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Mangat B, Taylor C, Wong G, Vyselaar J, Perry M, Vandergriend R, Ignaszewski A, Ramanathan K. 202 Cardiac Rehabilitation Improves Metabolic Parameters Post-ST Elevation Myocardial Infarction (STEMI) Across Multiple Ethnic Groups. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.200] [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] Open
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Papadopoulos NG, Arakawa H, Carlsen KH, Custovic A, Gern J, Lemanske R, Le Souef P, Mäkelä M, Roberts G, Wong G, Zar H, Akdis CA, Bacharier LB, Baraldi E, van Bever HP, de Blic J, Boner A, Burks W, Casale TB, Castro-Rodriguez JA, Chen YZ, El-Gamal YM, Everard ML, Frischer T, Geller M, Gereda J, Goh DY, Guilbert TW, Hedlin G, Heymann PW, Hong SJ, Hossny EM, Huang JL, Jackson DJ, de Jongste JC, Kalayci O, Aït-Khaled N, Kling S, Kuna P, Lau S, Ledford DK, Lee SI, Liu AH, Lockey RF, Lødrup-Carlsen K, Lötvall J, Morikawa A, Nieto A, Paramesh H, Pawankar R, Pohunek P, Pongracic J, Price D, Robertson C, Rosario N, Rossenwasser LJ, Sly PD, Stein R, Stick S, Szefler S, Taussig LM, Valovirta E, Vichyanond P, Wallace D, Weinberg E, Wennergren G, Wildhaber J, Zeiger RS. International consensus on (ICON) pediatric asthma. Allergy 2012; 67:976-97. [PMID: 22702533 PMCID: PMC4442800 DOI: 10.1111/j.1398-9995.2012.02865.x] [Citation(s) in RCA: 259] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2012] [Indexed: 01/08/2023]
Abstract
Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences, thus providing a concise reference. The principles of pediatric asthma management are generally accepted. Overall, the treatment goal is disease control. To achieve this, patients and their parents should be educated to optimally manage the disease, in collaboration with healthcare professionals. Identification and avoidance of triggers is also of significant importance. Assessment and monitoring should be performed regularly to re-evaluate and fine-tune treatment. Pharmacotherapy is the cornerstone of treatment. The optimal use of medication can, in most cases, help patients control symptoms and reduce the risk for future morbidity. The management of exacerbations is a major consideration, independent of chronic treatment. There is a trend toward considering phenotype-specific treatment choices; however, this goal has not yet been achieved.
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Wong G, Chapman JR, Craig JC. mTOR inhibitors: a myth, a cure for cancer or something in between? Am J Transplant 2012; 12:1075-6. [PMID: 22537261 DOI: 10.1111/j.1600-6143.2012.04007.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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154
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Lehtonen S, Oksanen M, Lakso M, Wong G, Courtney M, Koistinaho J. 3.142 CAENORHABDITIS ELEGANS AS A MODEL SYSTEM OF PARKINSON DISEASE FOR HIGH-CONTENT SCREENING. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70858-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Mangat B, Talyor C, Wong G, Chan S, McLeod K, Isserow S, Ignaszewski A, Ramanathan K. 136 Ethnic disparities in cardiac rehabilitation attendance post-st elevation myocardial infarction (STEMI). Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.094] [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] Open
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Argiris K, Vasani S, Wong G, Stimpson P, Gunning E, Caulfield H. Audit of tongue-tie division in neonates with breastfeeding difficulties: how we do it. Clin Otolaryngol 2011; 36:256-60. [DOI: 10.1111/j.1749-4486.2011.02278.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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157
