26
|
Said S, Thomas J, Montelione K, Fafaj A, Beffa L, Krpata D, Prabhu A, Rosen M, Petro C. Tanaka score predicts surgical intensive care admission following abdominal wall reconstruction. Hernia 2022; 26:873-880. [PMID: 35429304 DOI: 10.1007/s10029-022-02605-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE With the advancement of abdominal wall reconstruction, more complex hernia patients are undergoing repairs that may require a postoperative surgical intensive care unit (SICU) admission. The volume ratio (VR) of the hernia sac to the abdominal cavity is an easily applied method to quantify disease severity and the ensuing physiologic insult. This study aimed to predict postoperative SICU admission using VR and other preoperative variables. METHODS A single-center retrospective review was conducted for patients undergoing large abdominal hernias (width ≥ 18 cm) repaired from September 2014 to October 2019. Patient demographics, comorbidities, abdominal surgical history, and VR were analyzed through univariate and multivariable methods to identify predictors of SICU admission within the first two postoperative days. A predictive model was generated and validated. RESULTS Of 434 patients meeting inclusion criteria, 127(29%) required a SICU admission within the first two postoperative days. VR was significantly higher in SICU patients (Median 30.6% [IQR 14.4-59.0] vs. 10.6% [IQR 4.35-23.6], P < 0.001). Male sex, history of chronic obstructive pulmonary disease, prior component separation, recurrent incisional hernia, hernia grade 3, and VR showed higher odds of SICU admission. When validated on a testing dataset, these variables showed strong SICU admission predictions, with an area under the curve, sensitivity, and specificity of 0.82, 81.7% and 68.5%, respectively. CONCLUSIONS The volume ratio in combination with preoperatively available variables can reliably predict postoperative SICU admission following abdominal wall reconstruction. Anticipating such events preoperatively allows for bed space allocation as well as optimizing postoperative care.
Collapse
|
27
|
Chakrabarti S, Benrud R, Chau J, Hall W, Shreenivas A, Erickson B, Peterson C, Ridolfi T, Miller J, Banerjee A, Thomas J, Sharif S, Fei N, Ludwig K, Olshan P, Palsuledesai C, Malhotra M, Jurdi A, Aleshin A, Kasi P. P-39 Utility of circulating tumor DNA (ctDNA) to assess tumor response in patients with locally advanced rectal cancer undergoing neoadjuvant therapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
28
|
Hussain S, Breit KR, Thomas JD. The effects of prenatal nicotine and THC E-cigarette exposure on motor development in rats. Psychopharmacology (Berl) 2022; 239:1579-1591. [PMID: 35338387 DOI: 10.1007/s00213-022-06095-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/13/2022] [Indexed: 10/18/2022]
Abstract
RATIONALE In the USA, nicotine and cannabis are the most common licit and illicit drugs used among pregnant women. Importantly, nicotine and cannabis are now being combined for consumption via e-cigarettes, an increasingly popular delivery device. Both nicotine and tetrahydrocannabinol (THC), the primary psychoactive component of cannabis, cross the placenta barrier. However, the consequences of prenatal cannabis use are not well understood, and less is known about potential combination effects when consumed with nicotine, especially via e-cigarettes. OBJECTIVE The present study used a rodent model to examine how prenatal e-cigarette exposure to nicotine, THC, and the combination impacts motor development among offspring. METHODS Pregnant Sprague-Dawley rats were exposed to nicotine (36 mg/mL), THC (100 mg/mL), the combination, or vehicle via e-cigarette inhalation from gestational days (GD) 5-20. One sex pair per litter was tested on an early sensorimotor development task (postnatal days [PD] 12-20) and a parallel bar motor coordination task (PD 30-32). RESULTS Combined prenatal exposure to nicotine and THC delayed sensorimotor development, even though neither drug produced impairments on their own. In contrast, prenatal exposure to either nicotine or THC impaired motor coordination, whereas combined exposure exacerbated these effects, particularly among females. CONCLUSIONS These data illustrate that prenatal exposure to either nicotine or THC may alter motor development, and that the combination may produce more severe effects. These findings have important implications for pregnant women as we better understand the teratogenic effects of these drugs consumed via e-cigarettes.
