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Safarova M, Gorby L, Dutton J, Nugent A, Moriarty PM. Progression of carotid intima-media thickness in patients treated with lipoprotein apheresis: real-world evidence over 12 years. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/13/2022] Open
Abstract
Abstract
Background
The extent of intervention effects on carotid intima-media thickness (CIMT) can predict the degree of atherosclerotic cardiovascular disease (ASCVD) risk reduction. There is limited evidence of long-term effects of lipoprotein apheresis on the CIMT progression.
Purpose
We hypothesized that regular lipoprotein apheresis over the course of 10 years may slow down progression of CIMT in patients with severe hypercholesterolemia.
Methods
This case series describes ten Caucasian patients (mean age 60±9 years, 70% female, 80% statin intolerant) with familial hypercholesterolemia and/or hyperlipoproteinemia(a) treated with lipoprotein apheresis at a single academic center between 2005 and 2020. The mean and maximum diastolic CIMT of the distal 1 cm of the far wall of the right and left common carotid arteries was measured by the same, trained sonographer utilizing an automated border-detection algorithm.
Results
The median pre-treatment low-density lipoprotein cholesterol (LDL-C) level was 214 mg/dL (95% confidence interval, 145 to 248), lipoprotein(a), 26 mg/dL (15 to 109; 40% with lipoprotein(a) >60 mg/dL). Using the imputed trajectories, period-specific on-treatment time-weighted averages for LDL-C and lipoprotein(a) were 141 mg/dL (IQR, 89 to 152) and 24 mg/dL (IQR, 12 to 119), respectively. The baseline mean CIMT was 850±170μm and maximum CIMT was 1040±220μm across the age range of 46 to 70 years. Over a median duration of 12 years, regular treatment with lipoprotein apheresis resulted in an average reduction in the mean CIMT of −40μm (IQR, −50 to 20) and maximum CIMT −30μm (IQR, −60 to −10). Among tested lipid and lipoprotein fractions in this sample, the follow-up mean CIMT values strongly correlated only with the baseline lipoprotein(a) levels. Median CIMT progression rates were as follows: mean common carotid, −4μm/y (IQR, −9 to 1), mean common carotid, −12μm/3y (IQR, −26 to 4), maximal common carotid, −3μm/y (IQR, −8 to −1). This translated into 70% (7/10) of cases demonstrating composite mean CIMT below their expected chronologic age, gender and race-stratified vascular age. There was a strong direct correlation between the mean CIMT value at the end of the treatment period and the age of treatment initiation. In this cohort of primary and secondary prevention of patients with severe hypercholesterolemia, the overall rate of ASCVD was 37.5 per 1000 person-years while on lipoprotein apheresis.
Conclusions
Our observation performed in the clinical setting, demonstrated a real-world effectiveness of lipoprotein apheresis. This analysis supports implementation of aggressive lipid-modifying strategies across all ages. Surveillance with CIMT allows for continued monitoring of atherosclerosis progression and increases compliance with the lipid-modifying therapies in the high-risk patients with poor statin tolerance in the clinical setting.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): KUMC
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Affiliation(s)
- M Safarova
- University of Kansas Medical Center, Cardiovascular Medicine, Kansas City, United States of America
| | - L Gorby
- University of Kansas Medical Center, Pharmacology, Kansas City, United States of America
| | - J Dutton
- University of Kansas Medical Center, Pharmacology, Kansas City, United States of America
| | - A Nugent
- University of Kansas Medical Center, Pharmacology, Kansas City, United States of America
| | - P M Moriarty
- University of Kansas Medical Center, Pharmacology, Kansas City, United States of America
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da Silveira WA, Fazelinia H, Rosenthal SB, Laiakis EC, Kim MS, Meydan C, Kidane Y, Rathi KS, Smith SM, Stear B, Ying Y, Zhang Y, Foox J, Zanello S, Crucian B, Wang D, Nugent A, Costa HA, Zwart SR, Schrepfer S, Elworth RAL, Sapoval N, Treangen T, MacKay M, Gokhale NS, Horner SM, Singh LN, Wallace DC, Willey JS, Schisler JC, Meller R, McDonald JT, Fisch KM, Hardiman G, Taylor D, Mason CE, Costes SV, Beheshti A. Comprehensive Multi-omics Analysis Reveals Mitochondrial Stress as a Central Biological Hub for Spaceflight Impact. Cell 2021; 183:1185-1201.e20. [PMID: 33242417 DOI: 10.1016/j.cell.2020.11.002] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/01/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
Spaceflight is known to impose changes on human physiology with unknown molecular etiologies. To reveal these causes, we used a multi-omics, systems biology analytical approach using biomedical profiles from fifty-nine astronauts and data from NASA's GeneLab derived from hundreds of samples flown in space to determine transcriptomic, proteomic, metabolomic, and epigenetic responses to spaceflight. Overall pathway analyses on the multi-omics datasets showed significant enrichment for mitochondrial processes, as well as innate immunity, chronic inflammation, cell cycle, circadian rhythm, and olfactory functions. Importantly, NASA's Twin Study provided a platform to confirm several of our principal findings. Evidence of altered mitochondrial function and DNA damage was also found in the urine and blood metabolic data compiled from the astronaut cohort and NASA Twin Study data, indicating mitochondrial stress as a consistent phenotype of spaceflight.
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Affiliation(s)
| | - Hossein Fazelinia
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | | | | | - Man S Kim
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Cem Meydan
- Weill Cornell Medical College, New York, NY 10065, USA
| | - Yared Kidane
- Texas Scottish Rite Hospital for Children, Dallas, TX 75219, USA
| | - Komal S Rathi
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | | | - Benjamin Stear
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Yue Ying
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Yuanchao Zhang
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Jonathan Foox
- Weill Cornell Medical College, New York, NY 10065, USA
| | | | | | - Dong Wang
- University of California San Francisco, San Francisco, CA 94115, USA
| | | | | | - Sara R Zwart
- University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Sonja Schrepfer
- University of California San Francisco, San Francisco, CA 94115, USA
| | | | | | | | | | | | | | - Larry N Singh
- Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Douglas C Wallace
- Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | | | - Robert Meller
- Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - J Tyson McDonald
- Georgetown University Medical Center, Washington D.C. 20057, USA
| | | | - Gary Hardiman
- Queens University Belfast, Belfast BT9 5DL, UK; Medical University of South Carolina, Charleston, SC 29425, USA
| | - Deanne Taylor
- The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | | | - Afshin Beheshti
- KBR, NASA Ames Research Center, Moffett Field, CA 94035, USA.
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Nugent A, Conatser KR, Turner LL, Nugent JT, Sarino EM, Ricks-Santi LJ. Abstract LB-180: Underreporting of race in genomic sequencing studies increases cancer health information disparities. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-lb-180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: Minorities are often underrepresented in clinical cancer research and the frequency of reporting of race in genomic sequencing studies of cancer is unknown. Disproportionate reporting of race can widen health information disparities and impair clinical decision-making in the underrepresented minority populations in whom cancer disease burden is greatest. This study determined the extent to which race is reported as a clinical variable in sequencing studies of cancer in the United States, the factors associated with reporting of race, and the participation rates of minority populations.
Methods: PubMed was systematically searched from January 1, 2010 through November 15, 2018 and a total of 9,410 non-duplicated studies were assessed for eligibility. Publications reporting whole genome or exome sequencing data for patients with one of the ten most common cancers in the United States at sufficient depth to identify rare variants were included in this study.
Results: 234 publications containing sequencing data from 16,358 unique patients met inclusion criteria. 36% of studies reported race as a clinical variable compared to 84% of studies reporting age and 83% of studies reporting gender. Reporting of race was associated with cancer type, cohort size, sequencing method, and tissue acquisition date. Minority populations were significantly underpowered to detect recurrent mutations in the majority of cancer types due to small sample size.
Conclusion: Race is underreported as a clinical variable in whole genome and exome sequencing studies of cancer in the United States. As the patient populations represented in research studies directly inform clinical decision-making and outcomes, substantially increased efforts are needed to sequence patients from underrepresented populations in order to reduce health disparities in patients of non-European ancestry.
Citation Format: Adrienne Nugent, Kelly R. Conatser, Llaran L. Turner, James T. Nugent, Esther May Sarino, Luisel J. Ricks-Santi. Underreporting of race in genomic sequencing studies increases cancer health information disparities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-180.