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Richter AG, Wong G, Goddard S, Heslegrave J, Derbridge C, Srivastava S, Diwakar L, Huissoon AP, Krishna MT. Retrospective case series analysis of penicillin allergy testing in a UK specialist regional allergy clinic. J Clin Pathol 2011; 64:1014-8. [PMID: 21742749 DOI: 10.1136/jcp.2010.088203] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Penicillin allergy is the most common drug allergy. Skin testing for the major (PPL) and minor determinants (MDMs) of penicillin offers increased sensitivity and specificity over in vitro testing alone. Following a worldwide absence of reagents, a new kit was licensed in the UK in 2008 (Diater, Spain) and this report evaluates its use in a UK specialist allergy clinic. METHODS Prospective data on 50 consecutive patients tested with the new reagents were collected. The departmental protocol is adapted from the 2003 EAACI position paper. RESULTS 14% (7/50) and 12% (6/50) of patients were diagnosed with immediate and non-immediate reactions respectively. The negative predictive value of the PPL and MDM reagents at the neat concentration for an immediate reaction was 93% (true negatives 37, false negatives 3). Two patients experienced systemic reactions to DPT in the absence of demonstrable specific IgE. None of the patients were diagnosed using skin prick testing alone or at lower concentrations of IDT. Five patients were diagnosed at the IDT stage and two at the DPT stage in the absence of demonstrable specific IgE. Six patients were diagnosed with non-immediate reactions, two on IDT alone and four following IDT and DPT. CONCLUSION The new PPL and MDM determinants offer enhanced sensitivity when evaluating β-lactam hypersensitivity; however, there are limitations to the current testing regimens. The UK would benefit from local guidelines, which incorporate the new reagents and acknowledge the high amoxicillin prescription rate and the relatively lower specialist-to-patient ratio in this country.
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Bourguignon LYW, Earle C, Wong G, Spevak CC, Krueger K. Stem cell marker (Nanog) and Stat-3 signaling promote MicroRNA-21 expression and chemoresistance in hyaluronan/CD44-activated head and neck squamous cell carcinoma cells. Oncogene 2011; 31:149-60. [PMID: 21685938 PMCID: PMC3179812 DOI: 10.1038/onc.2011.222] [Citation(s) in RCA: 196] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
MicroRNAs are often associated with the pathogenesis of many cancers, including head and neck squamous cell carcinoma (HNSCC). In particular, microRNA-21 (miR-21) appears to have a critical role in tumor cell survival, chemoresistance and HNSCC progression. In this study, we investigated matrix hyaluronan (HA)-induced CD44 (a primary HA receptor) interaction with the stem cell markers, Nanog and Stat-3, in HNSCC cells (HSC-3 cells). Our results indicate that HA binding to CD44 promotes Nanog-Stat-3 (also tyrosine phosphorylated Stat-3) complex formation, nuclear translocation and transcriptional activation. Further analyses reveal that miR-21 is controlled by an upstream promoter containing Stat-3 binding site(s), while chromatin immunoprecipitation assays demonstrate that stimulation of miR-21 expression by HA/CD44 signaling is Nanog/Stat-3-dependent in HNSCC cells. This process results in a decrease of a tumor suppressor protein (PDCD4), and an upregulation of i nhibitors of the apoptosis family of proteins (IAPs) as well as chemoresistance in HSC-3 cells. Treatment of HSC-3 cells with Nanog- and/or Stat-3-specific small interfering RNAs effectively blocks HA-mediated Nanog-Stat-3 signaling events, abrogates miR-21 production and increases PDCD4 expression. Subsequently, this Nanog-Stat-3 signaling inhibition causes downregulation of survival protein (IAP) expression and enhancement of chemosensitivity. To further evaluate the role of miR-21 in tumor cell-specific functions, HSC-3 cells were also transfected with a specific anti-miR-21 inhibitor in order to silence miR-21 expression and block its target functions. Our results demonstrate that anti-miR-21 inhibitor not only upregulates PDCD4 expression but also decreases IAP expression and enhances chemosensitivity in HA-treated HNSCC cells. Together, these findings indicate that the HA-induced CD44 interaction with Nanog and Stat-3 has a pivotal role in miR-21 production leading to PDCD4 reduction, IAP upregulation and chemoresistance in HNSCC cells. This novel Nanog/Stat-3 signaling pathway-specific mechanism involved in miR-21 production is significant for the formation of future intervention strategies in the treatment of HA/CD44-activated HNSCC.
