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Maclean MA, Rogers PS, Muradov JH, Pickett GE, Friedman A, Weeks A, Greene R, Volders D. Contrast-Induced Encephalopathy and the Blood-Brain Barrier. Can J Neurol Sci 2024:1-10. [PMID: 38453685 DOI: 10.1017/cjn.2024.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Contrast-induced encephalopathy (CIE) is an adverse event associated with diagnostic and therapeutic endovascular procedures. Decades of animal and human research support a mechanistic role for pathological blood-brain barrier dysfunction (BBBd). Here, we describe an institutional case series and review the literature supporting a mechanistic role for BBBd in CIE. METHODS A literature review was conducted by searching MEDLINE, Web of Science, Embase, CINAHL and Cochrane databases from inception to January 31, 2022. We searched our institutional neurovascular database for cases of CIE following endovascular treatment of cerebrovascular disease during a 6-month period. Informed consent was obtained in all cases. RESULTS Review of the literature revealed risk factors for BBBd and CIE, including microvascular disease, pathological neuroinflammation, severe procedural hypertension, iodinated contrast load and altered cerebral blood flow dynamics. In our institutional series, 6 of 52 (11.5%) of patients undergoing therapeutic neuroendovascular procedures developed CIE during the study period. Four patients were treated for ischemic stroke and two patients for recurrent cerebral aneurysms. Mechanical stenting or thrombectomy were utilized in all cases. CONCLUSION In this institutional case series and literature review of animal and human data, we identified numerous shared risk factors for CIE and BBBd, including microvascular disease, increased procedure length, large contrast volumes, severe intraoperative hypertension and use of mechanical devices that may induce iatrogenic endothelial injury.
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Affiliation(s)
- Mark A Maclean
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Patrick S Rogers
- Department of Diagnostic Radiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Jamil H Muradov
- Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Gwynedd E Pickett
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Alon Friedman
- Department of Medical Neuroscience, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Adrienne Weeks
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Ryan Greene
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - David Volders
- Department of Diagnostic Radiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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2
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Han JH, Attwood K, Roy J, Weeks A. 109 A Small RNA Signature from Extracellular Vesicles in Patient Plasma Correlates With Recurrence or Progression of High-Grade Gliomas. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_109] [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: 03/18/2023] Open
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3
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Han J, Attwood K, Roy J, Weeks A. A small RNA signature from extracellular vesicles in patient plasma correlates with recurrence or progression of high-grade gliomas. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01049-8] [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: 11/03/2022]
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4
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Colman M, Castori M, Micale L, Ritelli M, Colombi M, Ghali N, Van Dijk F, Marsili L, Weeks A, Vandersteen A, Rideout A, Legrand A, Frank M, Mirault T, Ferraris A, Di Giosaffatte N, Grammatico P, Grunert J, Frank C, Symoens S, Syx D, Malfait F. Atypical variants in COL1A1 and COL3A1 associated with classical and vascular Ehlers-Danlos syndrome overlap phenotypes: expanding the clinical phenotype based on additional case reports. Clin Exp Rheumatol 2022; 40 Suppl 134:46-62. [DOI: 10.55563/clinexprheumatol/kzkq6y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/20/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Marlies Colman
- Centre for Medical Genetics, Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University and Ghent University Hospital, Belgium
| | - Marco Castori
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Lucia Micale
- Division of Medical Genetics, Fondazione IRCCS-Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Marco Ritelli
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Marina Colombi
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Neeti Ghali
- Ehlers-Danlos Syndrome National Diagnostic Service London, North West Thames Regional Genetics Service, London North West Healthcare University NHS Trust, Harrow, Middlesex, UK
| | - Fleur Van Dijk
- National Ehlers Danlos Syndrome Diagnostic Service, Northwick Park and St. Mark’s Hospitals, Harrow, UK
| | - Luisa Marsili
- Clinique de Génétique, CHU Lille, France and Utrecht University, University Medical Center Utrecht, Department of Genetics, Utrecht, The Netherlands
| | - Adrienne Weeks
- Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anthony Vandersteen
- Maritime Medical Genetics Service, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Andrea Rideout
- Maritime Medical Genetics Service, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Anne Legrand
- Département de Génétique, Centre National de Référence pour les Maladies Vasculaires Rares, Centre de Référence Européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Michael Frank
- Département de Génétique, Centre National de Référence pour les Maladies Vasculaires Rares, Centre de Référence Européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Tristan Mirault
- Département de Génétique, Centre National de Référence pour les Maladies Vasculaires Rares, Centre de Référence Européen VASCERN MSA, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Alessandro Ferraris
- Medical Genetics Unit, Experimental Medicine Department, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Niccolò Di Giosaffatte
- Medical Genetics Unit, Experimental Medicine Department, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | - Paola Grammatico
- Medical Genetics Unit, Experimental Medicine Department, Sapienza University, San Camillo-Forlanini Hospital, Rome, Italy
| | | | | | - Sofie Symoens
- Centre for Medical Genetics, Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University and Ghent University Hospital, Belgium
| | - Delfien Syx
- Centre for Medical Genetics, Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University and Ghent University Hospital, Belgium
| | - Fransiska Malfait
- Centre for Medical Genetics, Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University and Ghent University Hospital, Belgium.