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Affiliation(s)
| | | | | | - James T. Nugent
- 3Uniformed Services University of the Health Sciences, Bethesda, MD
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Nugent A, Conatser KR, Turner LL, Nugent JT, Sarino EMB, Ricks-Santi LJ. Reporting of race in genome and exome sequencing studies of cancer: a scoping review of the literature. Genet Med 2019; 21:2676-2680. [PMID: 31160752 PMCID: PMC6891161 DOI: 10.1038/s41436-019-0558-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 02/01/2019] [Accepted: 05/20/2019] [Indexed: 12/21/2022] Open
Abstract
Purpose Minorities are often underrepresented in clinical cancer research yet the frequency of reporting of race in genomic sequencing studies of cancer is unknown. This scoping review determines the rate at which race is reported as a demographic variable, the factors associated with reporting of race, and the participation rates of minority populations. Methods PubMed was systematically searched from 1 January 2010 through 15 November 2018 and 11,014 studies were assessed for eligibility. Publications reporting genome or exome sequencing data for patients with one of the ten most common cancers in the United States were included. Results A total of 231 publications containing sequencing data from 15,721 unique patients met inclusion criteria. Race was reported in 37% of studies compared with 84% of studies reporting age and 85% reporting gender. Reporting of race was associated with cohort size, sequencing method, familial cancer, cancers with disparities, and reporting of age and gender. Minority populations were significantly underpowered to detect recurrent pathogenic variants in most cancers. Conclusion Race is underreported as a demographic variable in genomic sequencing studies of cancer. Substantially increased efforts are needed to sequence patients from underrepresented populations to reduce health disparities in patients of non-European ancestry.
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Affiliation(s)
- Adrienne Nugent
- Cancer Research Center, Hampton University, Hampton, VA, USA.
| | - Kelly R Conatser
- Graduate Programs in Public Health, University of New England, Portland, ME, USA
| | - Llaran L Turner
- Cancer Research Center, Hampton University, Hampton, VA, USA
| | - James T Nugent
- Department of Pediatrics, Joint Base Langley-Eustis, Hampton, VA, USA.,Department of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Esther May B Sarino
- Edward E. Brickell Medical Sciences Library, Eastern Virginia Medical School, Norfolk, VA, USA
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Bruce I, Harris C, Nugent A, McDermott B, Johnston G, Bell A. Enhanced Endothelium‐dependent Vasodilator Responses in Patients with Systemic Vasculitis. Scand J Rheumatol 2019. [DOI: 10.1080/030097497199712063049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- I.N. Bruce
- Department of Rheumatology, Musgrave Park Hospital, Royal Victoria Hospital and Pathogenesis group, School of Clinical Medicine, The Queen's University of Belfast, UK
| | - C.M. Harris
- Department of Therapeutics and Pharmacology, School of Clinical Medicine, The Queen's University of Belfast, UK
| | - A. Nugent
- Department of Therapeutics and Pharmacology, School of Clinical Medicine, The Queen's University of Belfast, UK
| | - B.J. McDermott
- Department of Therapeutics and Pharmacology, School of Clinical Medicine, The Queen's University of Belfast, UK
| | - G.D. Johnston
- Department of Therapeutics and Pharmacology, School of Clinical Medicine, The Queen's University of Belfast, UK
| | - A.L. Bell
- Department of Rheumatology, Musgrave Park Hospital, Royal Victoria Hospital and Pathogenesis group, School of Clinical Medicine, The Queen's University of Belfast, UK
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7
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Hibar DP, Westlye LT, Doan NT, Jahanshad N, Cheung JW, Ching CRK, Versace A, Bilderbeck AC, Uhlmann A, Mwangi B, Krämer B, Overs B, Hartberg CB, Abé C, Dima D, Grotegerd D, Sprooten E, Bøen E, Jimenez E, Howells FM, Delvecchio G, Temmingh H, Starke J, Almeida JRC, Goikolea JM, Houenou J, Beard LM, Rauer L, Abramovic L, Bonnin M, Ponteduro MF, Keil M, Rive MM, Yao N, Yalin N, Najt P, Rosa PG, Redlich R, Trost S, Hagenaars S, Fears SC, Alonso-Lana S, van Erp TGM, Nickson T, Chaim-Avancini TM, Meier TB, Elvsåshagen T, Haukvik UK, Lee WH, Schene AH, Lloyd AJ, Young AH, Nugent A, Dale AM, Pfennig A, McIntosh AM, Lafer B, Baune BT, Ekman CJ, Zarate CA, Bearden CE, Henry C, Simhandl C, McDonald C, Bourne C, Stein DJ, Wolf DH, Cannon DM, Glahn DC, Veltman DJ, Pomarol-Clotet E, Vieta E, Canales-Rodriguez EJ, Nery FG, Duran FLS, Busatto GF, Roberts G, Pearlson GD, Goodwin GM, Kugel H, Whalley HC, Ruhe HG, Soares JC, Fullerton JM, Rybakowski JK, Savitz J, Chaim KT, Fatjó-Vilas M, Soeiro-de-Souza MG, Boks MP, Zanetti MV, Otaduy MCG, Schaufelberger MS, Alda M, Ingvar M, Phillips ML, Kempton MJ, Bauer M, Landén M, Lawrence NS, van Haren NEM, Horn NR, Freimer NB, Gruber O, Schofield PR, Mitchell PB, Kahn RS, Lenroot R, Machado-Vieira R, Ophoff RA, Sarró S, Frangou S, Satterthwaite TD, Hajek T, Dannlowski U, Malt UF, Arolt V, Gattaz WF, Drevets WC, Caseras X, Agartz I, Thompson PM, Andreassen OA. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry 2018; 23:932-942. [PMID: 28461699 PMCID: PMC5668195 DOI: 10.1038/mp.2017.73] [Citation(s) in RCA: 422] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/04/2017] [Accepted: 02/10/2017] [Indexed: 12/13/2022]
Abstract
Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen's d=-0.293; P=1.71 × 10-21), left fusiform gyrus (d=-0.288; P=8.25 × 10-21) and left rostral middle frontal cortex (d=-0.276; P=2.99 × 10-19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.
