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Wieland ML, Njeru JW, Weis JA, Lohr A, Nigon JA, Goodson M, Osman A, Molina L, Ahmed Y, Capetillo GP, Nur O, Sia IG. Rochester Healthy Community Partnership: Then and now. Front Public Health 2023; 10:1090131. [PMID: 36703848 PMCID: PMC9871468 DOI: 10.3389/fpubh.2022.1090131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Community-engaged research partnerships promote health equity through incorporation of regional contexts to inform partnership dynamics that shape research and interventions that reflect community voice and priorities. Long-term partnerships build trusted relationships and promote capacity building among community and academic partners, but there are many structural barriers to sustaining long-term partnerships. Here we describe lessons learned from sustaining Rochester Healthy Community Partnership (RHCP), an 18-year community-based participatory research (CBPR) partnership in Southeast Minnesota. RHCP collaborates with immigrant and refugee populations to co-create interventions that promote health equity for community health priorities. Challenges to sustainability include a tension between project-based funding and the needs of long-term community-based research infrastructure. These challenges can be met with a focus on shared CBPR principles, operating norms, partnership dynamics, and governance. RHCP began in 2004 through identification of a community health priority, defining the community, and establishment of CBPR principles. It grew through identification of broader community health priorities, capacity building for community and academic partners, and integration of diverse learners. We describe the capacity for RHCP to respond to new societal contexts, the importance of partnership dynamics as a barometer for partnership health, and lessons learned about sustainability of the CBPR partnership.
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Affiliation(s)
- Mark L. Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States,*Correspondence: Mark L. Wieland ✉
| | - Jane W. Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Jennifer A. Weis
- Rochester Healthy Community Partnership, Rochester, MN, United States,Center for Clinical and Translational Science, Mayo Clinic, Rochester, MN, United States
| | - Abby Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, United States,Rochester Healthy Community Partnership, Rochester, MN, United States
| | - Julie A. Nigon
- Rochester Healthy Community Partnership, Rochester, MN, United States,Hawthorne Education Center, Rochester, MN, United States
| | - Miriam Goodson
- Rochester Healthy Community Partnership, Rochester, MN, United States,Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, MN, United States
| | - Ahmed Osman
- Rochester Healthy Community Partnership, Rochester, MN, United States,Intercultural Mutual Assistance Association, Rochester, MN, United States
| | - Luz Molina
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Yahye Ahmed
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Graciela Porraz Capetillo
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
| | - Omar Nur
- Rochester Healthy Community Partnership, Rochester, MN, United States,Somali American Social Service Association, Rochester, MN, United States
| | - Irene G. Sia
- Rochester Healthy Community Partnership, Rochester, MN, United States,Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, United States
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Coulter K, Ingram M, Lohr A, Figueroa C, Coronado G, Espinoza C, Esparza M, Monge S, Velasco M, Itule-Klasen L, Bowen M, Wilkinson-Lee A, Carvajal S. Adaptation of a Community Clinical Linkages Intervention to the COVID-19 Pandemic: A Community Case Study. Front Public Health 2022; 10:877593. [PMID: 35812475 PMCID: PMC9256923 DOI: 10.3389/fpubh.2022.877593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
In this community case study, we describe the process within an academic-community partnership of adapting UNIDOS, a community health worker (CHW)-led community-clinical linkages (CCL) intervention targeting Latinx adults in Arizona, to the evolving landscape of the COVID-19 pandemic. Consistent with community-based participatory research principles, academic and community-based partners made decisions regarding changes to the intervention study protocol, specifically the intervention objectives, participant recruitment methods, CHW trainings, data collection measures and management, and mode of intervention delivery. Insights from this case study demonstrate the importance of community-based participatory research in successfully modifying the intervention to the conditions of the pandemic and also the cultural background of Latinx participants. This case study also illustrates how a CHW-led CCL intervention can address social determinants of health, in which the pandemic further exposed longstanding inequities along racial and ethnic lines in the United States.