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Cirino E, Iftimia I, Xiong L, Mower H, Wong G. SU-E-T-894: Rapid Arc for Stereotactic Body Radiotherapy. Med Phys 2011. [DOI: 10.1118/1.3612858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lau TW, Leung F, Siu D, Wong G, Luk KDK. Geriatric hip fracture clinical pathway: the Hong Kong experience. Osteoporos Int 2010; 21:S627-36. [PMID: 21058003 PMCID: PMC2974932 DOI: 10.1007/s00198-010-1387-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 08/23/2010] [Indexed: 11/28/2022]
Abstract
Geriatric hip fracture is one of the commonest fractures in orthopaedic trauma. There is a trend of further increase in its incidence in the coming decades. Besides the development of techniques and implants to overcome the difficulties in fixation of osteoporosis bone, the general management of the hip fracture is also very challenging in terms of the preparation of the generally poorer pre-morbid state and complicate social problems associated with this group of patients. In order to cope with the increasing demand, our hospital started a geriatric hip fracture clinical pathway in 2007. The aim of this pathway is to provide better care for this group of patients through multidisciplinary approach. From year 2007 to 2009, we had managed 964 hip fracture patients. After the implementation of the pathway, the pre-operative and the total length of stay in acute hospital were shortened by over 5 days. Other clinical outcomes including surgical site infection, 30 days mortality and also incidence of pressure sore improved when compared to the data before the pathway. The rate of surgical site infection was 0.98%, and the 30 days mortality was 1.67% in 2009. The active participation of physiotherapists, occupational therapists as well as medical social workers also helped to formulate the discharge plan as early as the patient is admitted. In conclusion, a well-planned and executed clinical pathway for hip fracture can improve the clinical outcomes of the geriatric hip fractures.
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Pert P, Butler J, Brodie J, Bruce C, Honzák M, Kroon F, Metcalfe D, Mitchell D, Wong G. A catchment-based approach to mapping hydrological ecosystem services using riparian habitat: A case study from the Wet Tropics, Australia. ECOLOGICAL COMPLEXITY 2010. [DOI: 10.1016/j.ecocom.2010.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wong G, Youdan B, Wong R. Misuse of the Official Information Act by the tobacco industry in New Zealand. Tob Control 2010; 19:346-7. [DOI: 10.1136/tc.2009.034637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vasani S, Whittaker M, Sharma P, Wong G, Patel S, Choa DI. Impact of modernising medical careers on operative training in otolaryngology. Clin Otolaryngol 2010; 35:255-6. [PMID: 20636765 DOI: 10.1111/j.1749-4486.2010.02144.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Scott BW, Chan KFY, Wong G, Ahmed M, Chieverton L, Liu RR, Wood J, Burnham WM. Cytogenesis in the adult rat dentate gyrus is increased following kindled seizures but is unaltered in pharmacological models of absence seizures. Epilepsy Behav 2010; 18:179-85. [PMID: 20537594 DOI: 10.1016/j.yebeh.2010.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2010] [Revised: 04/15/2010] [Accepted: 04/16/2010] [Indexed: 11/20/2022]
Abstract
The production of new neurons continues throughout adulthood in the dentate gyrus of the hippocampal formation, and is believed to play a role in hippocampus-dependent learning and memory. Seizure-induced changes in adult neurogenesis have been examined primarily in convulsive rodent seizure models, but not in models of nonconvulsive absence seizures. This study examined progenitor cell proliferation in the gamma-hydroxybutyrate (GHB) model of typical absence seizures and the AY-9944 model of atypical absence seizures, and compared these results with changes seen in the rat amygdala kindling model. Kindled subjects were found to have 189% more proliferating cells than sham-kindled control subjects, whereas no significant difference was found between the GHB or AY-9944 model and control subjects. These results suggest that changes in adult neurogenesis in models of absence seizures do not occur, and that seizure-induced enhancement of neurogenesis could depend on the characteristics of the seizure discharge.