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Affiliation(s)
- D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Janssen Research & Development, San Diego, CA, USA
| | - L T Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,Department of Psychology, University of Oslo, Oslo, Norway
| | - N T Doan
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - C R K Ching
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA,Neuroscience Interdepartmental Graduate Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - A Versace
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A C Bilderbeck
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - A Uhlmann
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - B Mwangi
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - B Overs
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - C B Hartberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Abé
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - D Dima
- Department of Psychology, City University London, London, UK,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - D Grotegerd
- Department of Psychiatry, University of Münster, Münster, Germany
| | - E Sprooten
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - E Jimenez
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - G Delvecchio
- IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy
| | - H Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J Starke
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - J R C Almeida
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - J M Goikolea
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - J Houenou
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,NeuroSpin, UNIACT Lab, Psychiatry Team, CEA Saclay, Gif Sur Yvette, France
| | - L M Beard
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - L Rauer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - L Abramovic
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Bonnin
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - M F Ponteduro
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Keil
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - M M Rive
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - N Yao
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - N Yalin
- Centre for Affective Disorders, King’s College London, London, UK
| | - P Najt
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - P G Rosa
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - R Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - S Trost
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - S Hagenaars
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S C Fears
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA,West Los Angeles Veterans Administration, Los Angeles, CA, USA
| | - S Alonso-Lana
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - T M Chaim-Avancini
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - T B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - T Elvsåshagen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - U K Haukvik
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Adult Psychiatry, University of Oslo, Oslo, Norway
| | - W H Lee
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - A J Lloyd
- Academic Psychiatry and Northern Centre for Mood Disorders, Newcastle University/Northumberland Tyne & Wear NHS Foundation Trust, Newcastle, UK
| | - A H Young
- Centre for Affective Disorders, King’s College London, London, UK
| | - A Nugent
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - A M Dale
- MMIL, Department of Radiology, University of California San Diego, San Diego, CA, USA,Department of Cognitive Science, Neurosciences and Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - B Lafer
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - B T Baune
- Department of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - C J Ekman
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden
| | - C A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - C E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - C Henry
- INSERM U955 Team 15 ‘Translational Psychiatry’, University Paris East, APHP, CHU Mondor, Fondation FondaMental, Créteil, France,Institut Pasteur, Unité Perception et Mémoire, Paris, France
| | - C Simhandl
- Bipolar Center Wiener Neustadt, Wiener Neustadt, Austria
| | - C McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - C Bourne
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Department of Psychology & Counselling, Newman University, Birmingham, UK
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa,MRC Unit on Anxiety and Stress Disorders, Groote Schuur Hospital (J-2), University of Cape Town, Cape Town, South Africa
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - D M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - D C Glahn
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - D J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - E Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - E Vieta
- Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - E J Canales-Rodriguez
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - F G Nery
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - F L S Duran
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G F Busatto
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - G Roberts
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - G D Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA,Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - G M Goodwin
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK
| | - H Kugel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H G Ruhe
- University Department of Psychiatry and Oxford Health NHS Foundation Trust, University of Oxford, Oxford, UK,Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J C Soares
- UT Center of Excellence on Mood Disorders, Department of Psychiatry & Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - J K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - J Savitz
- Laureate Institute for Brain Research, Tulsa, OK, USA,Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA
| | - K T Chaim
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - M G Soeiro-de-Souza
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - M P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M V Zanetti
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M C G Otaduy
- Department of Radiology, University of São Paulo, São Paulo, Brazil,LIM44-Laboratory of Magnetic Resonance in Neuroradiology, University of São Paulo, São Paulo, Brazil
| | - M S Schaufelberger
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, Brazil
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - M Ingvar
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - M L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M J Kempton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Landén
- Department of Clinical Neuroscience, Osher Centre, Karolinska Institutet, Stockholm, Sweden,Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Goteborg, Sweden
| | - N S Lawrence
- Department of Psychology, University of Exeter, Exeter, UK
| | - N E M van Haren
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N R Horn
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - N B Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - P R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - P B Mitchell
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - R S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Lenroot
- Neuroscience Research Australia, Sydney, NSW, Australia,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - R Machado-Vieira
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - R A Ophoff
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - S Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - S Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - T Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,National Institute of Mental Health, Klecany, Czech Republic
| | - U Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - U F Malt
- Division of Clinical Neuroscience, Department of Research and Education, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - V Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - W F Gattaz
- Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - W C Drevets
- Janssen Research & Development, Titusville, NJ, USA
| | - X Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I Agartz
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, CA, USA
| | - O A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway,NORMENT, KG Jebsen Centre for Psychosis Research—TOP Study, Oslo University Hospital, Ullevål, Building 49, Kirkeveien 166, PO Box 4956, Nydalen, 0424, Oslo, Norway. E-mail:
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8
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Allende ML, Cook EK, Larman BC, Nugent A, Brady JM, Golebiowski D, Sena-Esteves M, Tifft CJ, Proia RL. Cerebral organoids derived from Sandhoff disease-induced pluripotent stem cells exhibit impaired neurodifferentiation. J Lipid Res 2018; 59:550-563. [PMID: 29358305 PMCID: PMC5832932 DOI: 10.1194/jlr.m081323] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [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: 10/31/2017] [Revised: 12/29/2017] [Indexed: 12/21/2022] Open
Abstract
Sandhoff disease, one of the GM2 gangliosidoses, is a lysosomal storage disorder characterized by the absence of β-hexosaminidase A and B activity and the concomitant lysosomal accumulation of its substrate, GM2 ganglioside. It features catastrophic neurodegeneration and death in early childhood. How the lysosomal accumulation of ganglioside might affect the early development of the nervous system is not understood. Recently, cerebral organoids derived from induced pluripotent stem (iPS) cells have illuminated early developmental events altered by disease processes. To develop an early neurodevelopmental model of Sandhoff disease, we first generated iPS cells from the fibroblasts of an infantile Sandhoff disease patient, then corrected one of the mutant HEXB alleles in those iPS cells using CRISPR/Cas9 genome-editing technology, thereby creating isogenic controls. Next, we used the parental Sandhoff disease iPS cells and isogenic HEXB-corrected iPS cell clones to generate cerebral organoids that modeled the first trimester of neurodevelopment. The Sandhoff disease organoids, but not the HEXB-corrected organoids, accumulated GM2 ganglioside and exhibited increased size and cellular proliferation compared with the HEXB-corrected organoids. Whole-transcriptome analysis demonstrated that development was impaired in the Sandhoff disease organoids, suggesting that alterations in neuronal differentiation may occur during early development in the GM2 gangliosidoses.
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Affiliation(s)
- Maria L Allende
- Genetics of Development and Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Emily K Cook
- Genetics of Development and Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Bridget C Larman
- Genetics of Development and Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Adrienne Nugent
- Genetics of Development and Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Jacqueline M Brady
- National Institutes of Health Undiagnosed Diseases Program, National Institutes of Health Office of Rare Diseases Research and National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892
| | - Diane Golebiowski
- Department of Neurology and Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA 01605
| | - Miguel Sena-Esteves
- Department of Neurology and Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA 01605
| | - Cynthia J Tifft
- National Institutes of Health Undiagnosed Diseases Program, National Institutes of Health Office of Rare Diseases Research and National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892
| | - Richard L Proia
- Genetics of Development and Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
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9
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Rice N, Nugent A, Byrne D, Normand C. Potential of Earlier Detection and Treatment of Disease-Related Malnutrition with Oral Nutrition Supplements to Release Acute Care Bed Capacity. Ir Med J 2016; 109:422. [PMID: 27814439] [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: 06/06/2023]
Abstract
A recent systematic review and meta-analysis shows that appropriate use of oral nutrition supplements (ONS) in community patients is associated with a significant reduction in hospitalisations. Given higher use of acute care resource by malnourished versus normally nourished patients, this paper examines the potential to reduce bed utilisation by applying these results to Irish inpatient and malnutrition prevalence data. In 2013, adults admitted to hospital with medium or high malnutrition risk scores used an estimated 36% of adult acute inpatient bed days. Targeted use of ONS in community patients might reduce hospitalisation by 168,438 adult bed days per year, equivalent to 460 beds per day. This is particularly important, given high bed occupancy rates and twelve month daily averages of 254 patients on trolleys. Relevant stakeholders should consider strategies to ensure effective ONS use with a view to improving outcomes and reducing pressure on the acute care system.