Collapse
|
29
|
Rowe G, Gill G, Chikwe J, Thomas J, Peiris A, Roach A, Chen Q, Egorova N, Rampolla R, Emerson D, Megna D, Catarino P. Actual Size Mismatch in Lung Transplantation for Restrictive Lung Disease. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
30
|
Rowe G, Gill G, Chen Q, Zubair M, Roach A, Alhossan A, Peiris A, Thomas J, Emerson D, Kim R, Chikwe J. Repeat Pediatric Heart Transplantation in the United States: United Network for Organ Sharing Database Analysis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
31
|
Roach A, Chen Q, Egorova N, Thomas J, Peiris A, Alhossan A, Gill G, Rowe G, Emerson D, Megna D, Chikwe J, Catarino P. Survival Benefit of Lung Transplant in Septuagenarians: A United Network of Organ Sharing Database Analysis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
32
|
Pyarali F, Peiris A, Thomas J, Megna D, Catarino P, Rampolla R. Feeling the Burn: Esophageal PH and CLAD. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
33
|
Chen Q, Chan J, Roach A, Peiris A, Botting P, Rowe G, Gill G, Alhossan A, Thomas J, Megna D, Esmailian F, Catarino P, Chikwe J, Emerson D. Does Overnight Heart Transplantation Lead to Worse Outcomes? Results from a High Volume Transplant Center. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
34
|
Ali H, Thomas J, Guha A. Management of Pulmonary Hypertension Secondary to Valvular Heart Disease with Angiotensin-Receptor Neprilysin Inhibitor. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
35
|
Mercieca-Bebber R, Barnes EH, Wilson K, Samoon Z, Walpole E, Mai T, Ackland S, Burge M, Dickie G, Watson D, Leung J, Wang T, Bohmer R, Cameron D, Simes J, Gebski V, Smithers M, Thomas J, Zalcberg J, Barbour AP. Patient-reported outcome (PRO) results from the AGITG DOCTOR trial: a randomised phase 2 trial of tailored neoadjuvant therapy for resectable oesophageal adenocarcinoma. BMC Cancer 2022; 22:276. [PMID: 35291965 PMCID: PMC8922838 DOI: 10.1186/s12885-022-09270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background AGITG DOCTOR was a randomised phase 2 trial of pre-operative cisplatin, 5 fluorouracil (CF) followed by docetaxel (D) with or without radiotherapy (RT) based on poor early response to CF, detected via PET, for resectable oesophageal adenocarcinoma. This study describes PROs over 2 years. Methods Participants (N = 116) completed the EORTC QLQ-C30 and oesophageal module (QLQ-OES18) before chemotherapy (baseline), before surgery, six and 12 weeks post-surgery and three-monthly until 2 years. We plotted PROs over time and calculated the percentage of participants per treatment group whose post-surgery score was within 10 points (threshold for clinically relevant change) of their baseline score, for each PRO scale. We examined the relationship between Grade 3+ adverse events (AEs) and PROs. This analysis included four groups: CF responders, non-responders randomised to DCF, non-responders randomised to DCF + RT, and “others” who were not randomised. Results Global QOL was clinically similar between groups from 6 weeks post-surgery. All groups had poorer functional and higher symptom scores during active treatment and shortly after surgery, particularly the DCF and DCF + RT groups. DCF + RT reported a clinically significant difference (−13points) in mean overall health/QOL between baseline and pre-surgery. Similar proportions of patients across groups scored +/− 10 points of baseline scores within 2 years for most PRO domains. Instance of grade 3+ AEs were not related to PROs at baseline or 2 years. Conclusions By 2 years, similar proportions of patients scored within 10 points of baseline for most PRO domains, with the exception of pain and insomnia for the DCF + RT group. Non-responders randomised to DCF or DCF + RT experienced additional short-term burden compared to CF responders, reflecting the longer duration of neoadjuvant treatment and additional toxicity. This should be weighed against clinical benefits reported in AGITG DOCTOR. This data will inform communication of the trajectory of treatment options for early CF non-responders. Trial registration Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN12609000665235. Registered 31 July 2009. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09270-4.
