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Wang HM, Zhao HH, Zhao CZ, Chu D. EST-SSR markers from Heterodera glycines Ichinohe. GENETIKA 2014; 50:1259-1262. [PMID: 25720259 DOI: 10.7868/s0016675814100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The soybean cyst nematode Heterodera glycines Ichinohe is a severe agricultural pest for which genetic resources are limited. In this study, 295 simple sequence repeats (SSRs) were identified from 259 expressed sequenced tags (ESTs), Which were selected from 9,443 unigenes. The successful primer pairs were designed against six regions. In total, 30 alleles were identified from 30 individuals using the six markers, with an average of five alleles per locus (range, 4-7). The observed and expected heterozygosities were 0.074-0.900 and 0.266-0.775, respectively. Significant departure from Hardy-Weinberg equilibrium was found at three of the six loci. The EST-based SSR markers developed in this study may contribute to better understanding of the genetic structure of H. glycines populations.
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Lattanzi R, Petchprapa C, Ascani D, Babb JS, Chu D, Davidovitch RI, Youm T, Meislin RJ, Recht MP. Detection of cartilage damage in femoroacetabular impingement with standardized dGEMRIC at 3 T. Osteoarthritis Cartilage 2014; 22:447-56. [PMID: 24418673 DOI: 10.1016/j.joca.2013.12.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 12/10/2013] [Accepted: 12/21/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed at identifying the optimal threshold value to detect cartilage lesions with Standardized delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) at 3 T and evaluate intra- and inter-observer repeatability. DESIGN We retrospectively reviewed 20 hips in 20 patients. dGEMRIC maps were acquired at 3 T along radial imaging planes of the hip and standardized to remove the effects of patient's age, sex and diffusion of gadolinium contrast. Two observers separately evaluated 84 Standardized dGEMRIC maps, both by visual inspection and using an average index for a region of interest (ROI) in the acetabular cartilage. A radiologist evaluated the acetabular cartilage on morphologic MR images at exactly the same locations. Using intra-operative findings as reference, the optimal threshold to detect cartilage lesions with Standardized dGEMRIC was assessed and results were compared with the diagnostic performance of morphologic magnetic resonance imaging (MRI). RESULTS Using z < -2 as threshold and visual inspection of the color-adjusted maps, sensitivity, specificity and accuracy for Observer 1 and Observer 2, were 83%, 60% and 75%, and 69%, 70% and 69%, respectively. Overall performance was 52%, 67% and 58%, when using an average z for the acetabular cartilage, compared to 37%, 90% and 56% for morphologic assessment. The kappa coefficient was 0.76 and 0.68 for intra- and inter-observer repeatability, respectively, indicating substantial agreement. CONCLUSIONS Standardized dGEMRIC at 3 T is accurate in detecting cartilage damage and could improve preoperative assessment in femoroacetabular impingement (FAI). As cartilage lesions in FAI are localized, visual inspection of the Standardized dGEMRIC maps is more accurate than an average z for the acetabular cartilage.
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Chu D, Mohammed-Ali Z, Walker T, Goncharova S, Llop-Guevara A, Barra N, Gillgrass A, Ashkar A, Bramson J, Humbles A, Kolbeck R, Waserman S, Jordana M. Initiation of food allergy by a CD4+ T cell-intrinsic IL-4 program, controlled by OX40L (P6204). THE JOURNAL OF IMMUNOLOGY 2013. [DOI: 10.4049/jimmunol.190.supp.62.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Intestinal Th2 immunity in food allergy results in the production of IgG1 and IgE, and upon antigen challenge, anaphylaxis and eosinophilic inflammation. Although allergic sensitization critically requires IL-4 to develop, the source and control of IL-4 during the initiation of Th2 immunity remains unclear. Non-intestinal and non-food allergy systems have suggested a role for innate lymphocytes such as NKT or γδ T cells as a rapid source of IL-4 required to induce Th2 polarization. In contrast, we show here that NKT-deficient IL-15 KO, β2m KO and anti-NK1.1 treated mice have completely intact Th2 food allergic responses comparable to NKT-sufficient mice, including antigen-specific IgG1 and IgE, anaphylaxis, eosinophilic inflammation and cytokine production. Likewise, γδ T cell-deficient TCRδ KO mice mount comparable Th2 immune responses to oral antigen as their WT counterparts. By restricting IL-4 expression to only CD4+ Th cells, we find that IL-4 from CD4+ Th cells themselves induce food allergy. Further, IL-4 reporter mice show that CD4+ Th cell production of IL-4 in vivo is dependent on OX40L, a costimulatory molecule that we have shown to be highly expressed on allergen-exposed dendritic cells (DCs). Although NKT and γδ T cells express IL-4, this is not upregulated after allergen priming. Together, these data show that intestinal Th2 immunity in food allergy is initiated by a CD4+ Th cell-intrinsic IL-4 program that is controlled by DC-OX40L and not NKT or γδ T cells.