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Affiliation(s)
| | - A Nugent
- UCD Institute of Food and Health
| | - D Byrne
- St James Hospital, James Street, Dublin 8
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10
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Bacci M, Harland K, Schlichting A, Nugent A. 219 The Recognition of Hospice-Eligible Patients in the Emergency Department: A Missed Opportunity. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.252] [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: 10/23/2022]
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11
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von Minckwitz G, Loibl S, Untch M, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch C, Huober J, Solbach C, Jackisch C, Kunz G, Blohmer JU, Hauschild M, Fehm T, Nekljudova V, Gerber B, Gnauert K, Heinrich B, Prätz T, Groh U, Tanzer H, Villena C, Tulusan A, Liedtke B, Blohmer JU, Kittel K, Mau C, Potenberg J, Schilling J, Just M, Weiss E, Bückner U, Wolfgarten M, Lorenz R, Doering G, Feidicker S, Krabisch P, Deichert U, Augustin D, Kunz G, Kast K, von Minckwitz G, Nestle-Krämling C, Rezai M, Höß C, Terhaag J, Fasching P, Staib P, Aktas B, Kühn T, Khandan F, Möbus V, Solbach C, Tesch H, Stickeler E, Heinrich G, Wagner H, Abdallah A, Dewitz T, Emons G, Belau A, Rethwisch V, Lantzsch T, Thomssen C, Mattner U, Nugent A, Müller V, Noesselt T, Holms F, Müller T, Deuker JU, Schrader I, Strumberg D, Uleer C, Solomayer E, Runnebaum I, Link H, Tomé O, Ulmer HU, Conrad B, Feisel-Schwickardi G, Eidtmann H, Schumacher C, Steinmetz T, Bauerfeind I, Kremers S, Langanke D, Kullmer U, Ober A, Fischer D, Kohls A, Weikel W, Bischoff J, Freese K, Schmidt M, Wiest W, Sütterlin M, Dietrich M, Grießhammer M, Burgmann DM, Hanusch C, Rack B, Salat C, Sattler D, Tio J, von Abel E, Christensen B, Burkamp U, Köhne CH, Meinerz W, Graßhoff ST, Decker T, Overkamp F, Thalmann I, Sallmann A, Beck T, Reimer T, Bartzke G, Deryal M, Weigel M, Huober J, Weder P, Steffens CC, Lemster S, Stefek A, Ruhland F, Hofmann M, Schuster J, Simon W, Kronawitter U, Clemens M, Fehm T, Janni W, Latos K, Bauer W, Roßmann A, Bauer L, Lampe D, Heyl V, Hoffmann G, Lorenz-Salehi F, Hackmann J, Schlag R. Survival after neoadjuvant chemotherapy with or without bevacizumab or everolimus for HER2-negative primary breast cancer (GBG 44-GeparQuinto)†. Ann Oncol 2014; 25:2363-2372. [PMID: 25223482 DOI: 10.1093/annonc/mdu455] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The GeparQuinto study showed that adding bevacizumab to 24 weeks of anthracycline-taxane-based neoadjuvant chemotherapy increases pathological complete response (pCR) rates overall and specifically in patients with triple-negative breast cancer (TNBC). No difference in pCR rate was observed for adding everolimus to paclitaxel in nonearly responding patients. Here, we present disease-free (DFS) and overall survival (OS) analyses. PATIENTS AND METHODS Patients (n = 1948) with HER2-negative tumors of a median tumor size of 4 cm were randomly assigned to neoadjuvant treatment with epirubicin/cyclophosphamide followed by docetaxel (EC-T) with or without eight infusions of bevacizumab every 3 weeks before surgery. Patients without clinical response to EC ± Bevacizumab were randomized to 12 weekly cycles paclitaxel with or without everolimus 5 mg/day. To detect a hazard ratio (HR) of 0.75 (α = 0.05, β = 0.8) 379 events had to be observed in the bevacizumab arms. RESULTS With a median follow-up of 3.8 years, 3-year DFS was 80.8% and 3-year OS was 89.7%. Outcome was not different for patients receiving bevacizumab (HR 1.03; P = 0.784 for DFS and HR 0.974; P = 0.842 for OS) compared with patients receiving chemotherapy alone. Patients with TNBC similarly showed no improvement in DFS (HR = 0.99; P = 0.941) and OS (HR = 1.02; P = 0.891) when treated with bevacizumab. No other predefined subgroup (HR+/HER2-; locally advanced (cT4 or cN3) or not; cT1-3 or cT4; pCR or not) showed a significant benefit. No difference in DFS (HR 0.997; P = 0.987) and OS (HR 1.11; P = 0.658) was observed for nonearly responding patients receiving paclitaxel with or without everolimus overall as well as in subgroups. CONCLUSIONS Long-term results, in opposite to the results of pCR, do not support the neoadjuvant use of bevacizumab in addition to an anthracycline-taxane-based chemotherapy or everolimus in addition to paclitaxel for nonearly responding patients. CLINICAL TRIAL NUMBER NCT 00567554, www.clinicaltrials.gov.
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Affiliation(s)
- G von Minckwitz
- Headquarter, German Breast Group, Neu-Isenburg; Department of Gynaecology and Obstetrics, University Hospital, Frankfurt.
| | - S Loibl
- Headquarter, German Breast Group, Neu-Isenburg
| | - M Untch
- Department of Gynaecology and Obstetrics, Klinikum Berlin-Buch, Berlin
| | - H Eidtmann
- Department of Gynaecology and Obstetrics, University Hospital, Kiel
| | - M Rezai
- Breast Center, Luisenkrankenhaus, Düsseldorf
| | - P A Fasching
- Department of Gynaecology and Obstetrics, University Hospital, Erlangen
| | - H Tesch
- Department of Medical Oncology, Chop GmbH, Frankfurt
| | - H Eggemann
- Department of Gynaecology and Obstetrics, University Hospital, Magdeburg
| | - I Schrader
- Department of Gynaecology and Obstetrics, Henriettenstiftung, Hannover
| | - K Kittel
- Department of Gynaecology and Obstetrics, Praxisklinik, Berlin
| | - C Hanusch
- Department of Gynaecology and Obstetrics, Rot-Kreuz-Klinikum, München
| | - J Huober
- Department of Gynaecology and Obstetrics, University Hospital, Ulm
| | - C Solbach
- Department of Gynaecology and Obstetrics, University Hospital, Frankfurt
| | - C Jackisch
- Department of Gynaecology and Obstetrics, Sana-Klinikum, Offenbach
| | - G Kunz
- Department of Gynaecology and Obstetrics, St Johannes Hospital, Dortmund
| | - J U Blohmer
- Department of Gynaecology and Obstetrics, St Gertrauden-Hospital, Berlin
| | - M Hauschild
- Department of Gynaecology and Obstetrics, Hospital, Rheinfelden
| | - T Fehm
- Department of Gynaecology and Obstetrics, University Hospital, Tübingen
| | | | - B Gerber
- Department of Gynaecology and Obstetrics, University Hospital, Rostock, Germany
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Tarrant R, Nugent M, Nugent A, Moore D, Kiely P. OP018: Postoperative Weight Loss and its Impact on Outcomes in Patients with Adolescent Idiopathic Scoliosis After Major Spinal Deformity Surgery. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50018-0] [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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13
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Buchweitz O, Juergens S, Nugent A, Biel P, Bazargan M, Krueger E, Nugent W, Moeller C. Surgical Treatment of Peritoneal Endometriosis: A Prospective Randomized Trial of Excision Versus Ablation for Mild Endometriosis. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.020] [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: 11/15/2022]
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14
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Juergens S, Buchweitz O, Moeller C, Nugent W, Krueger E, Nugent A, Biel P, Bazargan M. A Randomized, Controlled Study Comparing the Cosmetic Outcome of a New Wound Closure Device with Prolene Suture Closing Caesarean Wounds. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.307] [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: 10/26/2022]
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15
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Miller M, Chacko B, Nugent A, Harland K, Denning G. 424 Type and Level of Resident Education Affects Emergency Department Patient Satisfaction. Ann Emerg Med 2012. [DOI: 10.1016/j.annemergmed.2012.06.456] [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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Faine B, Nunge M, Denning G, Nugent A. 349 Implementing Evidence-Based Changes in Emergency Department Treatment: Alternative Vitamin Therapy for Alcohol-Related Illnesses. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.380] [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: 10/17/2022]
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17
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Connolly A, Hearty A, Nugent A, McKevitt A, Boylan E, Flynn A, Gibney MJ. Pattern of intake of food additives associated with hyperactivity in Irish children and teenagers. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:447-56. [PMID: 20013441 DOI: 10.1080/19440040903470718] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A double-blind randomized intervention study has previously shown that a significant relationship exists between the consumption of various mixes of seven target additives by children and the onset of hyperactive behaviour. The present study set out to ascertain the pattern of intake of two mixes (A and B) of these seven target additives in Irish children and teenagers using the Irish national food consumption databases for children (n = 594) and teenagers (n = 441) and the National Food Ingredient Database. The majority of additive-containing foods consumed by both the children and teenagers contained one of the target additives. No food consumed by either the children or teenagers contained all seven of the target food additives. For each additive intake, estimates for every individual were made assuming that the additive was present at the maximum legal permitted level in those foods identified as containing it. For both groups, mean intakes of the food additives among consumers only were far below the doses used in the previous study on hyperactivity. Intakes at the 97.5th percentile of all food colours fell below the doses used in Mix B, while intakes for four of the six food colours were also below the doses used in Mix A. However, in the case of the preservative sodium benzoate, it exceeded the previously used dose in both children and teenagers. No child or teenager achieved the overall intakes used in the study linking food additives with hyperactivity.
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Affiliation(s)
- A Connolly
- UCD Institute of Food & Health, UCD Agriculture & Food Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
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18
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Salfelder A, Gallinat A, Möller C, Nugent W, Krüger E, Nugent A, Biel P, Jürgens S, Bormann C, Gai H, Scotland V. Risiken bei der laparoskopischen Morcellation: Uterus-(Myom-)Residuen, Endometriose und maligne Befunde – Diskussion anhand von 5 Kasuistiken. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1186177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Savitz JB, Drevets WC, Bogers W, Wright N, Solomon G, Nugent A, Bonne O. Increased Left Subgenual Prefrontal Cortex and Right Infralimbic Cortex Volumes in Post-Traumatic Stress Disorder. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70091-6] [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] Open
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Qureshi R, Nugent A, Hayat J, Qureshi M, Norton R. Should surgical pleurectomy for spontaneous pneumothorax be always thoracoscopic? Interact Cardiovasc Thorac Surg 2008; 7:569-72. [DOI: 10.1510/icvts.2007.174755] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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22
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Carlson PJ, Bain E, Tinsley R, Nugent A, Carson R, Luckenbaugh D, Kling M, Gold P, Remaley A, Drevets W. Relationship between serotonin-1A binding and HPA axis in subjects with major depression and healthy controls. Neuroimage 2008. [DOI: 10.1016/j.neuroimage.2008.04.114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Martin-Soelch C, Szczepanik J, Barhaghi K, Rollis D, Cannon D, Nugent A, Herscovitch P, Carson R, Drevets W. Lack of dopamine release in response to monetary reward in depressed patients: A [11C]raclopride PET study. Neuroimage 2008. [DOI: 10.1016/j.neuroimage.2008.04.230] [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: 12/01/2022] Open
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Sehouli J, Oskay-Oezcelik G, Stengel D, du Bois A, Markmann S, Loibl S, Wilke J, Nugent A, Belau A, Lichtenegger W. Topotecan weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer (TOWER): A randomized, two-stage phase-II study of the North-Eastern German Society of Gynaecological Oncology (NOGGO). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5526] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5526 Background: Optimizing the therapeutic index (that is, maintaining drug effectiveness while reducing toxicity) is a major goal in chemotherapy for platinum-resistant ovarian cancer. Early phase-I/II studies suggest that weekly topotecan (T) might be effective and apparently better tolerated than the established 5-day regimen. As yet, no randomized comparison of both regimes was attempted. To prove the hypothesis of an improved therapeutic index with weekly T, we conducted a randomized, multicenter, two-stage phase-II trial, and herein present the data of the planned interim analysis. Methods: Pts with platinresistent ovarian and fallopian tube cancers or primary peritoneal carcinoma, measurable or assessable disease (GCIG-CA-125 response criteria), were eligible. Pts were randomized to receive either weekly T (d1,8,15/q28d, 4 mg/m2) or T from d1–5/q21d at a dose of 1.25 mg/m2. According to Gehan’s two-stage-design, both arms were handled as independent studies. Overall response rate (CR + PR) was defined as primary study endpoint, secondary endpoints of the interim analysis were toxicity and safety. Results: 28 pts in the weekly and 21 pts in the conventional group, enrolled at 38 centers form the basis of this report. 230 cycles of chemotherapy were evaluated for toxicity analyses. Median age was 61 years (range, 36 - 82 years). Demographic baseline characteristics, including tumor stage and grade were well balanced between treatment arms. There were 2/28 and 5/21 responses in weekly and the conventional arm, respectively (Risk Ratio [RR] 0.30, 95% confidence interval [CI] 0.06 - 1.40, p=0.122). The risk of early treatment termination due to tumor progression (RR 1.39, 95%CI 0.75 - 2.56), haematological (RR 0.20, 95% CI 0.01 - 3.97) or non- hematological toxicities (RR 1.96, 95% CI 0.18 - 20.83) did not differ significantly between groups. The only three events of neutropenic fever occurred in the conventional arm (RR 1.70, 95% CI 0.99 - 1.16). Conclusions: Weekly T is well tolerated and potentially active. The second stage of this study will require additional 46 patients each arm. Complete enrolment is expected to be accomplished in May 2007. No significant financial relationships to disclose.
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Affiliation(s)
- J. Sehouli
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - G. Oskay-Oezcelik
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - D. Stengel
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - A. du Bois
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - S. Markmann
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - S. Loibl
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - J. Wilke
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - A. Nugent
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - A. Belau
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
| | - W. Lichtenegger
- University Hospital Charite, Berlin, Germany; Horst-Schmidt Hospital, Wiesbaden, Germany; University Hospital Rostock, Rostock, Germany; University Hospital Ulm, Ulm, Germany; Medical Hospital Fürth, Fürth, Germany; University Hospital Hamburg, Hamburg, Germany; University Hospital Greifswald, Greifswald, Germany
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Carlson P, Bain E, Tinsley R, Nugent A, Carson R, Luckenbaugh D, Alesci S, Kling M, Gold P, Drevets W. Serotonin-1A receptor binding in depression: Correlates with interleukin-6 and the hypothalamic–pituitary–adrenal axis. Neuroimage 2006. [DOI: 10.1016/j.neuroimage.2006.04.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Salfelder A, Lueken RP, Bormann C, Gallinat A, Moeller CP, Busche D, Nugent W, Krueger E, Nugent A, Caglar G, Tasci Y, Kayikcioglu F, Haberal A, Hasskamp T, Krichbaum M, Aka N, Köse G, Sabah G, Sayharman ES, Kumru P, Aka N, Karaca K, Köse G, Kumru P, Sayharman ES, Haydardedeoglu B, Simsek E, Kilicdag E, Tarim E, Bagis T, Dede FS, Dilbaz B, Dede H, Ilhan AK, Haberal A, Dede FS, Dilbaz B, Oral S, Erten A, Ilhan AK, Haberal A, Ertas IE, Kahyaoglu S, Turgay I, Tug M, Kalyoncu S, Batioglu S, Zorlu G, Arici C, Akar ME, Ari ES, Ari E, Erbay OU, Caliskan MO, Akar ME, Simsek M, Taskm O, Gümüs I, Turhan NO, Arikan G, Giuliani A, Kelekci S, Yorgancioglu Z, Yilmaz B, Yasar L, Savan K, Sonmez S, Kart C, Vural M, Tanriverdi HA, Cinar E, Barut A, Özbay K, Yardim T, Demir B, Kilinc N, Gul T, Erden AC, Turgay I, Kahyaoglu S, Kokanali MK, Batioglu S, Haydardedeoglu B, Simsek E, Kilicdag EB, Tarim E, Aslan E, Bagis T, Seval M, Taskin S, Özmen B, Kahraman K, Yarci A, Tasci T, Unlü C, Taskin S, Seval M, Özmen B, Kahraman K, Gözükücük M, Kurt S, Unlü C, Taskin S, Özmen B, Bozaci EA, Seval M, Ortac F, Yasar L, Sönmez AS, Zebitay AG, Gezer N, Yazicioglu HF, Mehmetoglu G, Dede FS, Dilbaz B, Kocak M, Dede H, Haberal A, Erten A, Ilhan AK, Algül YL, Erden AC, Yasar L, Zebitay AG, Ozcan J, Duman O, Sonmez S, Yazicioglu F, Sensoy Y, Koc S, Cebi Z, Yasar L, Zebitay AG, Özcan J, Duman O, Sönmez S, Yazicioglu F, Sensoy Y, Cebi Z, Zebitay AG, Yasar L, Özcan J, Duman O, Sönmez S, Yazicioglu F, Sensoy Y, Koc S, Cebi Z, Zebitay AG, Yasar L, Özcan J, Duman O, Sönmez S, Yazicioglu F, Sensoy Y, Cebi Z, Simsek M, Mendilcioglu I, Özekinci M, Ulukus M, Ulukus EC, Seval Y, Cinar O, Zheng W, Arici A, Erkan L, Soylu F, Tatli O, Ozkent V, Dilbaz B, Ilhan AK, Oral S, Dede H, Dogan AR, Gün I, Erdemoglu E, Sargin H, Kamaci M, Dede FS, Erten A, Sendag F, Akman L, Yucebilgin S, Karadadas N, Oztekin K, Bilgin O, Topuz S, Cigerli E, Iyibozkurt CA, Akhan ES, Saygili H, Berkman S, Bezircioglu I, Karakaya E, Baran N, Baloglu A, Aydin C, Hizli N, Cetinkaya B, Kavas A, Baloglu A, Cukurova K, Köksal A, Yetimalar H, Yildiz A, Ivit H, Keklik A, Pinar F, Aka N, Köse G, Tosun N, Kumru P, Tuncel T, Boynukalin K, Salman MC, Ozyuncu O, Bozdag G, Ayhan A, Ates U, Usta T, Seyhan A, Ata B, Sidal B, Guler OT, Salman MC, Bozdag G, Ozyuncu O, Esin S, Ozyuncu O, Salman MC, Bozdag G, Guven S, Gürban A, Gürban G, Özen S, Kirecci A, Özkesici B, Yücel S, Süer N, Erdemoglu E, Gün I, Sargin H, Erdemoglu CE, Kamaci M, Akhan SE, Citil I, Topuz S, Iyibozkurt C, Kesim MD, Atis A, Aydin Y, Özpak D, Tashan F, Zeteroglu S, Kolusari A, Altunay H, Sahin HG, Kamaci M, Kayikcioglu F, Erol O, Sarici S, Haberal A, Dingiloglu BS, Güngör T, Özdal B, Cavkaytar S, Bilge Ü, Mollamahmutoglu L, Toprak KM, Özsoy S, Hekim N, Özel E, Senates M, Yener C, Göker N, Caliskan E, Filiz T, Yucesoy G, Coskun E, Vural B, Corakci A, Narin MA, Caliskan E, Kayikcioglu F, Haberal A, Meydanli MM, Kamaci M, Sahin HG, Kolusari A, Yildizbas B, Bolluk G, Ates U, Usta T, Ata B, Seyhan A, Ozdemir B, Sidal B, Ünlü BS, Aytan H, Evsen S, Tapisiz ÖL, Zergeroglu S, Zeteroglu S, Sahin HG, Guler A, Kolusari A, Kamaci M, Altay MM, Can A, Ungormus A, Polat A, Haberal A. General gynecology. Arch Gynecol Obstet 2005. [DOI: 10.1007/bf02954776] [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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Salfelder A, Lueken RP, Bormann C, Gallinat A, Möller CP, Busche D, Nugent W, Krüger E, Nugent A, Maucher A, Auweiler U, Deckardt R, Saks M, Füger T, Haßkamp T, Krichbaum M, Brökelmann J, Bung P, Hennefründ J, Heeder M, Dohnke H, Hoffmeister U, Scotland V. Die laparoskopische suprazervikale Hysterektomie. Prospektive Multizenterstudie des VAAO. Geburtshilfe Frauenheilkd 2005. [DOI: 10.1055/s-2005-837595] [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: 10/25/2022] Open