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Affiliation(s)
- Kiera Coulter
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- *Correspondence: Kiera Coulter
| | - Maia Ingram
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Abby Lohr
- Department of Community Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Carlos Figueroa
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Gloria Coronado
- Yuma County Public Health Services District, Yuma, AZ, United States
| | - Cynthia Espinoza
- Yuma County Public Health Services District, Yuma, AZ, United States
| | - Maria Esparza
- Yuma County Public Health Services District, Yuma, AZ, United States
| | - Stacey Monge
- Pima County Health Department, Tucson, AZ, United States
| | - Maria Velasco
- El Rio Community Health Center, Tucson, AZ, United States
| | | | | | - Ada Wilkinson-Lee
- Department of Mexican American Studies, University of Arizona, Tucson, AZ, United States
| | - Scott Carvajal
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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Strelnick H, Jiménez EB, Lohr A, Espinoza C. Beyond the Manuscript: A Conversation with Community Health Workers. Prog Community Health Partnersh 2022. [DOI: 10.1353/cpr.2022.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Coulter K, Ingram M, McClelland DJ, Lohr A. Positionality of Community Health Workers on Health Intervention Research Teams: A Scoping Review. Front Public Health 2020; 8:208. [PMID: 32612967 PMCID: PMC7308474 DOI: 10.3389/fpubh.2020.00208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
Community health workers (CHWs) are increasingly involved as members of health intervention research teams. Given that CHWs are engaged in a variety of research roles, there is a need for better understanding of the ways in which CHWs are incorporated in research and the potential benefits. This scoping review synthesizes evidence regarding the kinds of health research studies involving CHWs, CHWs' roles in implementing health intervention research, their positionality on research teams, and how their involvement benefits health intervention research. The scoping review includes peer-reviewed health intervention articles published between 2008-2018 in the U.S. A search of PubMed, Embase and CINAHL identified a total of 3,129 titles and abstracts, 266 of which met the inclusion criteria and underwent full text review. A total of 130 articles were identified for a primary analysis of the research and the level of CHWs involvement, and of these 23 articles were included in a secondary analysis in which CHWs participated in 5 or more intervention research phases. The scoping review found that CHWs are involved across the spectrum of research, including developing research questions, intervention design, participant recruitment, intervention implementation, data collection, data analysis, and results dissemination. CHW positionality as research partners varied greatly across studies, and they are not uniformly integrated within all stages of research. The majority of these studies employed a community based participatory research (CBPR) approach, and CBPR studies included CHWs as research partners in more phases of research relative to non-CBPR studies. This scoping review documents specific benefits from the inclusion of CHWs as partners in health intervention research and identifies strategies to engage CHWs as research partners and to ensure that CHW contributions to research are well-documented.
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Affiliation(s)
- Kiera Coulter
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Maia Ingram
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Deborah Jean McClelland
- University of Arizona Health Sciences Library, University of Arizona, Tucson, AZ, United States
| | - Abby Lohr
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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Ingram M, Doubleday K, Bell ML, Lohr A, Murrieta L, Velasco M, Blackburn J, Sabo S, Guernsey de Zapien J, Carvajal SC. Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records. Am J Public Health 2017; 107:1668-1674. [PMID: 28817321 PMCID: PMC5607666 DOI: 10.2105/ajph.2017.303934] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs). METHODS We examined EHRs of 32 147 patients at risk for chronic disease during 2012 to 2015. Variables included contact with clinic-based CHWs, vitals, and laboratory tests. We estimated a mixed model for all outcomes. RESULTS Within-group findings showed statistically significant improvements in chronic disease indicators after exposure to CHWs. In health center 1, HbA1c (glycated hemoglobin) decreased 0.15 millimoles per mole (95% confidence interval [CI] = -0.24, -0.06), body mass index decreased 0.29 kilograms per meter squared (CI = -0.39, -0.20), and total cholesterol decreased 11.9 milligrams per deciliter (CI = -13.5, -10.2). In health center 2, HbA1c decreased 0.43 millimoles per mole (CI = -0.7, -0.17), body mass index decreased by 0.08 kilograms per meter squared (CI = -0.14, -0.02), and triglycerides decreased by 22.50 milligrams per deciliter (CI = -39.0, -6.0). Total cholesterol of 3.62 milligrams per deciliter (CI = -6.6, -0.6) in health center 1 was the only improvement tied to CHW contact. CONCLUSIONS Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.
