoing memory impairments in schizophrenia.
Collapse
|
43
|
Klewchuk EM, McCusker CG, Mulholland C, Shannon C. Cognitive biases for trauma stimuli in people with schizophrenia. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 46:333-45. [PMID: 17535526 DOI: 10.1348/014466507x173385] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES This study investigates whether cognitive biases related to trauma (physical and sexual trauma) are present in a sample of participants with a diagnosis of schizophrenia. METHOD Fifty-three participants, with a DSM-IV diagnosis of schizophrenia, completed tasks of attentional and memory bias, followed by several trauma report questionnaires. Those who reported a history of sexual and/or physical trauma were compared with a 'non-specific/no-trauma' subgroup. The reliability of trauma reports was determined by comparing current data on the Trauma History Questionnaire to that gathered one year previously, for a subsample of participants. Concordance rates and kappa coefficients suggested moderate to high reliability for reports of sexual and physical trauma. Attentional bias was assessed by comparing colour-naming times on modified Stroops, of either a sexual or physical nature, with control Stroops with negative, positive and neutral emotionally valenced stimuli. A subsequent incidental recall memory task was then employed. RESULTS High rates of sexual and/or physical trauma were found. Those who reported a history of sexual trauma evidenced a statistically significant increase in colour-naming times for sexual trauma stimuli, compared to both the 'physical trauma only' and the 'non-specific/no trauma' control groups. They also showed greater incidental recall of sexual trauma words in comparison to the other groups. Such a pattern was not, however, discerned for those reporting histories of physical trauma. CONCLUSIONS Findings suggest cognitive schemata related to sexual trauma remains 'active' in those people with schizophrenia who report a related history.
Collapse
|
44
|
Mowlds W, Shannon C, McCusker CG, Meenagh C, Robinson D, Wilson A, Mulholland C. Autobiographical memory specificity, depression, and trauma in bipolar disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 49:217-33. [DOI: 10.1348/014466509x454868] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
45
|
Shannon C, Veatch M, Chong E, Agnew K, Nucatola D, Newhall E, Sheehan K, Winikoff B. Vaginal and rectal clostridial colonization among women of reproductive age in the United States. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
46
|
Swica Y, Bracken H, Shannon C, Chong E, Dzube I, Tsereteli T, Maistruk G, Winikoff B. The extended gestational age medical abortion study: the effectiveness of medical abortion with mifepristone and misoprostol at 57–63 days versus 64–70 days gestation. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
47
|
Davidson G, Shannon C, Mulholland C, Campbell J. A longitudinal study of the effects of childhood trauma on symptoms and functioning of people with severe mental health problems. J Trauma Dissociation 2009; 10:57-68. [PMID: 19197712 DOI: 10.1080/15299730802485169] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examines the relationship between childhood trauma and the psychiatric symptoms and psychosocial functioning of adults with severe mental health problems. Participants (n = 31) were recruited from the caseloads of community mental health services in Northern Ireland and assessed at baseline, 9 months, and 18 months. More than half had a history of childhood trauma (n = 17). There were no differences between the no childhood trauma (n = 14) and childhood trauma groups on psychiatric symptoms, but a significant relationship was found between trauma history and all aspects of social functioning. Those with no history of trauma showed improved psychosocial functioning over time, whereas those with a history of trauma deteriorated. These findings have implications for current service provision.
Collapse
|
48
|
Maguire C, McCusker CG, Meenagh C, Mulholland C, Shannon C. Effects of trauma on bipolar disorder: the mediational role of interpersonal difficulties and alcohol dependence. Bipolar Disord 2008; 10:293-302. [PMID: 18271909 DOI: 10.1111/j.1399-5618.2007.00504.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study examined: (i) the prevalence of trauma in a bipolar disorder (BD) sample, and (ii) how trauma histories mediated by interpersonal difficulties and alcohol dependence impact on the severity of BD. The prevalence of posttraumatic stress disorder (PTSD) and its relationship to outcomes in BD were also examined. METHODS Sixty participants were recruited from a geographically well-defined mental health service in Northern Ireland. Self-reported trauma histories, PTSD, interpersonal difficulties and alcohol dependence and were examined in relation to illness severity. RESULTS A high prevalence of trauma was found. Trauma predicted the frequency of hospital admissions (R(2) = 0.08), quality of life (R(2) = 0.23) and inter-episode depressive symptoms (R(2) = 0.13). Interpersonal difficulties, but not alcohol dependence, appeared to play an important role in mediating these adverse effects. While only 8% of the sample met criteria for active PTSD, this comorbid disorder was associated with BD severity. CONCLUSIONS This study indicates that awareness of trauma is important in understanding individual differences in bipolar presentations. The theoretical and clinical implications of evidence that trauma is related to more adverse outcomes in BD are discussed. The finding that interpersonal difficulties mediate the relationship between trauma and BD severity is novel. The need for adjunctive evidence-based treatments targeting interpersonal difficulties is considered.
Collapse
|
49
|
Mainwaring PN, Shannon C. A phase II study of dose-dense chemotherapy (doxorubicin (A), cyclophosphamide (C), paclitaxel (T), gemcitabine (G)) supported by pegfilgrastim (P) and darbepoetin-alfa (D) for patients with high-risk early stage breast cancer (ICANDO). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11068 Background: The primary objective of this study was to estimate the proportion of chemotherapy dose delays in a dose- dense regimen consisting of A (60mg/m2), C (600 mg/m2) x 4 cycles q2 weeks followed by T (175 mg/m2) G (1g/m2) x 4 cycles q2w with pegfilgrastim (6 mg/m2 sc d2) and darbepoetin-alfa (2.25 microg/kg if Hb < 110g/L) as treatment for patients with high-risk early stage breast cancer. Dose delay was defined by the proportion of subjects experiencing delay = 7 days in any cycle. Entry criteria path stage IIA-IIIA breast adenocarcinoma; node positive patients > 6 axillary lymph nodes removed or sentinel LN biopsy positive for metastasis. Treatment commenced within 8 weeks. Secondary endpoints included proportion of delays by cycle, causes of delay by cycle, causes of dose reduction by cycle, as well as time to haematological engraftment. Patients underwent weekly FBC, electrolytes, LFTs, with a normal baseline echo assessment. Herceptin therapy was approved in Australia 1st October 2006 and was added to TG therapy for FISH/CISH/IHC 3+ positive patients. All patients completed FACT-F QOL forms. The half-width confidence interval to predict for delay based on the AC-T data is 0.17 for n = 20 patients. Results: Twenty (20) women; median age 50 (41–66) met the criteria for treatment. No patients had treatment delays ≥ 2 days for any reason. One (5%) patient underwent a blood transfusion for a rapid decline in haemoglobin (Hb) prior to darbepoetin therapy. One (5%) patient was admitted for uncontrolled vomiting. Seven (35%) patients received darbepoetin therapy without secondary Hb rise above 130 g/L. One (5%) patient had a 20% dose reduction in A dose due to mucositis. For nausea >G1 aprepitant therapy was added. There have been no dose modifications due to hepatic toxicity. Final cycle, QOL and pharmacogenomic data will be presented at the meeting. [Table: see text] No significant financial relationships to disclose.
Collapse
|
50
|
Biernaskie J, Sparling J, McKenzie I, Xie R, Liu J, Lam C, Wong A, Sutherland D, Choo A, Shannon C, Miller F, Tetzlaff W. [P41]: Skin‐derived precursors: A neural crest‐like precursor capable of remyelinating the injured spinal cord. Int J Dev Neurosci 2006. [DOI: 10.1016/j.ijdevneu.2006.09.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|