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Chu D, Mulukutla S, Smith C, Schmidhofer M, Marroquin O, Lee J, Bakaeen F, Anaya D, Morell V, Wei L, Badhwar V. Feasibility of Implementing a Multidisciplinary Heart Team: A Pilot Study. J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bakaeen F, Chu D, Kelly R, Holman W, Jessen M, Ward H. Perioperative Outcomes After On-pump Versus Off-pump Coronary Artery Bypass Grafting: A Propensity-Matching Analysis. J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chu D, Chamorro S, Arrieta F, Cobo ME, Calañas A, Botella JI, Balsa J, Zamarrón I, Vázquez C. [Percutaneous gastrostomy complicated with abdominal wall hematoma; severe anemia secondary to percutaneous endoscopic gastrostomy]. NUTR HOSP 2012; 27:1361-3. [PMID: 23165587 DOI: 10.3305/nh.2012.27.4.5828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Accepted: 03/02/2012] [Indexed: 12/01/2022] Open
Abstract
Endoscopic percutaneous gastrostomy (PEG) is a safe and effective procedure that offers clear advantages over nasogastric tube feeding to ensure adequate nutrition in patients with swallowing problems who have an intact digestive tract. With proper placement and monitoring methodology there are few complications in both the peritrack procedure as in the long run. However, despite being considered a safe technique it is not devoided of serious complications. We report a patient with dysphagia, requiring percutaneous endoscopic gastrostomy placement developing a severe anemia with severe subcutaneous hematoma, given the exceptional case and literature review.
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Yechoor P, Blaustein A, Bakaeen F, Cornwell L, Coselli J, LeMaire S, Chu D. The Natural History of Moderate Aortic Stenosis in a Veteran Population. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gopaldas R, Chu D, Dao T. Staged Versus Synchronous Carotid Endarterectomy and Coronary Artery Bypass Grafting: Analysis of 10-Year Nationwide Outcomes. J Vasc Surg 2011. [DOI: 10.1016/j.jvs.2011.10.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Chu D, Zabet N, von der Haar T. A novel and versatile computational tool to model translation. Bioinformatics 2011; 28:292-3. [DOI: 10.1093/bioinformatics/btr650] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Chu D, Zhang Z, Li Y, Ji G. Reply to Notch1 and Notch2 have opposite prognostic effects on patients with colorectal cancer. Ann Oncol 2011; 22:2534. [PMID: 32599683 DOI: 10.1093/annonc/mdr310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chu D, Gao CS, De Barro P, Wan FH, Zhang YJ. Investigation of the genetic diversity of an invasive whitefly (Bemisia tabaci) in China using both mitochondrial and nuclear DNA markers. BULLETIN OF ENTOMOLOGICAL RESEARCH 2011; 101:467-475. [PMID: 21320364 DOI: 10.1017/s0007485311000022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
It is often considered that reduced genetic variation due to bottlenecks and founder effects limits the capacity for species to establish in new environments and subsequently spread. The recent invasion (during the past five years) of an alien whitefly, one member of Bemisia tabaci cryptic species complex, referred to as Mediterranean (herein referred to as Q-type) in Shandong Province, China, provides an ideal opportunity to study the changes in genetic variation between its home range in the Mediterranean region and its invasion range. Using both the mitochondrial cytochrome oxidase I (mtCOI) and nuclear (microsatellite) DNA, we show that Q in Shandong likely originated in the western Mediterranean. We also found that the haplotype diversity was low compared with its presumed geographic origin, whereas microsatellite allele diversity showed no such decline. A key factor in invasions is the establishment of females and so bottleneck and founder events can lead to a very rapid and considerable loss of mitochondrial diversity. The lack of haplotype diversity in Shandong supports the interpretation that, at one or more points between the western Mediterranean and China, the invading Q lost haplotype diversity, most probably through the serial process of establishment and redistribution through trade in ornamental plants. However, the loss in haplotype diversity does not necessarily mean that nuclear allelic diversity should also decline. Provided females can mate freely with whichever males are available, allelic diversity can be maintained or even increased relative to the origin of the invader. Our findings may offer some explanation to the apparent paradox between the concept of reduced genetic variation limiting adaptation to new environments and the observed low diversity in successful invaders.
