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Borza T, Yan P, Kaufman SR, Herrel L, Skolarus TA, Shahinian VB, Hollenbeck B. PD52-01 ASSOCIATION BETWEEN RADIATION FACILITY OWNERSHIP AND VARIATION IN PROSTATE CANCER TREATMENT AND SPENDING. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Fam M, Yabes J, Hale N, Turner R, Yu M, Macleod L, Hugar L, Gingrich J, Borza T, Skolarus T, Davies B, Jacobs B. MP44-02 CHANGING TRENDS IN THE USE OF CHEMOTHERAPY FOR MUSCLE-INVASIVE BLADDER CANCER IN THE UNITED STATES. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee M, Hollenbeck B, Oerline M, Skolarus T, Jacobs B, Jen R, Luckenbaugh A, Shahinian V, Borza T. MP86-16 SPILLOVER EFFECTS OF THE HOSPITAL READMISSION REDUCTION PROGRAM ON RADICAL CYSTECTOMY READMISSIONS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2896] [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]
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Skolarus TA, Caram MV, Borza T. Editorial Comment. J Urol 2018; 199:1172-1173. [PMID: 29391136 DOI: 10.1016/j.juro.2017.10.071] [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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Hollenbeck BK, Kaufman SR, Borza T, Yan P, Herrel LA, Miller DC, Luckenbaugh AN, Skolarus TA, Shahinian VB. Accountable care organizations and prostate cancer care. UROLOGY PRACTICE 2017; 4:454-461. [PMID: 29170755 DOI: 10.1016/j.urpr.2016.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose Accountable care organizations have the potential to increase the value of healthcare by improving population health and enhanced financial stewardship. How practice context modifies effects on a specialty-focused disease, such as prostate cancer care, has implications for their success. Methods We performed a retrospective cohort study of newly diagnosed men with prostate cancer between 2012 and 2013 using national Medicare data. Practice affiliation (small single-specialty, large single-specialty, multispecialty groups) and accountable care organization alignment were measured at the patient level. Generalized linear multivariable models were fitted to derive adjusted rates of treatment and spending for the 12-month period after diagnosis according to accountable care organization alignment and practice affiliation. Results Of 15,640 patients with newly diagnosed prostate cancer, 1,100 (7.0%) were aligned with accountable care organizations. Patients in these organizations had similar use of curative treatment to those not in accountable care organizations (71.4% vs. 70.0%, respectively; p=0.33), which did not vary with practice affiliation (p=0.39). Adjusted spending was higher among patients in accountable care organizations ($20,916 vs. $19,773, p=0.03); however, this relationship was independent of the practice affiliation (p=0.90). Higher accountable care organization penetration within a practice was associated with increased spending (p<0.05) but not with treatment (p=0.87). Conclusions Prostate cancer patients aligned with accountable care organizations had similar rates of treatment, but increased spending, in the year following diagnosis. These findings were similar across practice affiliations. Better specialist engagement by accountable care organizations may be necessary for them to alter practice patterns for specialty care.
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Borza T, Kaufman SR, Yan P, Herrel LA, Luckenbaugh AN, Miller DC, Skolarus TA, Jacobs BL, Hollingsworth JM, Norton EC, Shahinian VB, Hollenbeck BK. Early effect of Medicare Shared Savings Program accountable care organization participation on prostate cancer care. Cancer 2017; 124:563-570. [PMID: 29053177 DOI: 10.1002/cncr.31081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/18/2017] [Accepted: 09/20/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Accountable care organizations (ACOs) can improve prostate cancer care by decreasing treatment variations (ie, avoidance of treatment in low-value settings). Herein, the authors performed a study to understand the effect of Medicare Shared Savings Program ACOs on prostate cancer care. METHODS Using a 20% Medicare sample, the authors identified men with newly diagnosed prostate cancer from 2010 through 2013. Rates of treatment, potential overtreatment (ie, treatment in men with a ≥75% chance of 10-year mortality from competing risks), and Medicare payments were measured using regression models. The impact of ACO participation was assessed using difference-in-differences analyses. RESULTS Before implementation of ACOs, the treatment rate was 71.8% (95% confidence interval [95% CI], 70.2%-73.3%) for ACO-aligned beneficiaries and 72.3% (95% CI, 71.7%-73.0% [P = .51]) for non-ACO-aligned beneficiaries. After implementation, this rate declined to 68.4% (95% CI, 66.1%-70.7% [P = .017]) for ACO-aligned beneficiaries and 69.3% (95% CI, 68.5%-70.1% [P<.001]) for non-ACO-aligned beneficiaries. There was no differential effect noted for ACO participation. The rate of potential overtreatment decreased from 48.2% (95% CI, 43.1%-53.3%) to 40.2% (95% CI, 32.4%-48.0% [P = .087]) for ACO-aligned beneficiaries and increased from 44.3% (95% CI, 42.1%-46.5%) to 47.0% (95% CI, 44.5%-49.5% [P = .11]) for non-ACO-aligned beneficiaries. These changes resulted in a significant relative decrease in overtreatment of 17% for ACO-aligned beneficiaries (difference-in-differences, 10.8%; P = .031). Payments were not found to be differentially affected by ACO alignment. CONCLUSIONS The treatment of prostate cancer and annual payments decreased significantly between 2010 and 2013, but ACO participation did not appear to impact these trends. Among men least likely to benefit, Medicare Shared Savings Program ACO alignment was associated with a significant decline in prostate cancer treatment. Cancer 2018;124:563-70. © 2017 American Cancer Society.
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Caram ME, Borza T, Min HS, Griggs JJ, Miller DC, Hollenbeck BK, Mukherjee B, Skolarus TA. Early National Dissemination of Abiraterone and Enzalutamide for Advanced Prostate Cancer in Medicare Part D. J Oncol Pract 2017; 13:e694-e702. [PMID: 28628393 PMCID: PMC5555032 DOI: 10.1200/jop.2016.020206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Abiraterone and enzalutamide were approved by the Food and Drug Administration in 2011 and 2012 to treat men with metastatic castration-resistant prostate cancer (mCRPC). Most men with mCRPC are > 65 years of age and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D data. METHODS We evaluated the number of prescriptions for abiraterone and enzalutamide by provider specialty and hospital referral region (HRR) using Medicare Part D and Dartmouth Atlas data. We categorized HRRs by abiraterone and enzalutamide prescriptions, adjusted for prostate cancer incidence, and examined factors associated with regional variation using multilevel regression models. RESULTS Among providers who wrote the majority of prescriptions for abiraterone or enzalutamide in 2013 (n = 2,121), 87.5% were medical oncologists, 3.3% were urologists, and 9.2% were other provider specialties. Among prescribers, approximately 30% were responsible for three quarters of the claims for abiraterone and 20% were responsible for more than half the claims for enzalutamide. Some HRRs demonstrated low-prescribing rates despite average medical oncology and urology physician workforce density. Our multilevel model demonstrated that regional factors potentially influenced variation in care. CONCLUSION The majority of prescriptions written for abiraterone and enzalutamide through Medicare Part D in 2013 were written by a minority of providers, with marked regional variation across the United States. Better understanding of the early national dissemination of these effective but expensive drugs can help inform strategies to optimize introduction of new, evidence-based mCRPC treatments.
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Shahinian VB, Kaufman SR, Yan P, Herrel LA, Borza T, Hollenbeck BK. Reimbursement and use of intensity-modulated radiation therapy for prostate cancer. Medicine (Baltimore) 2017; 96:e6929. [PMID: 28640073 PMCID: PMC5484181 DOI: 10.1097/md.0000000000006929] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The use of intensity-modulated radiation therapy (IMRT) for prostate cancer increased through the mid-2000s, in association with acquisition of the devices by large urology groups. More recently, reimbursement for IMRT in the office setting (generally representing freestanding facilities owned by physicians) has been declining. The aim of the study was to examine trends in IMRT use and related payments in the office versus hospital outpatient setting over time.In this retrospective cohort study, a total of 66,967 men aged 66 years or older, with newly diagnosed prostate cancer from 2007 through 2012 were identified in a 20% national sample of Medicare claims. IMRT use in the office versus hospital outpatient setting was examined over time, adjusted for patient characteristics using multivariable logistic regression models. Mean reimbursement for IMRT treatments and total IMRT-related payments were plotted by year.IMRT use increased from 28.6% to 38.0% of newly diagnosed men with prostate cancer over the study period, exclusively related to growth in the office setting. In particular, use in the office setting increased from 13.2% in 2007 to 22.1%, whereas use in the hospital outpatient setting remained essentially steady throughout the period around 15%. During the same period mean reimbursement for IMRT in the office setting declined from $504 per individual radiation treatment to $381, whereas it increased from $283 to $380 in the hospital outpatient setting. However, total IMRT-related payments in the office setting increased through 2011 due to increased utilization, falling only in 2012 (to $35.7 million from $48.3 million in 2011) related both to continued declines in reimbursement and a large reduction in new cases of prostate cancer.In conclusion, use of IMRT in the physician office setting in men diagnosed with prostate cancer has continued to increase in the face of declining reimbursement. Total payments for IMRT fell only in 2012, following a substantial reduction in new cases of prostate cancer.
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Kirk PS, Govani S, Borza T, Hollenbeck BK, Davis J, Shumway D, Waljee AK, Skolarus TA. Implications of Prostate Cancer Treatment in Men With Inflammatory Bowel Disease. Urology 2017; 104:131-136. [PMID: 28163082 PMCID: PMC5520802 DOI: 10.1016/j.urology.2017.01.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 01/24/2017] [Accepted: 01/27/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the influences of inflammatory bowel disease (IBD), a rare but morbid disease with increasing incidence, on prostate cancer management decisions. We examined whether prostate cancer treatment differed for men with IBD, and whether treatment choice was associated with risk of IBD flare. MATERIALS AND METHODS Using Veterans Health Administration cancer registry and administrative data, we identified 52,311 men diagnosed with prostate cancer from 2005 to 2008. We used International Classification of Diseases-9 codes and pharmacy and utilization data to identify IBD diagnoses, IBD-directed therapy, and flares (glucocorticoid escalation, hospitalization, and surgical intervention). We compared characteristics across men with and without IBD, and used multivariable regression to examine IBD flares after treatment according to treatment type. RESULTS Two hundred and forty men (0.5%) had IBD prior to prostate cancer diagnosis. Compared to non-IBD patients, IBD patients were more likely Caucasian (P < .001) with lower-risk cancer (P = .02). Surgery was more common in IBD patients (41% vs 28%, P < .001). In the year following prostate cancer treatment, 18% of IBD patients experienced flares. After adjustment, the only predictor of flare in the year after treatment was flare in the year prior to treatment (adjusted odds ratio, 12.5; 95% confidence interval, 5.4-29.2). CONCLUSION IBD patients were more likely to have lower-risk disease and be treated with surgery. Choice of prostate cancer treatment did not predict flares in the subsequent year. Better understanding of the intersection of IBD and prostate cancer can help inform treatment decisions for the increasing number of men managing both diseases.
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Borza T, Oerline MK, Skolarus TA, Jacobs BL, Luckebaugh AN, Lee M, Jen R, Hollingsworth JM, Shahinian VB, Hollenbeck BK. MP32-07 ASSOCIATION BETWEEN HOSPITAL ACCOUNTABLE CARE ORGANIZATION STATUS AND READMISSION FOLLOWING CYSTECTOMY AND OTHER MAJOR SURGERY. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.982] [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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Auffenberg G, Dunn R, Qin Y, Winkelman T, Dupree J, Hollenbeck B, Skolarus T, Miller D, Borza T. PD58-05 CONTRIBUTING TO A CRISIS? DEFINING NATIONAL PATTERNS IN OPIOID PRESCRIBING AFTER OUTPATIENT VASECTOMY. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2620] [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]
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Goldfarb R, Brandes S, Kirk P, Borza T, Qin Y, Skolarus T. PD60-11 POPULATION-BASED MANAGEMENT OF MALE URETHRAL STRICTURE DISEASE. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2757] [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]
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Kirk P, Borza T, Dupree J, Wei J, Ellimoottil C, Caram M, Hollenbeck B, Skolarus T. PD14-05 ECONOMIC IMPLICATIONS OF UROLOGIST PRESCRIPTION PRACTICES AMONG MEDICARE PART D BENEFICIARIES. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.706] [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]
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Borza T, Kaufman SR, Yan P, Herrel L, Luckebaugh AN, Miller DC, Skolarus TA, Jacobs BL, Norton E, Shahinian VB, Hollenbeck BK. PD32-03 IMPACT OF MEDICARE SHARED SAVINGS PROGRAM ACCOUNTABLE CARE ORGANIZATIONS ON PROSTATE CANCER TREATMENT. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1394] [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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Borza T, Dunn RL, Qui Y, Winkelman TN, Skolarus TA, Miller DC, Hollenbeck BK, Auffenberg GB. MP75-04 VARIATION IN NATIONAL OPIOID PRESCRIBING PATTERNS FOLLOWING OUTPATIENT NEPHROLITHIASIS PROCEDURES. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.2152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Caram MV, Borza T, Min HS, Griggs JJ, Miller DC, Hollenbeck BK, Mukherjee B, Skolarus TA. Early national dissemination of abiraterone and enzalutamide for advanced prostate cancer in Medicare Part D. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.8_suppl.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
35 Background: Abiraterone and enzalutamide are oral medications approved by the Food & Drug Administration in 2011 and 2012 to treat men with advanced castration-resistant prostate cancer. Most men with advanced prostate cancer are over age 65 and thus eligible for Medicare Part D. We conducted a study to better understand the early dissemination of these drugs across the United States using national Medicare Part D data. Methods: We evaluated the number of prescriptions for abiraterone and enzalutamide by provider specialty and hospital referral region (HRR) using Medicare Part D and Dartmouth Atlas data. We categorized HRRs by abiraterone and enzalutamide prescriptions, adjusted for prostate cancer incidence, and examined factors associated with regional variation using multilevel regression models. Results: Among all providers who wrote prescriptions for abiraterone or enzalutamide in 2013 (n=2121), 87.5% were medical oncologists, 3.3% urologists, and 9.2% were listed as other provider specialties. Among those who prescribed either drug, 5% of providers were responsible for 75% of the claims for abiraterone, and 7% were responsible for 75% of the claims for enzalutamide. Some HRRs demonstrated low-prescribing rates despite average medical oncology and urology physician workforce density. Conclusions: The majority of prescriptions written for abiraterone and enzalutamide through Medicare Part D in 2013 were written by a minority of providers with marked regional variation across the United States. Better understanding the early national dissemination of these effective but expensive drugs can help inform strategies to optimize introduction of new, evidence-based advanced prostate cancer treatments.
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Jacobs BL, He C, Li BY, Helfand A, Krishnan N, Borza T, Ghaferi AA, Hollenbeck BK, Helm JE, Lavieri MS, Skolarus TA. Variation in readmission expenditures after high-risk surgery. J Surg Res 2017; 213:60-68. [PMID: 28601334 DOI: 10.1016/j.jss.2017.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/14/2017] [Accepted: 02/16/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010. We fit a multivariable logistic regression model with generalized estimation equations to examine patient and index admission factors associated with readmission costs. RESULTS The 30-d readmission rate was 16% for major chest and 22% for major abdominal surgery (P < 0.001). Discharge to a skilled nursing facility was associated with higher readmission costs for both chest (odds ratio [OR]: 1.99; 95% confidence interval [CI]: 1.60-2.48) and abdominal surgeries (OR: 1.86; 95% CI: 1.24-2.78). Comorbidities, length of stay, and receipt of blood or imaging was associated with higher readmission costs for chest surgery patients. Readmission >3 wk after discharge was associated with lower costs among abdominal surgery patients. CONCLUSIONS Readmissions after high-risk surgery are common, affecting about one in six patients. Predictors of higher readmission costs differ among major chest and abdominal surgeries. Better identifying patients susceptible to higher readmission costs may inform future interventions to either reduce the intensity of these readmissions or eliminate them altogether.
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Borza T, Kaufman SR, Shahinian VB, Yan P, Miller DC, Skolarus TA, Hollenbeck BK. Sharp Decline In Prostate Cancer Treatment Among Men In The General Population, But Not Among Diagnosed Men. Health Aff (Millwood) 2017; 36:108-115. [DOI: 10.1377/hlthaff.2016.0739] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Russell CM, Lebastchi AH, Borza T, Spratt DE, Morgan TM. The Role of Transurethral Resection in Trimodal Therapy for Muscle-Invasive Bladder Cancer. Bladder Cancer 2016; 2:381-394. [PMID: 28035319 PMCID: PMC5181666 DOI: 10.3233/blc-160076] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
While radical cystectomy (RC) with pelvic lymph node dissection (PLND) represents the accepted gold standard for the treatment of muscle-invasive bladder cancer, this treatment approach is associated with significant morbidity. As such, bladder preservation strategies are often utilized in patients who are either deemed medically unfit due to significant comorbidities or whom decline management with RC and PLND secondary to its associated morbidity. In a select group of patients, meeting strict criteria, bladder preservation approaches may be employed with curative intent. Trimodal therapy, consisting of complete transurethral resection of bladder tumor (TURBT), chemotherapy, and radiation therapy has demonstrated durable oncologic control and long-term survival in a number of studies. The review presented here provides a description of trimodal therapy and the role of TURBT in bladder preservation for patients with muscle-invasive bladder cancer.