Collapse
|
36
|
Thomas J, Bertram C, Daru J, Patwari J, Langguth I, Zhou P, Marx D, Morgenstern K, Bovensiepen U. Competition between Coulomb and van der Waals Interactions in Xe-Cs^{+} Aggregates on Cu(111) Surfaces. PHYSICAL REVIEW LETTERS 2021; 127:266802. [PMID: 35029471 DOI: 10.1103/physrevlett.127.266802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/07/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
Microscopic insight into interactions is a key for understanding the properties of heterogenous interfaces. We analyze local attraction in noncovalently bonded Xe-Cs^{+} aggregates and monolayers on Cu(111) as well as repulsion upon electron transfer. Using two-photon photoemission spectroscopy, scanning tunneling microscopy, and coupled cluster calculations combined with an image-charge model, we explain the intricate impact Xe has on Cs^{+}/Cu(111). We find that attraction between Cs^{+} and Xe counterbalances the screened Coulomb repulsion between Cs^{+} ions on Cu(111). Furthermore, we observe that the Cs 6s electron is repelled from Cu(111) due to xenon's electron density. Together, this yields a dual, i.e., attractive or repulsive, response of Xe depending on the positive or negative charge of the respective counterparticle, which emphasizes the importance of the Coulomb interaction in these systems.
Collapse
|
37
|
Duez L, Défossez F, Maymo SR, Ballarin A, Thomas J, Odent M, Szalai A, Aglave R, Preiser JC, Arvanitakis M. Risk stratification, prevention and occurrence of refeeding syndrome in adults using a computer-based tool: a prospective cohort study. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
38
|
Thomas J, Martin L, Muir G. Getting to grips with grip strength: A scoping review of patients mapped against sarcopenia consensus cut points. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
39
|
Acero MA, Adamson P, Aliaga L, Anfimov N, Antoshkin A, Arrieta-Diaz E, Asquith L, Aurisano A, Back A, Backhouse C, Baird M, Balashov N, Baldi P, Bambah BA, Bashar S, Bays K, Bernstein R, Bhatnagar V, Bhuyan B, Bian J, Blair J, Booth AC, Bowles R, Bromberg C, Buchanan N, Butkevich A, Calvez S, Carroll TJ, Catano-Mur E, Choudhary BC, Christensen A, Coan TE, Colo M, Cremonesi L, Davies GS, Derwent PF, Ding P, Djurcic Z, Dolce M, Doyle D, Dueñas Tonguino D, Dukes EC, Duyang H, Edayath S, Ehrlich R, Elkins M, Ewart E, Feldman GJ, Filip P, Franc J, Frank MJ, Gallagher HR, Gandrajula R, Gao F, Giri A, Gomes RA, Goodman MC, Grichine V, Groh M, Group R, Guo B, Habig A, Hakl F, Hall A, Hartnell J, Hatcher R, Hausner H, Heller K, Hewes J, Himmel A, Holin A, Huang J, Jargowsky B, Jarosz J, Jediny F, Johnson C, Judah M, Kakorin I, Kalra D, Kalitkina A, Kaplan DM, Keloth R, Klimov O, Koerner LW, Kolupaeva L, Kotelnikov S, Kralik R, Kullenberg C, Kubu M, Kumar A, Kuruppu CD, Kus V, Lackey T, Lasorak P, Lang K, Lesmeister J, Lin S, Lister A, Liu J, Lokajicek M, Magill S, Manrique Plata M, Mann WA, Marshak ML, Martinez-Casales M, Matveev V, Mayes B, Méndez DP, Messier MD, Meyer H, Miao T, Miller WH, Mishra SR, Mislivec A, Mohanta R, Moren A, Morozova A, Mu W, Mualem L, Muether M, Mulder K, Naples D, Nayak N, Nelson JK, Nichol R, Niner E, Norman A, Norrick A, Nosek T, Oh H, Olshevskiy A, Olson T, Ott J, Paley J, Patterson RB, Pawloski G, Petrova O, Petti R, Phan DD, Plunkett RK, Porter JCC, Rafique A, Raj V, Rajaoalisoa M, Ramson B, Rebel B, Rojas P, Ryabov V, Samoylov O, Sanchez MC, Sánchez Falero S, Shanahan P, Sheshukov A, Singh P, Singh V, Smith E, Smolik J, Snopok P, Solomey N, Sousa A, Soustruznik K, Strait