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Nugent A, Black N, Parsons B, Smith S, Murphy AW. A national census of Irish general practice training programme graduates 1990-1996. Ir Med J 2003; 96:10-2. [PMID: 12617435] [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: 03/01/2023]
Abstract
We followed the career pathways of all graduates of Irish general practice training schemes between 1990 and 1996 inclusive, with specific reference to their current positions, ten year aspirations, perceived barriers to their ideal career and attitudes to out of hours work. A postal survey using a structured questionnaire was performed. Addresses were identified for 253 of the 266 graduates (95%). A total of two hundred and nine responses were received (84% of those with an identifiable address). 173 (83%) have remained in general practice; 90% in Ireland and 60% in the same health board of their training programme. The preferred career option for 79% was to be a general practice principal; this differed significantly between males (89%) and females (74%) (p=0.016). Being a single-handed general practitioner was the preferred option for 2%; 43% considered this unacceptable. A half would prefer to work in a country town; one third considered a rural location as unacceptable. 'Out of hours' commitment and availability of local posts were the most commonly perceived barriers to career progress (53% and 45% respectively). 26% were not prepared to do any out of hours work; this differed significantly between males (10%) and females (30%) (p<.001). 17% have permanently left a career in general practice. Female general practitioners were not significantly more likely than male general practitioners to have left (19% vs. 14%, p=0.3). The most common reason given for leaving general practice was other career interest (78%). The significant increase in female general practice graduates over the past twenty years is highlighted. The vast majority of these female graduates wished to be a principal in a group practice and were prepared to undertake out of hours work. There is also a mismatch between career aspirations and the present structure of general practice in Ireland. The urgent need for changes in health system organisation to ensure that these intentions can be fulfilled is emphasised.
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Affiliation(s)
- A Nugent
- Dublin General Practice Training Scheme, Dublin 8, Ireland
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Conneely A, Nugent A, O'Keeffe M. Use of solid phase extraction for the isolation and clean-up of a derivatised furazolidone metabolite from animal tissues. Analyst 2002; 127:705-9. [PMID: 12146898 DOI: 10.1039/b203058f] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [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: 11/21/2022]
Abstract
A method is presented for the determination of protein-bound residues of furazolidone in animal tissue. The use of furazolidone in food-producing animals has been banned in the EU. Illegal use of furazolidone can be monitored most effectively by testing for bound residues containing the 3-amino-2-oxazolidone (AOZ) moiety which, unlike the parent drug, is stable and can be detected for prolonged periods after cessation of treatment. This paper reports the development of an extraction and clean-up procedure for AOZ from liver using solid phase extraction. The method replaces solvent extraction and provides extensive sample clean-up with removal of approximately 99% of the derivatising agent, 2-nitrobenzaldehyde, which may interfere with the determination. It also offers the advantage of being suitable for automation, thereby increasing throughput of samples. The extraction procedure may be used for HPLC and ELISA screening techniques. The method has been validated in fortified and incurred pig liver samples, yielding mean recovery of AOZ in excess of 60%.
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Affiliation(s)
- A Conneely
- Teagasc, The National Food Centre, Castleknock, Dublin, Ireland
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Salfelder A, Nugent A, Lueken RP, Gallinat A, Möller CP, Busche D, Nugent W, Krüger E, Schmidt-Rhode P. Spätergebnisse laparoskopischer Operationen von malignen Ovarialtumoren. Geburtshilfe Frauenheilkd 2002. [DOI: 10.1055/s-2002-32290] [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: 10/14/2022] Open
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Daubeney P, Nugent A, Chondros P, Wilkinson L, Davis A, Kleinert S, Chow C, Wilkinson J, Weintraub R. Incidence and natural history of left ventricular non-compaction presenting during childhood. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.08552.x] [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: 11/20/2022]
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Goldsmith I, Lip GY, Emsden K, Nugent A, Patel RL. Hyperlipidaemia management after primary coronary artery bypass surgery: a survey of patients and general practitioners. J Cardiovasc Risk 1999; 6:263-7. [PMID: 10501279 DOI: 10.1177/204748739900600412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is well established that, in patients with increased cholesterol concentrations and vascular disease, decreasing the cholesterol concentration significantly reduces the risk of coronary events. After coronary artery bypass graft surgery (CABG), the risk of further coronary events is likely to be reduced if there is effective control of cholesterol concentrations. The aim of the survey was to review awareness among general practitioners and patients of the need for maintenance of serum cholesterol values, frequency of serum cholesterol checks, dietary advice and lipid-decreasing medication in patients after CABG. METHODS Hospital notes of 200 patients who underwent primary, coronary artery bypass surgery from January 1994 to 1996 were examined and postal questionnaires sent to patients and their general practitioners inquiring whether they had had their serum cholesterol tested in the past 3 years; whether dietary advice had been given if cholesterol concentrations were increased to more than 5.2 mmol/l; whether a repeat serum cholesterol test was performed 3 months later if values were greater than 5.2 mmol/l; and (for those with serum cholesterol values greater than 5.2 mmol/l), whether they were on lipid-decreasing medication. RESULTS We considered 146 (76%) replies to be complete. Hospital and general practitioner records of these patients showed, that in the previous 3 years, after CABG, only 63% (n=92) had their serum lipid profile checked and, of these, 74% (n=68) had increased serum cholesterol concentrations of more than 5.2 mmol/l. Only 46% (n=31) received dietary advice alone. After dietary advice had been given, serum cholesterol was rechecked in 26% (n=8) of patients and only 3% (n=1) had a decrease in serum cholesterol to less than 5.2 mmol/l. Among the patients with increased serum cholesterol, 50% (n=34) received lipid-decreasing medication, but serum cholesterol was rechecked in only 52% (n=17) of patients. In 9% (n=3) of these, serum cholesterol concentrations had decreased to less than 5.2 mmol/l. Among the 146 complete replies from patients, 95% (n=139) indicated that control of serum cholesterol was important, 82% (n=120) had received dietary advice and 39% (n=57) were on lipid-decreasing medication. CONCLUSION General practitioners and patients were generally aware of cholesterol control after CABG. However, a relatively low proportion of patients underwent serum cholesterol checks and received documented dietary advice, lipid-decreasing medication, or both. Dietary advice alone may be inadequate in controlling lipid concentrations and, in many cases, needed to be supplemented with adequate lipid-decreasing therapy.