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165
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Li D, Al Mehthel M, Pudek M, Ur E, Francis G, Prior J, Ronco J, Wong G, Redekop G, Sirrs S. Catecholamine response in critical illness. Clin Biochem 2010. [DOI: 10.1016/j.clinbiochem.2010.04.035] [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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166
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Ho WS, Lee F, Roach M, Small A, Liem BJ, Wong G, Heywood G, Fekrazad MH, Patt YZ. Phase II trial using combination of oxaliplatin, capecitabine, and celecoxib with concurrent radiation in patients with operable rectal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14117] [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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167
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Arnaoutakis K, Morse AB, Ambika S, Wong G, Parameswaran R. Practice-based improvement (PBI) via web based tool (WBT) in multidisciplinary gynecologic oncology clinic (MGOC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e17545] [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
e17545 PBI is a key core competency in fellowship training. Care delivery measurement is increasingly important in medical practice comprising diverse health care professionals. Our MGOC brings together oncology fellows and oncology nurse practitioners (NPs). Long-term survivorship issues like osteoporosis (OP) are important to quality of life. Surgery, chemotherapy or radiation results in early menopause which increase OP risk. Few studies document evaluation of risk of late side effects of cancer therapy. With a retrospective sequential patient (pts) sample, we used American Board of Internal Medicine Practice Improvement Module (ABIM PIM) to assess documented comprehensiveness of OP risk factor evaluation in 25 MGOC pts. ABIM PIM is WBT that enables care process and outcomes assessment in clinical settings compared with national guidelines. Part 1 includes chart abstraction tools, pts, and practice system surveys; part 2 has quality improvement (QI) tools. Part 1 evaluation showed that 68 % pts had endometrial adenocarcinoma; 20% cervical cancer; 12% uterine sarcoma or carcinosarcoma. 76% received whole pelvic radiation; 24% received brachytherapy. Mean age was 63 years (range 41–87). 67% pts had normal bone density scan. Smoking status (100%); exercise levels (84%) were well documented. Exam documented height (84%), weight (96%), height loss (76%); presence or absence of kyphosis (96%) in the majority. 64% of pts had bone density scans. Vitamin(vit) D levels were documented in 4%. No pts had complete fall risk evaluation, estimated dietary calcium (Ca)/vitamin D intake or documented adequacy of Ca or vit D intake. Counseling for appropriate Ca/vitamin D intake was poor (4%/8%). Counseling for weight bearing exercise (WBE) was poor (8%). We have targeted areas for improvement for part 2: vit D level evaluation, assessment of and counseling for adequate of Ca/ vit D intake and WBE. An improvement plan has been implemented. Reassessment of documentation adequacy will be performed on a systematic random sample of 25 pts in 6 months. The ABIM PIM in OP enables fellows and NPs to identify weaknesses in documentation practices and pt care leading to formal QI plans to address long term survivorship issue of OP in MGOC. No significant financial relationships to disclose.
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Wong G, Webster AC, Chapman JR, Craig JC. Reported cancer screening practices of nephrologists: results from a national survey. Nephrol Dial Transplant 2009; 24:2136-43. [DOI: 10.1093/ndt/gfp009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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169
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Webster AC, Wong G, Craig JC, Chapman JR. Managing cancer risk and decision making after kidney transplantation. Am J Transplant 2008; 8:2185-91. [PMID: 18782291 DOI: 10.1111/j.1600-6143.2008.02385.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Kidney transplant recipients are at higher risk of cancer at most sites, and cancer after transplantation causes considerable morbidity and mortality. To optimize long-term patient outcomes, clinicians balance the prospect of graft failure and dialysis, with competing risks of diabetes, cardiovascular and cerebrovascular disease and the risk of malignancy. In this paper we critically examine the assumptions underpinning primary prevention, immunization, chemoprevention and screening programs, and highlight considerations when applying evidence to the kidney transplant population, and suggest a clinical research agenda that aims to define a rational approach to managing posttransplant cancer risk.