M, Suter L, Sutton A, Swain S, Sweeney C, Tapia Oregui B, Tas P, Thakore T, Thayyullathil RB, Thomas J, Tiras E, Tripathi J, Trokan-Tenorio J, Tsaris A, Torun Y, Urheim J, Vahle P, Vallari Z, Vasel J, Vokac P, Vrba T, Wallbank M, Warburton TK, Wetstein M, Whittington D, Wickremasinghe DA, Wojcicki SG, Wolcott J, Wu W, Xiao Y, Yallappa Dombara A, Yonehara K, Yu S, Yu Y, Zadorozhnyy S, Zalesak J, Zhang Y, Zwaska R. Search for Active-Sterile Antineutrino Mixing Using Neutral-Current Interactions with the NOvA Experiment. PHYSICAL REVIEW LETTERS 2021; 127:201801. [PMID: 34860065 DOI: 10.1103/physrevlett.127.201801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/30/2021] [Indexed: 06/13/2023]
Abstract
This Letter reports results from the first long-baseline search for sterile antineutrinos mixing in an accelerator-based antineutrino-dominated beam. The rate of neutral-current interactions in the two NOvA detectors, at distances of 1 and 810 km from the beam source, is analyzed using an exposure of 12.51×10^{20} protons-on-target from the NuMI beam at Fermilab running in antineutrino mode. A total of 121 of neutral-current candidates are observed at the far detector, compared to a prediction of 122±11(stat.)±15(syst.) assuming mixing only between three active flavors. No evidence for ν[over ¯]_{μ}→ν[over ¯]_{s} oscillation is observed. Interpreting this result within a 3+1 model, constraints are placed on the mixing angles θ_{24}<25° and θ_{34}<32° at the 90% C.L. for 0.05 eV^{2}≤Δm_{41}^{2}≤0.5 eV^{2}, the range of mass splittings that produces no significant oscillations at the near detector. These are the first 3+1 confidence limits set using long-baseline accelerator antineutrinos.
Collapse
|
40
|
Nussbaumer-Streit B, Ellen M, Klerings I, Sfetcu R, Riva N, Mahmić-Kaknjo M, Poulentzas G, Martinez P, Baladia E, Ziganshina LE, Marqués ME, Aguilar L, Kassianos AP, Frampton G, Silva AG, Affengruber L, Spjker R, Thomas J, Berg RC, Kontogiani M, Sousa M, Kontogiorgis C, Gartlehner G. Resource use during systematic review production varies widely: a scoping review. J Clin Epidemiol 2021; 139:287-296. [PMID: 34091021 DOI: 10.1016/j.jclinepi.2021.05.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We aimed to map the resource use during systematic review (SR) production and reasons why steps of the SR production are resource intensive to discover where the largest gain in improving efficiency might be possible. STUDY DESIGN AND SETTING We conducted a scoping review. An information specialist searched multiple databases (e.g., Ovid MEDLINE, Scopus) and implemented citation-based and grey literature searching. We employed dual and independent screenings of records at the title/abstract and full-text levels and data extraction. RESULTS We included 34 studies. Thirty-two reported on the resource use-mostly time; four described reasons why steps of the review process are resource intensive. Study selection, data extraction, and critical appraisal seem to be very resource intensive, while protocol development, literature search, or study retrieval take less time. Project management and administration required a large proportion of SR production time. Lack of experience, domain knowledge, use of collaborative and SR-tailored software, and good communication and management can be reasons why SR steps are resource intensive. CONCLUSION Resource use during SR production varies widely. Areas with the largest resource use are administration and project management, study selection, data extraction, and critical appraisal of studies.