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5
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Nguyen TN, Haussen DC, Qureshi MM, Yamagami H, Fujinaka T, Mansour OY, Abdalkader M, Frankel M, Qiu Z, Taylor A, Lylyk P, Eker OF, Mechtouff L, Piotin M, Lima FO, Mont'Alverne F, Izzath W, Sakai N, Mohammaden M, Al-Bayati AR, Renieri L, Mangiafico S, Ozretic D, Chalumeau V, Ahmad S, Rashid U, Hussain SI, John S, Griffin E, Thornton J, Fiorot JA, Rivera R, Hammami N, Cervantes-Arslanian AM, Dasenbrock HH, Vu HL, Nguyen VQ, Hetts S, Bourcier R, Guile R, Walker M, Sharma M, Frei D, Jabbour P, Herial N, Al-Mufti F, Ozdemir AO, Aykac O, Gandhi D, Chugh C, Matouk C, Lavoie P, Edgell R, Beer-Furlan A, Chen M, Killer-Oberpfalzer M, Pereira VM, Nicholson P, Huded V, Ohara N, Watanabe D, Shin DH, Magalhaes PS, Kikano R, Ortega-Gutierrez S, Farooqui M, Abou-Hamden A, Amano T, Yamamoto R, Weeks A, Cora EA, Sivan-Hoffmann R, Crosa R, Möhlenbruch M, Nagel S, Al-Jehani H, Sheth SA, Lopez Rivera VS, Siegler JE, Sani AF, Puri AS, Kuhn AL, Bernava G, Machi P, Abud DG, Pontes-Neto OM, Wakhloo AK, Voetsch B, Raz E, Yaghi S, Mehta BP, Kimura N, Murakami M, Lee JS, Hong JM, Fahed R, Walker G, Hagashi E, Cordina SM, Roh HG, Wong K, Arenillas JF, Martinez-Galdamez M, Blasco J, Rodriguez Vasquez A, Fonseca L, Silva ML, Wu TY, John S, Brehm A, Psychogios M, Mack WJ, Tenser M, Todaka T, Fujimura M, Novakovic R, Deguchi J, Sugiura Y, Tokimura H, Khatri R, Kelly M, Peeling L, Murayama Y, Winters HS, Wong J, Teleb M, Payne J, Fukuda H, Miyake K, Shimbo J, Sugimura Y, Uno M, Takenobu Y, Matsumaru Y, Yamada S, Kono R, Kanamaru T, Morimoto M, Iida J, Saini V, Yavagal D, Bushnaq S, Huang W, Linfante I, Kirmani J, Liebeskind DS, Szeder V, Shah R, Devlin TG, Birnbaum L, Luo J, Churojana A, Masoud HE, Lopez CY, Steinfort B, Ma A, Hassan AE, Al Hashmi A, McDermott M, Mokin M, Chebl A, Kargiotis O, Tsivgoulis G, Morris JG, Eskey CJ, Thon J, Rebello L, Altschul D, Cornett O, Singh V, Pandian J, Kulkarni A, Lavados PM, Olavarria VV, Todo K, Yamamoto Y, Silva GS, Geyik S, Johann J, Multani S, Kaliaev A, Sonoda K, Hashimoto H, Alhazzani A, Chung DY, Mayer SA, Fifi JT, Hill MD, Zhang H, Yuan Z, Shang X, Castonguay AC, Gupta R, Jovin TG, Raymond J, Zaidat OO, Nogueira RG. Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic. Stroke Vasc Neurol 2021; 6:542-552. [PMID: 33771936 PMCID: PMC8006491 DOI: 10.1136/svn-2020-000695] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 10/19/2020] [Revised: 12/15/2020] [Accepted: 01/15/2021] [Indexed: 02/07/2023] Open
Abstract
Background During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study’s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines. Methods We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1 year and immediately before) and during the pandemic, defined as 1 March–31 May 2020. The prior 1-year control period (1 March–31 May 2019) was obtained to account for seasonal variation. Findings There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI −24.3% to −20.7%, p<0.0001). Embolisation of ruptured aneurysms declined with 1170–1035 procedures, respectively, representing an 11.5% (95%CI −13.5% to −9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95% CI −28.0% to −22.1%, p<0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile. Interpretation There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction.
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Affiliation(s)
- Thanh N Nguyen
- Neurology, Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Diogo C Haussen
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Muhammad M Qureshi
- Radiology, Radiation Oncology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Hiroshi Yamagami
- Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Toshiyuki Fujinaka
- Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | - Michael Frankel
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Zhongming Qiu
- Department of Neurology, Xinqiao Hospital, Chongqing, China
| | - Allan Taylor
- Neurosurgery, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Pedro Lylyk
- Neurosurgery, Interventional Neuroradiology, Clinica La Sagrada Familia, Buenos Aires, Argentina
| | - Omer F Eker
- Neuroradiologie, Neurologie Vasculaire, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Laura Mechtouff
- Neurologie Vasculaire, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes, France
| | - Michel Piotin
- Interventional Neuroradiology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France
| | | | | | - Wazim Izzath
- Neuroradiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Nobuyuki Sakai
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Mahmoud Mohammaden
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Alhamza R Al-Bayati
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
| | - Leonardo Renieri
- Interventional Neurovascular Unit, University Hospital Careggi, Firenze, Toscana, Italy
| | - Salvatore Mangiafico
- Interventional Neurovascular Unit, University Hospital Careggi, Firenze, Toscana, Italy
| | - David Ozretic
- Neuroradiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Vanessa Chalumeau
- Interventional Neuroradiology, