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Klijn JGM, Berns EMJJ, Martens J, Jansen MPHM, Atkins D, Foekens JA, Wang Y. Gene expression profiles and molecular classification to predict distant metastasis and tamoxifen-resistant breast cancer. Breast Cancer Res 2005. [PMCID: PMC4231886 DOI: 10.1186/bcr1206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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77
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Atkins D, Murphy C, Saunders C. Polymethylsiloxanes...Thermal and Oxidation Stabilities. ACTA ACUST UNITED AC 2005. [DOI: 10.1021/ie50455a606] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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78
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Song* B, Atkins D. NEW ONSET MAMMALIAN MEAT ALLERGY PRESENTING WITH RECURRENT, DELAYED, PROLONGED ANAPHYLAXIS. - FP14. Ann Allergy Asthma Immunol 2004. [DOI: 10.1016/s1081-1206(10)61751-6] [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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79
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Backus J, Laughlin T, Min CJ, Mannie A, Tafra L, Belly R, Atkins D, Verbanac KM. Validation of markers for the intraoperative detection of metastasis in breast sentinel lymph nodes. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9547] [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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80
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Wang Y, Jatkoe T, Zhang Y, Mutch MG, Talantov D, Liang J, McLeod HL, Atkins D. Gene expression profiling to predict recurrent Dukes' B colon cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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81
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Bouquerand PE, Maio S, Normand V, Singleton S, Atkins D. Swelling and erosion affecting flavor release from glassy particles in water. AIChE J 2004. [DOI: 10.1002/aic.10267] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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82
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Atkins D. Is casual exposure to peanut butter by cutaneous contact or inhalation dangerous for most peanut-allergic children? Curr Allergy Asthma Rep 2004. [DOI: 10.1007/s11882-004-0039-8] [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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83
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Atkins D. Is anti-IgE effective in the treatment of peanut-allergic patients? Curr Allergy Asthma Rep 2004. [DOI: 10.1007/s11882-004-0040-2] [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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84
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Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, Kloeck WGJ, Billi J, Böttiger BW, Morley PT, Nolan JP, Okada K, Reyes C, Shuster M, Steen PA, Weil MH, Wenzel V, Hickey RW, Carli P, Vanden Hoek TL, Atkins D. Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Circulation 2003; 108:118-21. [PMID: 12847056 DOI: 10.1161/01.cir.0000079019.02601.90] [Citation(s) in RCA: 507] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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85
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Samson RA, Berg RA, Bingham R, Biarent D, Coovadia A, Hazinski MF, Hickey RW, Nadkarni V, Nichol G, Tibballs J, Reis AG, Tse S, Zideman D, Potts J, Uzark K, Atkins D. Use of automated external defibrillators for children: an update: an advisory statement from the pediatric advanced life support task force, International Liaison Committee on Resuscitation. Circulation 2003; 107:3250-5. [PMID: 12835409 DOI: 10.1161/01.cir.0000074201.73984.fd] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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86
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Becker M, Ingianni G, Lassner F, Atkins D, Schröder JM. [Intraoperative histological sections in obstetric brachial plexus lesions--comparison of macroscopic appearance, HE staining and toluidine blue staining]. HANDCHIR MIKROCHIR P 2003; 35:112-6. [PMID: 12874722 DOI: 10.1055/s-2003-40772] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
In brachial plexus lesions and their revision, evaluation of nerve stumps is very important for the reconstructive strategy. We intraoperatively perform cryostat sections, Haematoxilin-Eosin (HE) stained, and compare the clinical appearance of the nerves to the microscopic results. Toluidine blue staining is later used to validate the structural details. Intraneural fibrosis can be traced safely with both staining methods, in root avulsions a histology is helpful, too. For more proximal, intraforaminal lesions semithin section stained with toluidine-blue are less informative than are HE-stained cryostat sections. In these lesions the clinical control by electrical stimulation and evoked potentials is superior.
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87
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Atkins D. Reactions to cow’s milk hydrolysates and amino acid-derived formulas in children with cow’s milk allergy. Curr Allergy Asthma Rep 2003. [DOI: 10.1007/s11882-003-0009-6] [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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88
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Alaluf S, Heath A, Carter N, Atkins D, Mahalingam H, Barrett K, Kolb R, Smit N. Variation in melanin content and composition in type V and VI photoexposed and photoprotected human skin: the dominant role of DHI. PIGMENT CELL RESEARCH 2001; 14:337-47. [PMID: 11601655 DOI: 10.1034/j.1600-0749.2001.140505.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A combination of techniques, including high-performance liquid chromatography (HPLC), spectrophotometric measurements, and a novel method for quantifying melanosome morphology, were applied to the analysis of melanin content and composition in highly pigmented (Fitzpatrick type V and VI) human skin. We found that total epidermal melanin content is significantly elevated in photoexposed type V and VI skin (approximately 1.6 x), while analysis of individual melanin components suggests that pheomelanin content increases only slightly, whereas 5,6-dihydroxyindole-2-carboxylic acid (DHICA)-eumelanin and to a greater extent 5,6-dihydroxyindole (DHI)-eumelanin content are both markedly elevated. Analysis of the relative composition of epidermal melanin in these subjects revealed that DHI-eumelanin is the largest single component (approximately 60-70%), followed by DHICA-eumelanin (25-35%), with pheomelanin being a relatively minor component (2-8%). Moreover, there was a comparative enrichment of DHI-eumelanin at photoexposed sites, with a corresponding decline in the relative contributions from DHICA-eumelanin and pheomelanin. There was also a good correlation and close agreement between the concentration of spheroidal melanosomes determined by morphological image analysis and the concentration of pheomelanin determined by a combination of HPLC and spectrophotometric analysis (r = 0.89, P < 0.02). This study demonstrates the usefulness of melanosome morphology analysis as a sensitive new method for the quantification of melanin composition in human skin. The data also suggest that DHI-eumelanin formation is the dominant pathway for melanin synthesis in heavily pigmented (Fitzpatrick V and VI) skin types in vivo, and is the favoured pathway when melanin production is increased in chronically photoexposed skin.
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89
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Davis A, Atkins D. Metal distribution in Clark Fork River sediments. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2001; 35:3501-3506. [PMID: 11563653 DOI: 10.1021/es001881c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Accurate sampling of pore waters and sediments in gravel river beds is problematic because cobbles preclude most coring techniques, while the angularity of sand grains destroys the membranes of standard pore water samplers. In the Clark Fork River, the recipient of over 100 years of mining activity, a modified single tube core-freezing device was used to profile bed sediment (approximately 65% cobbles and 35% gravel substrate), and a novel pore water sampler was developed to collect interstitial water. In the sediment, the <63 microm fraction comprised <4 wt % yet contained approximately an order of magnitude higher metal concentrations compared to the 63 microm-2 mm fraction (constituting approximately 20% of the mass). However, on a mass basis the sand fraction contained 60% of the metals, compared to 40% in the clay/silt fraction in the gravels, while in point bars the distribution was approximately 50:50. The metals occur predominantly in sulfides frequently armored with an oxide rim and other sparingly soluble phases that may explain the low pore water metal concentrations. These data demonstrate that consideration of multiple particle size cutoffs is necessary to accurately characterize fluvial bed sediment metal conditions and that the form of the metal is important in understanding metal solubility in the benthos.
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90
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Maciosek MV, Coffield AB, McGinnis JM, Harris JR, Caldwell MB, Teutsch SM, Atkins D, Richland JH, Haddix A. Methods for priority setting among clinical preventive services. Am J Prev Med 2001; 21:10-9. [PMID: 11418252 DOI: 10.1016/s0749-3797(01)00309-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Methods used to compare the value of clinical preventive services based on two criteria-clinically preventable burden (CPB) and cost effectiveness (CE)-are described. A companion article provides rankings of clinical preventive services and discusses its uses for decision-makers; this article focuses on the methods, challenges faced, and solutions. The authors considered all types of data essential to measuring CPB and CE for services recommended by the U.S. Preventive Services Task Force and developed methods essential to ensuring valid comparisons of different services' relative value.
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91
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Coffield AB, Maciosek MV, McGinnis JM, Harris JR, Caldwell MB, Teutsch SM, Atkins D, Richland JH, Haddix A. Priorities among recommended clinical preventive services. Am J Prev Med 2001; 21:1-9. [PMID: 11418251 DOI: 10.1016/s0749-3797(01)00308-7] [Citation(s) in RCA: 226] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many recommended clinical preventive services are delivered at low rates. Decision-makers who wish to improve delivery rates, but face competing demands for finite resources, need information on the relative value of these services. This article describes the results of a systematic assessment of the value of clinical preventive services recommended for average-risk patients by the U.S. Preventive Services Task Force. METHODS The assessment of services' value for the U.S. population was based on two dimensions: burden of disease prevented by each service and cost effectiveness. Methods were developed for measuring these criteria consistently across different types of services. A companion article describes the methods in greater detail. Each service received 1 to 5 points on each of the two dimensions, for total scores ranging from 2 to 10. Priority opportunities for improving delivery rates were determined by comparing the ranking of services with what is known of current delivery rates nationally. RESULTS The highest ranked services (scores of 7+) with the lowest delivery rates (< or =50% nationally) are providing tobacco cessation counseling to adults, screening older adults for undetected vision impairments, offering adolescents an anti-tobacco message or advice to quit, counseling adolescents on alcohol and drug abstinence, screening adults for colorectal cancer, screening young women for chlamydial infection, screening adults for problem drinking, and vaccinating older adults against pneumococcal disease. CONCLUSIONS Decision-makers can use the results to set their own priorities for increasing delivery of clinical preventive services. The methods provide a basis for future priority-setting efforts.
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92
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Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, Atkins D. Current methods of the US Preventive Services Task Force: a review of the process. Am J Prev Med 2001; 20:21-35. [PMID: 11306229 DOI: 10.1016/s0749-3797(01)00261-6] [Citation(s) in RCA: 1101] [Impact Index Per Article: 47.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The U.S. Preventive Services Task Force (USPSTF/Task Force) represents one of several efforts to take a more evidence-based approach to the development of clinical practice guidelines. As methods have matured for assembling and reviewing evidence and for translating evidence into guidelines, so too have the methods of the USPSTF. This paper summarizes the current methods of the third USPSTF, supported by the Agency for Healthcare Research and Quality (AHRQ) and two of the AHRQ Evidence-based Practice Centers (EPCs). The Task Force limits the topics it reviews to those conditions that cause a large burden of suffering to society and that also have available a potentially effective preventive service. It focuses its reviews on the questions and evidence most critical to making a recommendation. It uses analytic frameworks to specify the linkages and key questions connecting the preventive service with health outcomes. These linkages, together with explicit inclusion criteria, guide the literature searches for admissible evidence. Once assembled, admissible evidence is reviewed at three strata: (1) the individual study, (2) the body of evidence concerning a single linkage in the analytic framework, and (3) the body of evidence concerning the entire preventive service. For each stratum, the Task Force uses explicit criteria as general guidelines to assign one of three grades of evidence: good, fair, or poor. Good or fair quality evidence for the entire preventive service must include studies of sufficient design and quality to provide an unbroken chain of evidence-supported linkages, generalizable to the general primary care population, that connect the preventive service with health outcomes. Poor evidence contains a formidable break in the evidence chain such that the connection between the preventive service and health outcomes is uncertain. For services supported by overall good or fair evidence, the Task Force uses outcomes tables to help categorize the magnitude of benefits, harms, and net benefit from implementation of the preventive service into one of four categories: substantial, moderate, small, or zero/negative. The Task Force uses its assessment of the evidence and magnitude of net benefit to make a recommendation, coded as a letter: from A (strongly recommended) to D (recommend against). It gives an I recommendation in situations in which the evidence is insufficient to determine net benefit. The third Task Force and the EPCs will continue to examine a variety of methodologic issues and document work group progress in future communications.
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Abstract
CONTEXT Screening and treatment of lipid disorders in people at high risk for future coronary heart disease (CHD) events has gained wide acceptance, especially for patients with known CHD, but the proper role in people with low to medium risk is controversial. OBJECTIVE To examine the evidence about the benefits and harms of screening and treatment of lipid disorders in adults without known cardiovascular disease for the U.S. Preventive Services Task Force. DATA SOURCES We identified English-language articles on drug therapy, diet and exercise therapy, and screening for lipid disorders from comprehensive searches of the MEDLINE database from 1994 through July 1999. We used published systematic reviews, hand searching of relevant articles, the second Guide to Clinical Preventive Services, and extensive peer review to identify important older articles and to ensure completeness. DATA SYNTHESIS There is strong, direct evidence that drug therapy reduces CHD events, CHD mortality, and possibly total mortality in middle-aged men (35 to 65 years) with abnormal lipids and a potential risk of CHD events greater than 1% to 2% per year. Indirect evidence suggests that drug therapy is also effective in other adults with similar levels of risk. The evidence is insufficient about benefits and harms of treating men younger than 35 years and women younger than 45 years who have abnormal lipids but no other risk factors for heart disease and low risk for CHD events (less than 1% per year). Trials of diet therapy for primary prevention have led to long-term reductions in cholesterol of 3% to 6% but have not demonstrated a reduction in CHD events overall. Exercise programs that maintain or reduce body weight can produce short-term reductions in total cholesterol of 3% to 6%, but longer-term results in unselected populations have found smaller or no effect. To identify accurately people with abnormal lipids, at least two measurements of total cholesterol and high-density lipoprotein cholesterol are required. The role of measuring triglycerides and the optimal screening interval are unclear from the available evidence. CONCLUSIONS On the basis of the effectiveness of treatment, the availability of accurate and reliable tests, and the likelihood of identifying people with abnormal lipids and increased CHD risk, screening appears to be effective in middle-aged and older adults and in young adults with additional cardiovascular risk factors.
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Rathore S, McGreevey J, Schulman K, Atkins D. Mandated Coverage for Cancer-Screening Services: Whose Guidelines Do States Follow? J Low Genit Tract Dis 2001. [DOI: 10.1046/j.1526-0976.2001.52011-8.x] [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]
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95
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Woolf SH, Atkins D. The evolving role of prevention in health care: contributions of the U.S. Preventive Services Task Force. Am J Prev Med 2001; 20:13-20. [PMID: 11306228 DOI: 10.1016/s0749-3797(01)00262-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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96
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Atkins D, Walsh JM, Pignone M, Phillips CJ. Lipid screening in women. JOURNAL OF THE AMERICAN MEDICAL WOMEN'S ASSOCIATION (1972) 2000; 55:234-40. [PMID: 10935359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Evidence of the benefits of lowering cholesterol in various populations continues to grow, but questions persist about screening and treatment of lipid disorders in women. In this paper, we review the distinct features of the epidemiology of lipids and coronary heart disease in women and data from recent long-term treatment trials specific to women. Although data from primary prevention trials in women remain sparse, recent trials demonstrating benefits of cholesterol reduction across a broad range of cholesterol levels and cardiac risk in men and women bolster the conclusion that benefits may extend to asymptomatic women who are otherwise at high risk for coronary disease. Periodic lipid screening beginning in middle age will identify most women who are at high enough risk to merit drug therapy or more intensive individual lifestyle interventions. More detailed consideration of age, diabetes, blood pressure, specific lipid levels, or the ratio of total cholesterol to high-density lipoprotein cholesterol, and other risk factors can more accurately estimate individual risk of coronary heart disease and identify high-risk women most likely to benefit from lipid reduction. Advice about healthy diet, weight control, and physical activity can benefit all women, but authorities differ on the benefits of routine lipid screening in low-risk younger women.
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97
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Mighty HE, Atkins D. Pregnancy and inflammatory bowel disease: current management. JOURNAL OF THE ASSOCIATION FOR ACADEMIC MINORITY PHYSICIANS : THE OFFICIAL PUBLICATION OF THE ASSOCIATION FOR ACADEMIC MINORITY PHYSICIANS 2000; 11:38-43. [PMID: 10953543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Inflammatory bowel disease primarily affects adolescents and young adults, presenting management concerns for obstetricians caring for these women during pregnancy. Interdisciplinary care by the obstetrician and gastroenterologist and selection of individual courses of management produce pregnancy outcomes that approach those of an unaffected population. Routine medical management using glucocorticoids, metronidazole, and asacol derivatives as well as more aggressive therapy using immunomodulators azathioprine and 6-mercaptopurine are shown to be of low risk to the fetus. Effective medical management greatly reduces need for surgical intervention during pregnancy. An understanding of current management perspectives assures positive pregnancy outcomes for mother and infant.
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98
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Rathore SS, McGreevey JD, Schulman KA, Atkins D. Mandated coverage for cancer-screening services: whose guidelines do states follow? Am J Prev Med 2000; 19:71-8. [PMID: 10913895 DOI: 10.1016/s0749-3797(00)00179-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To determine the prevalence and nature of state coverage mandates for cancer screening. METHODS We contacted insurance departments in 50 states, Washington, DC, and Puerto Rico for copies of state codes that mandate coverage of screening for breast, cervical, prostate, and colorectal cancer by private insurers. We further compared mandates, when identified, with American Cancer Society (ACS) and U.S. Preventive Services Task Force (USPSTF) guidelines for likely sources of screening recommendations. RESULTS Forty-three states and the District of Columbia currently mandate coverage of cancer screening. Breast cancer-screening coverage was most frequently mandated (n =44), followed by cervical (n =22), prostate (n =18), and colorectal cancer screening (n =1). Twenty-three states used ACS guidelines only, 18 states used ACS and non-ACS/non-USPSTF guidelines, and 3 states used only non-ACS/non-USPSTF guidelines in development of coverage mandates. No state screening coverage mandate reflected USPSTF-screening guidelines. Of 85 mandates in place, 57 have been passed since 1990. CONCLUSIONS Although state mandates for insurer coverage of cancer screening are common and increasing, we found noticeable inter- and intra-state variation in coverage, selection, and use of screening guidelines.
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Atkins D, Miller M, De Bouvere B, van Aerschot A, Herdewijn P. Evaluation of the cellular uptake of hexitol nucleic acids in HeLa cells. DIE PHARMAZIE 2000; 55:615-7. [PMID: 10989842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Two major hurdles to the widespread use of synthetic nucleic acids as drugs are the biological stability of the compounds and efficiency of cellular penetration. Recent advances in the chemistry of nucleic acids has given rise to highly stable derivatives with an anhydrohexitol backbone. This report addresses the cellular uptake of these molecules. We show that the uptake of HNA in the absence of a carrier is very low but HNA is efficiently internalized with a range of transfection reagents.
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100
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Seliger B, Rongcun Y, Atkins D, Hammers S, Huber C, Störkel S, Kiessling R. HER-2/neu is expressed in human renal cell carcinoma at heterogeneous levels independently of tumor grading and staging and can be recognized by HLA-A2.1-restricted cytotoxic T lymphocytes. Int J Cancer 2000; 87:349-59. [PMID: 10897039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The HER-2/neu oncoprotein, a 185 kDa membrane-associated tyrosine kinase with extensive homology to the epidermal growth factor receptor (EGF-R), is overexpressed in breast and ovarian carcinomas. Its overexpression is closely associated with poor prognosis in the course of disease. Here we demonstrate HER-2/neu overexpression in both established cell lines and biopsy material obtained from renal epithelial tumors. Immunohistochemical analysis of human kidney tumor lesions using 2 HER-2/neu-specific antibodies revealed HER-2/neu expression in more than 40% of primary epithelial renal tumors and more than 30% of primary renal cell carcinoma (RCC) specimens. A distinctive HER-2/neu expression pattern was found in different subtypes of kidney tumors with the highest frequency in chromophilic and chromophobic RCC, but neither associated with disease stage nor tumor grade. Eight of 10 RCC cell lines expressed significant levels of HER-2/neu mRNA and protein, but at a lower level compared with HER-2/neu overexpressing ovarian carcinoma cells. To evaluate the immune response against HER-2/neu expressing HLA-A2-positive (HLA-A2(+)) RCC cells, allogeneic HLA-A2-restricted cytotoxic T-lymphocyte (CTL) lines generated by pulsing dendritic cells with 3 different HER-2/neu-derived peptides, (HER-2(9.369), HER-2(9.435) and HER-2(9.689), were utilized in chromium-release assays. Specific lysis of HER-2/neu expressing HLA-A2(+) RCC cell lines was mediated by CTL lines specific for each of these 3 HER-2/neu-derived epitopes. The fine specificity of 2 CTL clones was defined to the epitopes HER-2(9.435) and HER-2(9.689). Their specificity was then confirmed by cold target inhibition assays. In addition, CTL-mediated lysis was enhanced by pulsing tumor cells with exogenous HER-2/neu-specific peptides. Our data suggest that (i) HER-2/neu is heterogeneously expressed in different subtypes of RCC, (ii) HER-2/neu is naturally processed by RCC and (iii) HER-2/neu epitopes presented by RCC can be recognized by HLA-A2-restricted, HER-2/neu-specific CTL.
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MESH Headings
- Antigens, Neoplasm/biosynthesis
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/immunology
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/immunology
- Carcinoma, Renal Cell/metabolism
- Carcinoma, Renal Cell/pathology
- Cytotoxicity, Immunologic
- Dendritic Cells/immunology
- Epitopes/immunology
- Genes, erbB-2
- HLA-A2 Antigen/immunology
- Humans
- Kidney Neoplasms/genetics
- Kidney Neoplasms/immunology
- Kidney Neoplasms/metabolism
- Kidney Neoplasms/pathology
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Neoplasm Staging
- Peptide Fragments/immunology
- RNA, Messenger/biosynthesis
- RNA, Neoplasm/biosynthesis
- Receptor, ErbB-2/biosynthesis
- Receptor, ErbB-2/immunology
- T-Lymphocytes, Cytotoxic/immunology
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