Collapse
|
41
|
Wilson J, Carson G, Fitzgerald S, Llewelyn MJ, Jenkins D, Parker S, Boies A, Thomas J, Sutcliffe K, Sowden AJ, O'Mara-Eves A, Stansfield C, Harriss E, Reilly J. Are medical procedures that induce coughing or involve respiratory suctioning associated with increased generation of aerosols and risk of SARS-CoV-2 infection? A rapid systematic review. J Hosp Infect 2021; 116:37-46. [PMID: 34245806 PMCID: PMC8264274 DOI: 10.1016/j.jhin.2021.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The risk of transmission of SARS-CoV-2 from aerosols generated by medical procedures is a cause for concern. AIM To evaluate the evidence for aerosol production and transmission of respiratory infection associated with procedures that involve airway suctioning or induce coughing/sneezing. METHODS The review was informed by PRISMA guidelines. Searches were conducted in PubMed for studies published between January 1st, 2003 and October 6th, 2020. Included studies examined whether nasogastric tube insertion, lung function tests, nasendoscopy, dysphagia assessment, or suctioning for airway clearance result in aerosol generation or transmission of SARS-CoV-2, SARS-CoV, MERS, or influenza. Risk of bias assessment focused on robustness of measurement, control for confounding, and applicability to clinical practice. FINDINGS Eighteen primary studies and two systematic reviews were included. Three epidemiological studies found no association between nasogastric tube insertion and acquisition of respiratory infections. One simulation study found low/very low production of aerosols associated with pulmonary lung function tests. Seven simulation studies of endoscopic sinus surgery suggested significant increases in aerosols but findings were inconsistent; two clinical studies found airborne particles associated with the use of microdebriders/drills. Some simulation studies did not use robust measures to detect particles and are difficult to equate to clinical conditions. CONCLUSION There was an absence of evidence to suggest that the procedures included in the review were associated with an increased risk of transmission of respiratory infection. In order to better target precautions to mitigate risk, more research is required to determine the characteristics of medical procedures and patients that increase the risk of transmission of SARS-CoV-2.
Collapse
|
42
|
Ludford K, Raghav K, Murphy MB, Fleming N, Nelson D, Lee M, Smaglo B, You Y, Tillman M, Kamiya-Matsuoka C, Thirumurthi S, Messick C, Johnson B, Vilar E, Thomas J, Foo W, Qiao W, Kopetz S, Overman M. 1758O Neoadjuvant pembrolizumab in localized/locally advanced solid tumors with mismatch repair deficiency. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1703] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
43
|
Gouda M, Overman M, Huang H, Thomas J, Dasari N, Meric-Bernstam F, Kopetz S, Janku F. 91P Liquid biopsy for detection of minimal residual disease after liver metastasectomy in stage IV colorectal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
44
|
Thomas J, Kochamparambil BP, Menon S. Dialysis-related amyloidosis. QJM 2021; 114:335. [PMID: 32814965 DOI: 10.1093/qjmed/hcaa251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
45
|
Montazeri K, Dranitsaris G, Thomas JD, Curran C, Preston MA, Steele GS, Kilbridge KL, Mantia C, Ravi P, McGregor BA, Mossanen M, Sonpavde G. An economic analysis comparing health care resource use and cost of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin versus gemcitabine and cisplatin as neoadjuvant therapy for muscle invasive bladder cancer. Urol Oncol 2021; 39:834.e1-834.e7. [PMID: 34162500 DOI: 10.1016/j.urolonc.2021.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/11/2021] [Accepted: 04/23/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE To compare healthcare resource utilization (HRU) and costs associated with dose-dense methotrexate, vinblastine, doxorubicin, cisplatin (ddMVAC) and gemcitabine, cisplatin (GC) as neoadjuvant chemotherapy for muscle-invasive bladder cancer (MIBC). METHODS Patient treated at Dana-Farber Cancer Institute from 2010 to 2019 were identified. HRU data on chemotherapy administered, supportive medications, patient monitoring, clinic, infusion, emergency department (ED) visits and hospitalization were collected retrospectively. Unit costs for HRU components were obtained from the Centers for Medicare and Medicaid Website and HRU was compared between groups using quantile regression analysis. RESULTS 137 patients were included; 51 received ddMVAC and 86 GC. Baseline characteristics were similar, except lower mean age (P < 0.001) and higher proportion of ECOG-PS = 0 (P < 0.001) for ddMVAC. ddMVAC required more granulocyte-colony stimulating factor support (P < 0.001), central line placement (P = 0.017), cardiac imaging (P < 0.001), and infusion visits (P < 0.001), whereas GC required more clinic visits. ED visits were higher for ddMVAC (P = 0.048), while chemotherapy cycle delays and hospitalization days were higher for GC (P = 0.008). After adjusting for ECOG-PS and age, the cost per patient was approximately 41% lower (95%CI: 28% to 52%; P < 0.001) for GC vs. ddMVAC, which translated to a median adjusted cost savings of $7,410 (95%CI: $5,474-$9,347) per patient. CONCLUSIONS Although excess HRU did not clearly favor one regimen, adjusting for PS and age indicated lower costs with GC vs. ddMVAC. Given the similar cumulative cisplatin delivery with both regimens, the associated values and costs supports the preferential selection of GC in the neoadjuvant setting of MIBC.
Collapse
|
46
|
Bhamidipati D, Colina A, Hwang H, Wang H, Katz M, Fournier K, Serpas V, Thomas J, Sun R, Wolff RA, Raghav K, Overman MJ. Metastatic small bowel adenocarcinoma: role of metastasectomy and systemic chemotherapy. ESMO Open 2021; 6:100132. [PMID: 33940348 PMCID: PMC8111574 DOI: 10.1016/j.esmoop.2021.100132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/03/2021] [Accepted: 04/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background Metastatic small bowel adenocarcinoma (SBA) has a poor prognosis. Due to its rarity, high-quality data are lacking to guide treatment. This retrospective analysis was conducted to help characterize the treatment options for patients with metastatic SBA while providing clinically meaningful prognostic information. Patients and methods In total, 437 patients who initially presented with or developed metastatic SBA between September 1977 and September 2019 were identified from the MD Anderson Tumor Registry. Clinical data were collected from review of the medical record. Overall response rates (ORR), time to progression (TTP), and overall survival (OS) were assessed across various treatments and treatment lines. Results The median OS from diagnosis of metastatic disease was 15.9 months [95% confidence interval (CI): 14.3-17.9]. Seventy-five patients (17.1%) underwent metastasectomy, which was associated with a median OS of 34.5 versus 17.1 months among patients who received chemotherapy alone (P < 0.001). Fluoropyrimidine plus platinum (n = 164) was the most common first-line chemotherapy, associated with an ORR of 59% and TTP of 8.1 months. Irinotecan with 5-FU (n = 101) was the most common second-line therapy associated with an ORR of 31% and TTP of 4.0 months. Twenty-two patients received immunotherapy; 5 of 6 patients with deficient mismatch repair (dMMR) responded, while 0 of 16 with proficient mismatch repair (pMMR) responded. Taxane-based chemotherapy was given to 34 patients with an ORR of 21% and a median TTP of 2.4 months. Among 11 patients who received anti-epidermal-growth-factor-receptor (EGFR) monotherapy, the best response was stable disease (SD) in 1 patient. Conclusions In well-selected patients with SBA, metastasectomy appears to be associated with improved OS. This improvement was seen across metastasectomy sites, including liver, lung and peritoneal. Anti-programmed cell death protein 1 (PD-1) based immunotherapy was active for dMMR SBA but not pMMR SBA. While taxane-based chemotherapy demonstrates therapeutic activity, the activity of anti-EGFR therapy was limited. Metastasectomy for well-selected metastatic SBA patients was associated with improved OS. Anti-PD1-based immunotherapy was active for dMMR SBA but not pMMR SBA. Taxane-based chemotherapy demonstrated clinical activity in refractory SBA. Anti-EGFR therapy demonstrated minimal activity in SBA.
Collapse
|
47
|
Horne CM, Augenstein V, Malcher F, Yunis J, Huang LC, Zolin SJ, Fafaj A, Thomas JD, Krpata DM, Petro CC, Rosen MJ, Prabhu AS. Understanding the benefits of botulinum toxin A: retrospective analysis of the Abdominal Core Health Quality Collaborative. Br J Surg 2021; 108:112-114. [PMID: 33711107 DOI: 10.1093/bjs/znaa050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 11/12/2022]
Abstract
This was a retrospective analysis of a prospectively maintained database that objectively evaluated the benefit of preoperative chemical component separation with botulinum toxin A in complex hernia repairs.
Continued evaluation.