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Affiliation(s)
- Maia Ingram
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Kevin Doubleday
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Melanie L Bell
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Abby Lohr
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Lucy Murrieta
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Maria Velasco
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - John Blackburn
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Samantha Sabo
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Jill Guernsey de Zapien
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
| | - Scott C Carvajal
- Maia Ingram, Kevin James Doubleday, Melanie L. Bell, Abby Lohr, Samantha Sabo, Jill Guernsey de Zapien, and Scott C. Carvajal are with the College of Public Health, University of Arizona, Tucson. Lucy Murrieta is with the Sunset Community Health Center, Yuma, AZ. Maria Velasco and John Blackburn are with the El Rio Community Health Center, Tucson
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Batfalsky A, Lohr A, Heussen N, Neunhoeffer F, Orlikowsky TW. Diagnostic value of an interleukin-6 bedside test in term and preterm neonates at the time of clinical suspicion of early- and late-onset bacterial infection. Neonatology 2012; 102:37-44. [PMID: 22507910 DOI: 10.1159/000336632] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 01/16/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND For quick detection or exclusion of neonatal early-onset bacterial infection (EOBI) or late-onset bacterial infection (LOBI), interleukin (IL)-6 is used. Its clinical use is sometimes limited due to prolonged recall times. Therefore, an IL-6 bedside test was established. OBJECTIVE To compare the diagnostic value of plasma IL-6 and an IL-6 bedside test at the time of clinical suspicion in the course of EOBI and LOBI. METHODS Eighteen term (mean gestational age 40.2 weeks, SD 1.3) and 88 preterm (mean gestational age 30.1 weeks, SD 4.2) neonates with clinical and serological signs of bacterial infection were analysed. Eight had an EOBI, and 24 had a LOBI, of whom 13 were blood culture positive. Twelve term and 62 preterm neonates with risk factors but without proven EOBI/LOBI served as a non-infected group. RESULTS At the time of clinical suspicion, the sensitivity of the IL-6 bedside test in comparison to plasma IL-6 was 69 versus 75% (p = 0.7744, McNemar's test), and specificity was 77 versus 81% (p = 0.6476, McNemar's test; cutoff level 50 ng/l). For LOBI, both the sensitivity (75%) and specificity (82%) of the bedside test exceeded values calculated for EOBI (sensitivity 50%, specificity 75%). CONCLUSION No significant difference between the bedside and established plasma IL-6 test was detected for LOBI. For detection of EOBI, the bedside test was not sensitive enough. Larger studies are needed to verify our findings before IL-6 bedside tests can be recommended routinely.
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Affiliation(s)
- A Batfalsky
- Department of Neonatology, University Hospital RWTH Aachen, Aachen, Germany
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Lohr A, Batfalsky A, Heussen N, Neunhoeffer F, Vaeßen P, Orlikowsky T. IL-6-Bedsite-Test in der Diagnose von bakteriellen Infektionen bei Früh- und Reifgeborenen. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schoberer M, Faber K, Schimitzek HD, Vaeßen P, Lohr A, Grünhagen A, Orlikowsky T. Die perfekte Welle? Erfahrungen mit dem Pleth Variability Index (PVI) beim Früh- und Neugeborenen. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lohr A, Schoberer M, Heimann K, Wenzl T, Lämmel A, Orlikowsky T. Konnatale Diarrhoe bei zweieiigen Zwillingen: Glukose Galaktose Malabsorption. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vergote I, Finkler N, del Campo J, Lohr A, Hunter J, Matei D, Spriggs D, Kavanagh J, Vermorken J, Brown GL, Kaye S. Single agent, canfosfamide (C, TLK286) vs pegylated liposomal doxorubicin (D) or topotecan (T) in 3rd-line treatment of platinum (P) refractory or resistant ovarian cancer (OC): Phase 3 study results. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba5528] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA5528 Background: Canfosfamide (C) is a novel glutathione analog prodrug activated by glutathione S-transferase P1–1. P resistant OC has a poor prognosis and non-P agents are used for palliation. C reported objective responses in multicenter Phase 2 OC trials. Methods: Pts with P resistant OC who progressed after D or T, measurable disease (RECIST), adequate liver/renal/bone marrow function were eligible. Randomization was stratified by prior D or T treatment, ECOG PS (0 or 1 vs 2) and presence or absence of bulky disease (= 5cm). Patients received C at 1000 mg/m2 IV q3wks, or to D at 50 mg/m2 IV q4wks or T at 1.5 mg/m2 IV daily × 5 q3wks until progression. The trial had a 90% power to detect a 29% reduction in the relative risk of death. Results: 461 pts (C=232 and D or T=229) received 1052 cycles [median 3; range (r) 1–33], 699 (median 4; r 1–32), and 469 (median 5; r 1–21) for C, D and T respectively. Most common Grade 3–4 AEs for C were: nausea (31.6%), vomiting (8.7%), fatigue (6.1%), and anemia (5.6%), for D/T were: nausea (55.3%), anemia (15.2%), fatigue (6.9%), neutropenia (23.5%), thrombocytopenia (12.4%), febrile neutropenia (6%), stomatitis (6%), and PPE syndrome (6%). ORR for C was 4.3% including a CR, vs 10.9% ORR for D/T. Median survival (MS) was 8.5 mos for C, 13.6 mos for D/T (p=0.0001). Median progression-free survival was 2.3 mos for C and 4.4 mos for D/T, (p=0.0001). D/T MS was 14.2/10.8 mos, respectively. Conclusions: Canfosfamide did not meet the primary endpoint. C demonstrated single agent activity in P refractory or resistant OC and was well tolerated. C in combination with standard agents in less heavily treated OC trials are in progress. No significant financial relationships to disclose.