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Chu D, Gao CS, De Barro P, Zhang YJ, Wan FH, Khan IA. Further insights into the strange role of bacterial endosymbionts in whitefly, Bemisia tabaci: comparison of secondary symbionts from biotypes B and Q in China. BULLETIN OF ENTOMOLOGICAL RESEARCH 2011; 101:477-486. [PMID: 21329550 DOI: 10.1017/s0007485311000083] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The percentage infection of secondary symbionts (SS) (Wolbachia, Arsenophonus, Rickettsia, Hamiltonella, Fritschea and Cardinium) in the exotic Bemisia tabaci (Genn.) invaders, commonly known as biotypes B and Q from China, were determined by PCR. In total, 373 biotype B and 1830 biotype Q individuals were screened for the presence of SS. Biotype B was more abundant than biotype Q from 2005 to 2006, and biotype Q was more abundant from 2007 to 2009. Each of the SS, with the exception of Fritschea, was detected in both biotypes B and Q; Fritschea was found in none of the samples examined. For biotype B, the percentage infection of Hamiltonella was the highest (92.0%) followed by Rickettsia (70.2%). For biotype Q, the percentage infection of Hamiltonella was again the highest (73.3%). Arsenophonus was the least common of the SS observed in both biotypes B and Q. The percentage infection of Wolbachia, Rickettsia and Hamiltonella in biotype B was each significantly higher than in biotype Q, whereas the percentage infection of Cardinium in biotype B was significantly lower than in biotype Q. The percentage infection of SS in biotypes B and Q varied from year to year over the period 2005-2009. Furthermore, within biotype Q, two distinct subgroups were identified which differ from each other in terms of their SS complement. We discuss these results in the light of the potentially influential factors and roles of the SS.
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Chu D, Zhang Z, Zhou Y, Wang W, Li Y, Zhang H, Dong G, Zhao Q, Ji G. Notch1 and Notch2 have opposite prognostic effects on patients with colorectal cancer. Ann Oncol 2011; 22:2440-2447. [PMID: 21378202 DOI: 10.1093/annonc/mdq776] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Aberrantly activated Notch signaling has been shown to play a key role in carcinogenesis and progression of various human malignancies. In this study, we investigated the expression of Notch1 and Notch2 in colorectal cancer to determine whether they could serve as prognostic predictors. PATIENTS AND METHODS The protein expression of Notch1 and Notch2 was examined by immunohistochemistry in 1003 clinical colorectal cancer specimens. Notch1 and Notch2 protein levels were investigated by immunohistochemistry. Statistical analysis was carried out to assess their prognostic value. RESULTS Significantly negative correlation between Notch1 and Notch2 was found in colorectal cancer (P < 0.001). Notch1 and Notch2 were proved to be inversely correlated with tumor differentiation, depth of invasion, lymph node metastases, distant metastasis, TNM (tumor-node-metastasis) stage and survival of patients, suggesting opposite function of the two receptors. Notch1 and Notch2 were proved to be adverse independent prognostic predictors (P < 0.001). Moreover, a synergistic effect of positive Notch1 and negative Notch2 coexpression on predicting poor overall survival was proved. CONCLUSIONS Notch1 and Notch2 may be independent adverse prognostic predictors for patients with colorectal cancer. These results would contribute to identify more efficient prognostic predictors and therapeutic targets.