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Affiliation(s)
- I Goldsmith
- Department of Cardiothoracic Surgery, Walsgrave Hospital, Coventry, UK
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Abstract
BACKGROUND Tissuemed (Leeds, England) porcine bioprostheses are freshly mounted and dilated for correct functional sizing and commissural alignment, then fixed under low pressure. These valves closely approximate the natural leaflet geometry, reduce opening commissural bending stresses, and may provide a solution to structural valve failure from calcification and tears. To evaluate the performance of the bioprosthesis 207 Tissuemed bioprostheses were implanted in 203 patients, 114 men and 89 women (mean age 73 years; range 56 to 94 years), between 1991 and 1996. Preoperatively 66% of the patients were in New York Heart Association functional class III or IV. There were 175 aortic, 22 mitral, 2 tricuspid, and 4 multiple replacements. Concomitant procedures were performed in 26.1% (53 of 203) of patients. Follow-up was 99.5% (total cumulative follow-up 447.5 patient-years). RESULTS The 30 day mortality, influenced by age and valve position, was 11.8% with no early valve-related deaths. Patient survival at 5 years was 76% (standard error 3.3%). Valve-related complication rates (expressed as percent per patient-year and number of events) were thromboembolism 1.1% (5), hemorrhage 0.7% (3), bacterial endocarditis 0.2% (1), nonstructural valve failure 0.2% (1), and reoperation 0.5% (2). At 5 years freedom from valve-related events were as follows: thromboembolism 92.9% (standard error 2.7%), hemorrhage 96.1% (standard error 1.9%), endocarditis 98.1% (standard error 1.8%), nonstructural valve failure 99.2% (standard error 0.7%), structural valve dysfunction 100% (standard error 0.0%), and reoperation 98.1% (standard error 1.8%). At follow-up 73.8% of the patients were in New York Heart Association functional class I or II. CONCLUSIONS There were no early valve-related deaths, no episodes of structural valve failure, and valve-related complications compared favorably with other porcine series. There was overall clinical improvement in patient symptoms. Our experience suggests that the Tissuemed porcine bioprosthesis is a safe and reliable heart valve providing good clinical improvement in patient symptoms. Long-term clinical follow-up is, however, essential to complete the evaluation.
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Affiliation(s)
- I Goldsmith
- Department of Cardiothoracic Surgery, Walsgrave Hospital, Coventry, United Kingdom
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Abstract
OBJECTIVE To identify possible causes of inaccuracy in the use of the Hawksley random-zero sphygmomanometer and methods that could reduce this. METHODS Four Hawksley random-zero sphygmomanometers were compared with a standard sphygmomanometer under static conditions. Two methods (standard and rapid) were used to release pressure from the inflated cuff with pressures recorded by independent blinded observers. The rate at which the hand valve released pressure was analysed. The effects of varying filling times and pressures on the size of the final zero correction were investigated. RESULTS The Hawksley devices all under-recorded pressure compared with that measured by using a standard machine. A rapid means of pressure release approximately halved this error in each case. Pressure release through the hand valve was shown to have a characteristic and prolonged exponential decay. Using low filling times and pressures reduced the observed range of zeros seen, with the production of a correlation between the size of the zero and the inflation pressure used. CONCLUSION These findings suggest that overestimation of the final zero correction is a common and major source of error in the use of the Hawksley sphygmomanometer. A simple change in the design of the final pressure release would improve the machine's reliability in clinical usage. The machine's zero mechanism is susceptible to unintentional misuse. Such misuse could occur when the machine is used in accordance with current sphygmomanometry guidelines.
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Affiliation(s)
- C McGurk
- Department of Therapeutics and Pharmacology, Queen's University of Belfast, UK
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Bruce IN, Harris CM, Nugent A, McDermott BJ, Johnston GD, Bell AL. Enhanced endothelium-dependent vasodilator responses in patients with systemic vasculitis. Scand J Rheumatol 1997; 26:318-24. [PMID: 9310114] [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: 02/05/2023]
Abstract
The aim of the study was to investigate endothelium-dependent vasodilator responses in the forearm vasculature of patients with systemic vasculitis. We studied 10 patients with systemic vasculitis and 16 healthy control subjects using forearm venous occlusion plethysmography to assess changes in forearm blood flow in response to acetylcholine (ACh). NG-monomethyl-L-arginine (L-NMMA), was also used to assess the contribution of endothelium derived relaxing factor/nitric oxide (EDRF/NO) to the vasodilator responses to acetylcholine. A significantly greater vasodilator response to ACh was seen in the patient group at all doses infused (p < 0.01). After pre-infusion of L-NMMA, the differences in ACh dilator responses were no longer significant. There was a greater magnitude of inhibition of ACh responses by L-NMMA in the patient group. The enhanced vasodilator response to ACh observed was in part abolished by L-NMMA, suggesting that EDRF/NO is produced in excess in systemic vasculitis. The precise role played by EDRF/NO in the pathogenesis of systemic vasculitis requires further study.
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Affiliation(s)
- I N Bruce
- Department of Rheumatology, Musgrave Park Hospital, UK
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Lawler M, Locasciulli A, Bacigalupo A, Humphries P, Ljungman P, McCann SR, Nolan N, McDermott EW, Reynolds JR, McCann A, Rafferty R, Sweeney P, Carney D, O’Higgins NJ, Duffy MJ, Gardiner C, Reen DJ, O’Connell MA, Kelleher D, Hall N, O’Neill LAJ, Long A, McCarthy JV, Fernandes RS, Cotter TG, Ryan E, Kitching A, MacMathuna P, Mulligan E, Merriman R, Dervan P, Kelly P, Gorey TF, Lennon JR, Crowe J, Bennett MA, Kay EW, Curran B, O’Donoghue DP, Leader M, Croke DT, O’Connor JM, McKelvey-Martin VJ, McKenna PG, O’Riordan JM, Tobin A, O’Mahoney M, Keogh FM, O’Riordan J, McNamara C, McEneaney P, Daly PA, Farrell M, Young S, Gibbons D, McCarthy P, Mulcahy H, Parfrey NA, Sheahan K, Lambkin H, Mothersill C, Chin D, Sheehan K, Kelehan P, Parfrey N, Morrin M, Khan F, Delaney P, Rowan DM, Orminston WJ, Donnellan PP, Khalid A, Kerin M, O’Hanlon DM, Kent P, Given HF, Kennedy SM, McGeoch G, Spurr NK, Barrett J, O’Sullivan G, Collins JK, Willcocks T, Kennedy S, Dolan J, Gallagher W, McDermott E, O’Higgins N, Hagan R, McManus R, Ormiston W, Daly P, Sheils O, McDermott M, O’Briain DS, Maher D, Costello P, Flanagan F, Stack J, Ennis J, Grimes H, Yanni A, Harrison M, Lowry WS, Russell SEH, Atkinson RJ, White P, Hickey I, Bell DW, Biggart D, Doyle J, Staunton MJ, Gaffney EF, Dervan PA, McCabe MM, Fennelly JJ, Carney DN, O’Reilly M, McMahon JN, Moriarty M, Hurson B, O’Neill AJ, Magee H, O’Loughlin J, Dervan PA, Cremin P, Orminston W, McCarthy J, Redmond P, Duggan S, Rea S, Bouchier-Hayes D, O’Donnell J, Duggan C, Crown J, Bermingham D, Nugent A, Fleming C, Crosby P, Wolff S, McCarthy D, Walsh CB, Cassidy M, Husain S, Kay E, Thornhilll M, Whelan D, Barry D, Turner M, Prenderville W, Murphy F, Prendiville W, Gibson G, O’Grady T, Carmody M, Donohoe J, Walshe J, Murphy GM, O’Donoghue J, Kerin K, Ahern S, Molloy K, Goulden N, Pamphilon DH, O’Connell M, Power C, Leroux A, Perricaudet M, Walls D, Britton F, Brennan L, Barnett YA, Madden B, Wakelin LPG, Loughrey HC, Corley P, Redmond HP, Watson RWG, Keogh I, O’Hanlon D, Walsh S, Callaghan J, McNamara M, Benedict-Smith A, Barnes C, Neylon D, Fenton M, Searcey M, Topham CM, Wakelin LG, Howarth NM, Purohit A, Reed MJ, Potter BVL, Hatton WJ, McKerr G, Harvey D, Carson J, Hannigan BM, McCarthy PJ, McClean S, Hill BT, Costelloe C, Denny WA, Fingleton B, McDonnell S, Butler M, Corbally N, Dervan PA, Stephens JF, Martin G, McGirl A, Lawlor E, Gardiner N, Lynch S, Arce MD, O’Brien F, Duggan A, O’Herlihy S, Shanahan F, O’Keeffe G, McCann S, Sweeney K, Neill AO, Pamphilon D, Sheridan M, Reid I, Seymour CB, Walshe T, Hennessy TP, O’Mahony A, O’Connell’ J, Lawlor C, Nolan S, Morrisey D, Pedlow PJ, Walsh M, Lowry SW, McAleer JJA, McKeown SR, Afrasiabi M, Lappin TRJ, Joiner B, Hirst KV, Hirst DG, Sweeney E, VanderSpek J, Murphy J, Foss F. Irish Association for Cancer Research. Ir J Med Sci 1995. [DOI: 10.1007/bf02967834] [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: 11/28/2022]