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Wong G, Howard K, Webster AC, Chapman JR, Craig JC. IS SCREENING FOR CERVICAL CANCER IN KIDNEY TRANSPLANT RECIPIENTS COST-EFFECTIVE? THE COSTS AND HEALTH BENEFITS OF SCREENING FOR CERVICAL CANCER IN WOMEN WITH KIDNEY TRANSPLANTS. Transplantation 2008. [DOI: 10.1097/01.tp.0000331942.21850.eb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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171
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Ng C, Wong G, Kwong D, Chiu A. TU-FF-A1-04: Dosimetric Effect of Setup Errors On NPC IMRT Treatments. Med Phys 2008. [DOI: 10.1118/1.2962641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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172
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Bala A, Knuckey N, Wong G, Lee GYF. Longitudinal clivus fracture associated with trapped basilar artery: unusual survival with good neurological recovery. J Clin Neurosci 2008; 11:660-3. [PMID: 15261246 DOI: 10.1016/j.jocn.2003.11.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2003] [Accepted: 11/18/2003] [Indexed: 11/28/2022]
Abstract
A 46-year-old motorcyclist sustained severe cranio-facial fractures from a fall at 60 km/h. He gradually developed a left hemiparesis and diplopia but retained a GCS of 15. CT head scan revealed a longitudinal clivus fracture. MRA of intracranial vessels identified a trapped basilar artery. The patient made an excellent recovery with residual left abducens palsy on follow-up at 10 weeks. Such recovery with minimal residual deficit in the context of this injury has not previously been reported. Reported cases to date are reviewed and causative mechanisms discussed.
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Churas K, Wong G, Jarrard D, Paolone D, Graf A, Hedican S, Wegenke J, Ritter M. 2254. Int J Radiat Oncol Biol Phys 2006. [DOI: 10.1016/j.ijrobp.2006.07.661] [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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174
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Renno SI, Rao RD, Sloan J, Wong G, Johnson D, Howard GM, Novotny P, Patrick FJ, Loprinzi CL. The efficacy of lamotrigine in the management of chemotherapy-induced peripheral neuropathy: A phase III randomized, double blind, placebo-controlled NCCTG trial, N01C3. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8530] [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
8530 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose limiting complication of chemotherapy. Lamotrigine (an anti-convulsant drug) appears to have some benefit when used to treat pain from neuropathy due to various etiologies. Based on these data, we conducted a phase III randomized placebo controlled study to determine the efficacy of lamotrigine in treating symptoms from CIPN. Methods: Patients with CIPN for 1 month or more were randomly assigned to lamotrigine (target dose 300 mg/day, increased by 50 mg/2 weeks) or placebo for 10 weeks. The co-primary endpoints were differences in average CIPN symptoms assessed by pro-rated area under the curve (AUC) of a numerical pain rating scale (NRS) and the Eastern Cooperative Oncology Group sensory neuropathy (ESN) scale. Accrual of 60 patients per group provided t-tests with 80% power to detect a difference of 0.57 standard deviation for each co-primary endpoint (moderate effect size) with a type I error of 0.025. Results: 131patients were enrolled, with complete data available for analysis in 93 (72%). Analyses were limited to this cohort but will be updated. Chemotherapy drugs considered to be causative of the CIPN were vinca alkaloids (30%), taxanes (25%), platinum-agents (7%), combinations (34%), and others (3%). Patients were equally matched with regards to baseline characteristics. Patients who enrolled had severe symptoms, with a baseline median ESN at enrollment of 3 (out of 3) in both groups. Toxicities were similar in both groups, however, more patients discontinued lamotrigine due to toxicities/refusals than those on placebo (32% vs 13% resp; p=0.04) and were therefore less likely to complete the 10 weeks therapy (60% vs. 78% resp, p=0.08). Average AUC of NRS score for patients on lamotrigine and placebo was 30.5 and 33.7 resp (p=0.48). The corresponding average AUC of the ESN scores were 12.4 and 14.5 (p=0.23). The proportions of patients with a 10 point (of 100) improvement in worst pain score (39% vs 36%) and a 1 point change in ESN (25% vs 27%) were similar between the lamotrigine and placebo arms, resp. Conclusions: These results suggest that lamotrigine is not effective for managing pain and symptoms due to CIPN. No significant financial relationships to disclose.
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Wong G. Potential Adverse Reaction from Complementary and Alternative Medicines (CAM) Brought in from Overseas. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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