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Kosaka H, Gainsbury M, Chu D, Stucchi A, Becker J. KC and MIP-2 are Associated with Intraabdominal Adhesion Formation in a Mouse Model. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bakaeen F, Stephens E, Chu D, Coselli J, Holman W, Vaporciyan A, Cmolik B, Merril W, Grover F. The Value Of Veterans Affairs Hospitals In Cardiothoracic Surgical Training. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.281] [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]
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Liao J, Bakaeen F, Cornwell L, Dao T, Coselli J, LeMaire S, Huh J, Chu D. Early Outcomes Of Primary Transverse Sternal Plate Reinforcement For Morbidly Obese Patients After Cardiac Surgery. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.292] [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]
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Bakaeen F, Chu D, Misselbeck T, Huh J, LeMaire S, Sansgiry S, Coselli J. Mortality After High Risk Coronary Artery Bypass Surgery: Predictions Made By Surgeons Vs. Risk Model in A Veteran Population. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.876] [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]
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Gopaldas R, Bakaeen F, Dao T, Coselli J, LeMaire S, Huh J, Chu D. Ten-year Nationwide Trends In Off-pump Coronary Artery Bypass Grafting: Do Hospital Characteristics Influence Its Adoption? J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.618] [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]
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69
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Chu D, Wu G, Han B, Song X, Chen G, Zhou C, Wang Q, Wu S, Wang Y, Zi-Ping W. Docetaxel plus cisplatin versus vinorelbine plus cisplatin as adjuvant chemotherapy in stage IB-IIIA non-small cell lung cancer: Preliminary result of phase II pilot trial CHL001/TAX622. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ranpura V, Pulipati B, Chu D, Zhu X, Wu S. Increased risk of high-grade hypertension with bevacizumab in cancer patients: a meta-analysis. Am J Hypertens 2010; 23:460-8. [PMID: 20186127 DOI: 10.1038/ajh.2010.25] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hypertension is associated with the use of bevacizumab, an angiogenesis inhibitor widely used in cancer therapy. Currently, the risk of severe hypertension associated with bevacizumab is unclear. We performed a systematic review and meta-analysis of published randomized-controlled clinical trials (RCTs) to assess the risk of high-grade hypertension in cancer patients treated with bevacizumab. METHODS Databases from PUBMED, the Web of Science, and abstracts presented at the American Society of Clinical Oncology conferences until May 2009 were searched to identify relevant studies. Eligible studies included prospective RCTs in which bevacizumab was directly compared with controls in cancer patients receiving concurrent antineoplastic therapy. Summary incidence, relative risk (RR), and 95% confidence interval (CI) were calculated employing a fixed- or random-effects model based upon the heterogeneity of the included studies. RESULTS A total of 12,656 patients with a variety of tumors from 20 studies were included for the analysis. The incidence of all-grade hypertension in patients receiving bevacizumab was 23.6% (95% CI: 20.5-27.1) with 7.9% (95% CI: 6.1-10.2) being high-grade (grade 3 or 4). Patients treated with bevacizumab had a significantly increased risk of developing high-grade hypertension with an RR of 5.28 (95% CI: 4.15-6.71, P < 0.001) in comparison with controls. Even though not statistically significant, there was a trend suggesting that bevacizumab may increase the risk of hypertensive crisis (grade 4) with an RR of 3.16 (95% CI: 0.91-10.90). The increased risk of high-grade hypertension was observed in patients receiving bevacizumab at 2.5 mg/kg/week (RR = 4.78, 95% CI: 3.59-6.36) as well as 5 mg/kg/week (RR = 5.39, 95% CI: 3.68-7.90). The risk of high-grade hypertension may vary with tumor types, with RRs ranging from 2.49 (95% CI: 0.94-6.59) in patients with mesothelioma to 14.80 (95% CI: 0.92-238.51) in patients with breast cancer. CONCLUSION Bevacizumab may significantly increase the risk of high-grade hypertension in cancer patients. Close monitoring and adequate management are highly recommended to decrease cardiovascular complications.