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McCarthy J, Rea S, Duggan S, Redmond HP, Bouchier-Hayes D, O’Donnell JR, Ahmad M, Croke DT, Wang JH, Watson RGW, Duffy K, Duffy MJ, Nugent A, McDermott E, Fennelly JJ, O’Higgins N, McCormack D, McElwain J, Surana R, Puri P, Burke P, Chin D, Willcocks T, Gallagher W, Parfrey N, Kelly CJ, Cheung A, Motyka L, Gallagher H, Daly JM, Barry M, Kelly C, Hayes DB, Reid IM, Hickey JK, Grehan D, Walsh TN, Hennessy TPJ, Caldwell MTP, Marks P. Waterford Surgical October Club Proceedings of meeting held Saturday, 30th October, 1993. Ir J Med Sci 1994. [DOI: 10.1007/bf02967227] [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: 10/21/2022]
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Nugent A, Gallagher J, Dolan J, O'Higgins N, Duffy MJ. Assay of the c-erbB-2 oncogene encoded protein by ELISA and immunocytochemistry in human breast cancer. Ann Clin Biochem 1994; 31 ( Pt 2):171-3. [PMID: 7914719 DOI: 10.1177/000456329403100210] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The c-erbB-2 gene is amplified in a wide variety of different adenocarcinomas. Generally, gene amplification correlates with increased expression of the c-erbB-2 oncoprotein. Previous assays for the c-erbB-2 oncoprotein have been qualitative or semi-quantitative. In this investigation using human breast cancers, c-erbB-2 oncoprotein levels as measured by enzyme-linked immunosorbent assay (ELISA) correlated significantly with semi-quantitation by immunocytochemistry (r = 0.843, P < 0.0001, n = 97). The cut-off point for the ELISA which gave the strongest agreement with immunocytochemistry was 15 units/micrograms protein. It is concluded that detection of c-erbB-2 oncoprotein by ELISA is quantitative and objective.
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Affiliation(s)
- A Nugent
- Department of Nuclear Medicine, St Vincent's Hospital, Dublin, Ireland
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Nugent A, McDermott E, Duffy K, O'Higgins N, Fennelly JJ, Duffy MJ. Enzyme-linked immunosorbent assay of c-erbB-2 oncoprotein in breast cancer. Clin Chem 1992; 38:1471-4. [PMID: 1353709] [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: 03/25/2023]
Abstract
Amplification or increased expression of the c-erbB-2 gene has previously been reported to be a prognostic marker for breast cancer. Gene amplification is usually measured by Southern blotting, whereas increased protein expression is usually detected by immunocytochemistry. We measured c-erbB-2 protein with an enzyme-linked immunosorbent assay (ELISA). High concentrations of oncoprotein were found in 25 of 161 (16%) primary breast cancers and in 3 of 6 (50%) breast cancer metastases. High concentrations were not found in normal breast tissue or benign breast tumors. In the primary cancers, high concentrations of c-erbB-2 protein were found more frequently (a) in estrogen receptor-negative tumors than in estrogen receptor-positive tumors, (b) in progesterone receptor-negative tumors than in progesterone-positive tumors, and (c) in axillary node-positive cancers than in node-negative cancers. Patients with tumors containing high amounts of the c-erbB-2 protein had a significantly shorter (P less than 0.001) disease-free interval and overall survival rate than did patients with low amounts. We conclude that assay of c-erbB-2 protein by ELISA is simple, rapid, and quantitative and offers important prognostic information in breast cancer.
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Affiliation(s)
- A Nugent
- Department of Surgery, St. Vincent's Hospital, Dublin 4, Ireland
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Affiliation(s)
- A Nugent
- Department of Surgery, St. Vincent's Hospital, Dublin, Ireland
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van Kammen DP, Peters J, van Kammen WB, Nugent A, Goetz KL, Yao J, Linnoila M. CSF norepinephrine in schizophrenia is elevated prior to relapse after haloperidol withdrawal. Biol Psychiatry 1989; 26:176-88. [PMID: 2472177 DOI: 10.1016/0006-3223(89)90021-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Thirty-two male DSM-III diagnosed schizophrenic patients received a lumbar puncture (LP) during chronic haloperidol treatment that was followed by replacement with placebo for up to 6 weeks. Fourteen patients relapsed on placebo within 6 weeks. Patients received a second LP at the time of relapse or at the end of 6 weeks if they had not relapsed. Bunney-Hamburg Global Psychosis Ratings of the day and the hours of sleep of the night before the LP were obtained, as were the Brief Psychiatric Ratings Scale (BPRS) ratings during the week of the LPs. CSF norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), homovanillic acid (HVA), and 5-hydroxyindoleacetic acid (5 HIAA) concentrations were measured with high-pressure liquid chromatography (HPLC). Patients who relapsed had significantly higher CSF NE levels on and off haloperidol than patients who did not relapse. CSF MHPG was higher in the relapsers in the drug-free condition only, but CSF HVA and 5-HIAA were not significantly different in either condition. In the drug-free relapsed patients, CSF NE correlated significantly with the psychosis ratings of the day and hours of sleep the night prior to the LP. Our data indicate that elevated CSF NE levels during neuroleptic treatment may predict behavioral decompensation after discontinuing the medication.
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Affiliation(s)
- D P van Kammen
- Veterans Administration Medical Center, Pittsburgh, PA 15206
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Fields RB, Van Kammen DP, Peters JL, Rosen J, Van Kammen WB, Nugent A, Stipetic M, Linnoila M. Clonidine improves memory function in schizophrenia independently from change in psychosis. Preliminary findings. Schizophr Res 1988; 1:417-23. [PMID: 3154529 DOI: 10.1016/0920-9964(88)90024-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study provides initial evidence that the alpha 2-adrenergic receptor agonist, clonidine, enhances memory functioning in hospitalized schizophrenics. Ten patients were tested while drug free and while on stable doses of clonidine (0.4-1.4 mg/day) for approximately 3 weeks. Throughout the duration of the study, all patients, as well as the examiner, were blind to medication status. Memory test scores were significantly better during the clonidine trials. This improvement occurred independently of change in psychosis. Clonidine does not improve memory in normal adults or in young and unimpaired animals, but has been shown to improve memory in Korsakoff's patients and non-human primates who are old or have dorsolateral prefrontal cortical lesions. The present results have implications for the role of the noradrenergic system in memory as well as for our understanding of the nature of the cognitive deficits associated with schizophrenia.
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Affiliation(s)
- R B Fields
- Veterans Administration Medical Center, Pittsburgh, PA 15206
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Nugent A. Organizing trade unions to combat disease: the Workers' Health Bureau, 1921-1928. Labor Hist 1985; 26:423-446. [PMID: 19946976 DOI: 10.1080/00236568508584808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Nugent A. Fit for work: the introduction of physical examinations in industry. Bull Hist Med 1983; 57:578-595. [PMID: 6365220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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