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Affiliation(s)
- I. Vergote
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - N. Finkler
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. del Campo
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - A. Lohr
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. Hunter
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - D. Matei
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - D. Spriggs
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. Kavanagh
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - J. Vermorken
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - G. L. Brown
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
| | - S. Kaye
- Universitar Ziekenhuis Gathuisberg, Leuven, Belgium; Wright State University FL State Hospital, Orlando, FL; Hospital General Vail d’Hebron, Barcelona, Spain; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Cancer Treatment Center Greenville Hospital, Greenville, SC; Indiana University Cancer Center, Indianopolis, IN; Memorial Sloan Kettering Cancer Center, New York, NY; MD Anderson Cancer Center, Houston, TX; Universitar Ziekenhuis Antwerpen, Edegem, Belgium; Telik, Inc., Palo Alto, CA; The Royal Marsden
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Greiner G, Jung A, Conraux C, Lohr A, Hamadouche D. Récupérations auditives après dégagement de l'artère vertébrale par uncusectomie. Stereotact Funct Neurosurg 2007. [DOI: 10.1159/000103775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Wajner M, Barschak AG, Luft AP, Pires R, Grillo E, Lohr A, Funayama C, Sanseverino MT, Giugliani R, Vargas CR. [Organic aciduria: diagnosis in high-risk Brazilian patients]. J Pediatr (Rio J) 2001; 77:401-6. [PMID: 14647845 DOI: 10.2223/jped.282] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE: To determine the prevalence of organic acidurias in high-risk Brazilian patients. METHODS: Laboratory techniques for the detection and quantification of organic acids by gas chromatography/mass spectrometry were implemented in Porto Alegre, Brazil. We investigated 1,480 patients suspected of organic aciduria between January 1994 and June 2000. RESULTS: Seventy three (4.9%) cases of organic acidemias (acidurias) were diagnosed among the tested individuals. In most of these patients, prompt therapy resulted in rapid symptom improvement; these results are completely different from our previous cases diagnosed in other laboratories in Europe and the United States, where several patients died before any measures could be taken. CONCLUSIONS: These results demonstrate the importance of diagnosing organic acidurias in loco even in developing countries, in spite of the extra costs involved.
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Affiliation(s)
- M Wajner
- Hospital de Clínicas de Porto Alegre (HCPA), RS, Brazil
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14
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Katzenberger T, Lohr A, Ott MM, Kalla J, Rosenwald A, Müller-Hermelink HK, Ott G. [Genetic and biological features define two types of follicular non-Hodgkin grade 3 lymphoma]. Verh Dtsch Ges Pathol 2001; 84:153-61. [PMID: 11217435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In the REAL classification system, follicular lymphomas (FL) were subdivided into three grades depending on the number of blasts (6). In this study, we were interested in defining biological parameters possibly being important in the delineation of subgroups. Between 1990 and 1998, biological and cytogenetic investigations were performed on 91 FL. Clonal aberrations were found in all cases. The tumours were subclassified according to the blast content and the morphology of the centrocytes into 29 FL 1, 33 FL 2, 15 FL 3, and 14 FL 3 with a diffuse large B-cell lymphoma component (FL 3 + DLBL). They were characterised by classical cytogenetics, for their mitotic (MI) and proliferative (PI) indices, and CD10, bcl-2, and p53-expression. In contrast to FL 1 and FL 2, which showed a common genetic background with t(14;18), and only differed by their blast content and MI/PI, FL 3 (with or without associated DLBL) turned out to be an inhomogeneous group. 11 follicular lymphomas (with > 150 blasts/10HPF) still showed maturation to centrocytes. They were positive for CD10 and harboured the t(14;18) in 73%. These cases correspond to a "high grade" variant of centroblastic-centrocytic lymphoma according to the Kiel classification (FL 3a). In 18 cases with a follicular or follicular and diffuse growth pattern, the infiltrate consisted of centroblasts exclusively. These tumours were CD10+ in only 50% and were t(14;18)+ in only 22%. Secretory differentiation (clg+) was found in 44%. They were--with respect to primary and secondary chromosome aberrations--more comparable to a follicular variant of DLBL and hence, correspond to centroblastic lymphoma, follicular or centroblastic lymphoma, follicular and diffuse according to the Kiel classification (FL 3b). By histomorphological, biological and cytogenetic investigations, therefore, FL 3 can be delineated into two different biological subgroups with obviously different transformation pathways.
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15
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O'Neill P, Trombley L, Gundel M, Hunter T, Nicklas JA, Ferreira ML, Bugallo MJ, Farias AC, Lohr A, Diamantopoulos M, Raskin S. Identification of a new Lesch-Nyhan syndrome mutation (HPRTBrasil) and analysis of potentially heterozygous females. Arq Neuropsiquiatr 1999; 57:907-11. [PMID: 10683677 DOI: 10.1590/s0004-282x1999000600001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The mutation in the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene has been determined in two brothers affected with Lesch-Nyhan syndrome. Female members of the family who are at risk for being heterozygous carriers of the HPRT mutation were also studied to determine whether they carry the mutation. DNA sequencing revealed that the boys' mother is heterozygous for the mutation in her somatic cells, but that three maternal aunts are not heterozygous. Such carrier information is important for the future pregnancy plans of at-risk females. The mutation, an A-->T transversion at cDNA base 590 (590A-->T), results in an amino acid change of glutamic acid to valine at codon 197, and has not been reported previously in a Lesch-Nyhan syndrome male. This mutation is designated HPRTBrasil.
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Affiliation(s)
- P O'Neill
- Genetics Laboratory, University of Vermont, Burlington, USA
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17
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Sotomaior V, Janzen-Dück M, Barbosa C, Antoniuk S, Lohr A, Brunoni D, Barbato Filho J, Lewis E, Neto C, Riegel M, Raskin S. 5-29-09 Fragile-X syndrome DNA test. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)86440-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Howanitz PJ, Sunseri DA, Love LA, Lohr A. Adapting mobile robotic technology to intralaboratory specimen transport. Arch Pathol Lab Med 1996; 120:944-50. [PMID: 12046606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To evaluate and implement two identical inexpensive robotic vehicles for transport of patient specimens within our clinical laboratory. DESIGN We accepted delivery of the first two robotic vehicles produced by a local vendor and studied the vehicles for 13 months. The first 4 months of familiarization and customization were followed by 9 months of routine use. SETTING Within the specimen-processing, hematology, and chemistry sections of a large academic medical center's clinical laboratory, one floor below ground. INTERVENTION The vehicles replaced 1.5 individuals who transported specimens. OUTCOME MEASURES The number of kilometers the vehicles traveled and the number of routes begun, completed, not completed, and with unknown status. In addition, we assessed the types of problems that occurred, employee satisfaction, and financial payback. RESULTS When used on all shifts for 13 months, the vehicles traveled an average of over 2000 routes and 212 km per month. At any one time, at least one vehicle was operational. Of the 17 problems that occurred, the most frequent were navigational problems caused by obstacles, such as personnel, in the vehicle's right-of-way. For 6 of the last 9 months, navigational, mechanical, and electronic problems together occurred no more than two or three times per week. Financial payback for the vehicles occurred in less than one year. CONCLUSIONS By the end of the study, the robotic vehicles completed 99.4% of their routes. Specimen-processing and transport personnel reported the vehicles made their jobs easier and improved timeliness of specimen delivery. We anticipate our potential savings over 5 years to be approximately $200,000 (US).
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Affiliation(s)
- P J Howanitz
- Department of Pathology, University of California at Los Angeles Medical Center, 90095-1713, USA
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Gottlieb B, Lohr A, Becker W, Kleber M. Dynamics of electronic wave packets in field emission and intense-field laser-atom physics. Phys Rev A 1996; 54:R1022-R1025. [PMID: 9913662 DOI: 10.1103/physreva.54.r1022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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20
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Schendel KU, Lohr A, Komposch G. [The direct transplantation of desmodont fibroblasts onto the necks of the teeth--a step in the expansion of the treatment potentials in orthodontics?]. Fortschr Kieferorthop 1994; 55:126-31. [PMID: 8045484 DOI: 10.1007/bf02341485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The loss of periodontal support, especially of the periodontal ligament, presents the orthodontist with a constraining factor precisely in the treatment of patients who have reached adult and senior citizen age. Given this situation it was decided to take small biopsies of periodontal ligament cells, grow them, amplify them in vitro, and then with the help of different types of membranes, some of which consisted of resorbable materials, which served as cell carriers, transplant them onto tooth roots. The work reported here constitutes a starting point for research aimed at actively and directly re-populating tooth roots with periodontal ligament fibroblasts and thus, by improving the overall periodontal condition, widen the spectrum of treatment possibilities open to the orthodontist.
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Affiliation(s)
- K U Schendel
- Poliklinik für Kieferorthopädie, Universität Heidelberg
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21
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Embree L, Gelmon KA, Lohr A, Mayer LD, Coldman AJ, Cullis PR, Palaitis W, Pilkiewicz F, Hudon NJ, Heggie JR. Chromatographic analysis and pharmacokinetics of liposome-encapsulated doxorubicin in non-small-cell lung cancer patients. J Pharm Sci 1993; 82:627-34. [PMID: 8392545 DOI: 10.1002/jps.2600820617] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A sensitive and specific quantitative assay for total doxorubicin concentrations in plasma containing liposome-encapsulated doxorubicin hydrochloride (TLC D-99) was developed, with solvent extraction and reversed-phase high-performance liquid chromatography (HPLC). Separation of doxorubicin from its metabolites was accomplished with a 15 cm x 3.9 mm i.d., microBondapak phenyl analytical HPLC column. Optimum chromatographic conditions, obtained with a mobile phase gradient from 85 to 50% (v/v) 16 mM ammonium formate buffer in tetrahydrofuran at a flow rate of 2 mL/min, gave a detection limit of 0.3 pmol/injection. Eleven-point standard curves with from 0.00595 to 29.8 microM TLC D-99 and 0.1 microM internal standard in plasma were analyzed on three separate occasions to formally validate this assay. An overall correlation coefficient of 0.9985 was found for the logarithmic transformed data. The pharmacokinetic characteristics of doxorubicin were investigated after administration of TLC D-99 to 12 non-small-cell lung cancer patients as an intravenous infusion at doses of 60 and 75 mg/m2. The data are best described by a three-compartment model with alpha, beta, and gamma elimination half-lives of 0.0721, 2.84, and 25.2 h for the 60-mg/m2 group and 0.103, 2.56, and 14.9 h for the 75-mg/m2 patients. A mean plasma clearance of 9.89 L/h (range: 1.95 to 23.4 L/h) was found for the 60-mg/m2 patients, with that from the 75-mg/m2 group being within these values. Mean area under the plasma concentration versus time curve estimates of 37.1 and 47.9 microM/h were observed for the patients receiving 60 and 75 mg/m2, respectively. The plasma concentration-time course for total doxorubicin following administration of TLC D-99 suggests that the disposition of the liposomal formulation is determined more by the pharmacokinetics of the liposome than the encapsulated drug.
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Affiliation(s)
- L Embree
- British Columbia Cancer Agency, Vancouver, Canada
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Abstract
The case of 12 years-old boy with seizures, headache, severe vomit and focal neurological signs is reported. These episodes had several recurrences and regression with little neurologic deficits. In the investigation it was found: lactic acidosis; stroke like episodes and calcification in the basal ganglia on computerized axial tomography; ragged red fibers on muscle biopsy and decreased of cytochrome C oxidase in the muscle tissue. A revision about mitochondrial disorders with involvement of the central nervous system and muscle is made, with emphasis on diagnosis and recognition of MELAS.
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Affiliation(s)
- L C Werneck
- Departamento de Clínica Médica, Universidade Federal do Paraná, Curitiba
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Wackenheim A, Vierling JP, Lohr A, Greiner GF, Jung A. [Denervation of the carotid sinus in a case of sinusal hyper-reflectivity with Meniere's syndrome and cervico-cranial pains]. Ann Chir 1965; 19:1540-4. [PMID: 5853224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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