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Bakaeen F, Gopaldas R, Huh J, Sansgiry S, LeMaire S, De La Cruz K, Coselli J, Chu D. Operative Mortality after Aortic Valve Replacement: Predictions Made by Surgeons versus Risk Model. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gopaldas R, Chu D, Huh J, Dao T, LeMaire S, Coselli J, Bakaeen F. Impact of ACGME Work-Hour Restrictions on the Outcomes of Coronary Artery Bypass Grafting in a Cohort of 600,000 Patients. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.406] [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]
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Chow M, Younker T, Reeves-Viets J, Chu D, Bakaeen F, Wall M, Lakkis N, Mattox K, Tsai P. Surgical Management of an Acute on Chronic Massive Pulmonary Embolism with Impending Paradoxical Embolism. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Del Prete J, Bakaeen F, Dao T, Huh J, LeMaire S, Coselli J, Chu D. The Impact of Obesity on Long-Term Survival after Coronary Artery Bypass Grafting. J Surg Res 2010. [DOI: 10.1016/j.jss.2009.11.159] [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]
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Sher AF, Chu D, Wu S. Risk of bleeding in cancer patients treated with the angiogenesis inhibitor bevacizumab: A meta-analysis. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9584 Background: Bleeding is a serious adverse event associated with bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor (VEGF) used extensively in the treatment of cancer. Currently the overall risk of bleeding remains unclear. This study was conducted to determine the overall risk of bleeding associated with bevacizumab in cancer patients by a meta-analysis of randomized controlled trials (RCT). Methods: Databases from PUBMED and the Web Science from January 1966 until July 2008 and abstracts presented at the American Society of Clinical Oncology (ASCO) conferences from January 2000 to through July 2008 were searched to identify relevant studies. Eligible studies included prospective RCTs in which standard anti-neoplastic therapy was administered with and without the use of bevacizumab with available data of bleeding. Summary incidence rate, relative risk (RR), and 95% confidence interval (CI) were calculated employing fixed- or random-effect models based upon the heterogeneity of the included studies. Results: A total of 13048 patients with a variety of solid tumors from 20 RCTs were included for analysis. Among patients receiving bevacizumab, the incidence of all-grade bleeding was 36.3% (95% CI: 28.0 - 45.5), and the RR was 3.1 (95% CI: 2.4 - 4.1) as compared to controls. The incidence of high grade (grade 3 or above) bleeding with bevacizumab was 2.7% (95% CI: 2.0 - 3.6%), and the RR was 1.8 (95% CI: 1.2 - 2.7). The risk of bleeding varied with the dose of bevacizumab, with RR of 3.0 (95% CI: 2.4 - 3.6) at 5mg/kg/week and 1.6 (95% CI: 1.3 - 2.0) at 2.5mg/kg/week. The risk of bleeding with bevacizumab may vary with tumor type, with higher risk seen in patients with colorectal cancer (RR=6.6, 95% CI: 3.6–12.2) and renal cell cancer (RR=3.7, 95% CI: 2.6–5.5). Bevacizumab is associated with different patterns of bleeding, with epistaxis being the most common. The incidence of all grade epistaxis with bevacizumab was 33.8% (95% CI 24.5–44.6) with a RR of 3.1 (95% CI 2.4 - 4.0). Conclusions: There is a significant increase in the risk of bleeding in cancer patients receiving bevacizumab. The risk may vary with the dose of bevacizumab and tumor type. No significant financial relationships to disclose.
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