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Borza T, Caram M, Blake RM, Davis J, Makarov DV, Shelton JB, Leppert JT, Hollenbeck BK, Skolarus TA. PD06-03 IMAGING OVERUSE PERSISTS IN POST-PROSTATECTOMY PATIENTS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Borza T, Kaufman S, Shahinian VB, Yan P, Miller DC, Skolarus TA, Hollenbeck BK. MP04-10 TRENDS AND REGIONAL VARIATION IN PROSTATE CANCER TREATMENT. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1945] [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]
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Borza T, Jacobs BL, Montgomery JS, Morgan TM, Weizer AZ, Hafez KS, Lee CT, Li BY, He C, Helm JE, Lavieri MS, Hollenbeck BK, Skolarus TA. MP06-03 VARIATION IN READMISSION PARAMETERS BETWEEN OPEN AND ROBOTIC ASSISTED RADICAL CYSTECTOMY: A CONTEMPORARY POPULATION LEVEL ANALYSIS. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.2164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tracey J, Ambani S, Osawa T, Skolarus T, He C, Borza T, Weizer A, Montgomery J, Hafez K, Hollenbeck B, Lee C, Morgan T. MP63-17 WEEKEND DISCHARGE AFTER RADICAL CYSTECTOMY AND THE RISK OF READMISSION. J Urol 2016. [DOI: 10.1016/j.juro.2016.02.946] [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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Kulshreshtha G, Borza T, Rathgeber B, Stratton GS, Thomas NA, Critchley A, Hafting J, Prithiviraj B. Red Seaweeds Sarcodiotheca gaudichaudii and Chondrus crispus down Regulate Virulence Factors of Salmonella Enteritidis and Induce Immune Responses in Caenorhabditis elegans. Front Microbiol 2016; 7:421. [PMID: 27065981 PMCID: PMC4814495 DOI: 10.3389/fmicb.2016.00421] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/16/2016] [Indexed: 11/23/2022] Open
Abstract
Red seaweeds are a rich source of unique bioactive compounds and secondary metabolites that are known to improve human and animal health. S. Enteritidis is a broad range host pathogen, which contaminates chicken and poultry products that end into the human food chain. Worldwide, Salmonella outbreaks have become an important economic and public health concern. Moreover, the development of resistance in Salmonella serovars toward multiple drugs highlights the need for alternative control strategies. This study evaluated the antimicrobial property of red seaweeds extracts against Salmonella Enteritidis using the Caenorhabditis elegans infection model. Six red seaweed species were tested for their antimicrobial activity against S. Enteritidis and two, Sarcodiotheca gaudichaudii (SG) and Chondrus crispus (CC), were found to exhibit such properties. Spread plate assay revealed that SG and CC (1%, w/v) significantly reduced the growth of S. Enteritidis. Seaweed water extracts (SWE) of SG and CC, at concentrations from 0.4 to 2 mg/ml, significantly reduced the growth of S. Enteritidis (log CFU 4.5–5.3 and log 5.7–6.0, respectively). However, methanolic extracts of CC and SG did not affect the growth of S. Enteritidis. Addition of SWE (0.2 mg/ml, CC and SG) significantly decreased biofilm formation and reduced the motility of S. Enteritidis. Quantitative real-time PCR analyses showed that SWE (CC and SG) suppressed the expression of quorum sensing gene sdiA and of Salmonella Pathogenesis Island-1 (SPI-1) associated genes sipA and invF, indicating that SWE might reduce the invasion of S. Enteritidis in the host by attenuating virulence factors. Furthermore, CC and SG water extracts significantly improved the survival of infected C. elegans by impairing the ability of S. Enteritidis to colonize the digestive tract of the nematode and by enhancing the expression of C. elegans immune responsive genes. As the innate immune response pathways of C. elegans and mammals show a high degree of conservation, these results suggest that these SWE may also impart beneficial effects on animal and human health.
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Borza T, Bhojani N, Sood A, Schmid M, Gandaglia G, Ghani KR, Rai A, Pucheril D, Chang SL, Peabody JO, Menon M, Olugbade K, Ruhotina N, Sammon JD, Sukumar S, Varda B, Karakiewicz P, Sun M, Kibel AS, Zorn KC, Trinh QD. MP2-16 MORBIDITY AND MORTALITY AFTER BENIGN PROSTATIC HYPERPLASIA SURGERY: DATA FROM THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.174] [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]
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