Collapse
|
48
|
Unlu S, Mirea O, Bezy S, Duchenne J, Pagourelias ED, Bogaert J, Thomas JD, Badano LP, Voigt JU. Vendor-independent software shows limited variability in speckle tracking strain measurements on images of different vendors. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Vendors use proprietary speckle tracking software algorithms for echocardiographic strain measurements, which results in high inter-vendor variability. Little is known about potential advantages or disadvantages of using vendor-independent software in clinical practice.
Purpose
We therefore investigated the reproducibility, accuracy, and ability to identify scar of strain measurements on images from different vendors by using a vendor-independent software.
Methods
A vendor-independent software (TomTec Image Arena) was used to analyze datasets of 63 patients which were obtained on four ultrasound machines from different vendors (GE, Philips, Siemens, Toshiba). We measured the tracking feasibility, inter-vendor bias, the relative and absolute test-re-test variability of strain measurements and their ability to detect scar. Cardiac magnetic resonance delayed enhancement images were used as the reference standard of scar definition.
Results
Tracking feasibility differed depending on the image source (p < 0.05). Variability of global longitudinal strain (GLS) (Figure 1A) was similar (ANOVA p = 0.124) among the images of different vendors whereas variability of segmental longitudinal strain (SLS) (Figure 1B) showed modest difference (ANOVA- peak systolic strain (PS); p = 0.077, end-systolic strain (ES); p = 0.171, post-systolic strain (PSS); p = 0.020). Relative test-re-test variability of GLS showed no differences (ANOVA p = 0.360). Absolute test-re-test errors of SLS measurements showed modest differences among images of different vendors (ANOVA- PS; p = 0.018, ES; p = 0.001, PSS; p = 0.090). No relevant difference in scar detection capability was observed (Figure 1C).
Conclusions
Vendor independent software leads to low bias among strain measurements on images from different vendors. Likewise, measurement variability and the ability to identify scar becomes similar. Our findings suggest that a vendor independent speckle tracking software could help to overcome inter-vendor bias. To which extend such measurements would be more accurate compared to vendor specific software remains to be determined.
Abstract Figure 1
Collapse
|
49
|
Goriaev A, Wauters T, Möller S, Brakel R, Brezinsek S, Buermans J, Crombé K, Dinklage A, Habrichs R, Höschen D, Krause M, Kovtun Y, López-Rodríguez D, Louche F, Moon S, Nicolai D, Thomas J, Ragona R, Rubel M, Rüttgers T, Petersson P, Brunsell P, Linsmeier C, Van Schoor M. The upgraded TOMAS device: A toroidal plasma facility for wall conditioning, plasma production, and plasma-surface interaction studies. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2021; 92:023506. [PMID: 33648119 DOI: 10.1063/5.0033229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
The Toroidal Magnetized System device has been significantly upgraded to enable development of various wall conditioning techniques, including methods based on ion and electron cyclotron (IC/EC) range of frequency plasmas, and to complement plasma-wall interaction research in tokamaks and stellarators. The toroidal magnetic field generated by 16 coils can reach its maximum of 125 mT on the toroidal axis. The EC system is operated at 2.45 GHz with up to 6 kW forward power. The IC system can couple up to 6 kW in the frequency range of 10 MHz-50 MHz. The direct current glow discharge system is based on a graphite anode with a maximum voltage of 1.5 kV and a current of 6 A. A load-lock system with a vertical manipulator allows exposure of material samples. A number of diagnostics have been installed: single- and triple-pin Langmuir probes for radial plasma profiles, a time-of-flight neutral particle analyzer capable of detecting neutrals in the energy range of 10 eV-1000 eV, and a quadrupole mass spectrometer and video systems for plasma imaging. The majority of systems and diagnostics are controlled by the Siemens SIMATIC S7 system, which also provides safety interlocks.
Collapse
|
50
|
Hoyois A, Ballarin A, Thomas J, Lheureux O, Preiser JC, Bogerd SP, Taton O, Leduc D, Farine S, Van Ouytsel P, Arvanitakis M. Nutritional evaluation and management in patients with Covid-19 following hospitalization in intensive care units. Clin Nutr ESPEN 2020. [PMCID: PMC7832268 DOI: 10.1016/j.clnesp.2020.09.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
|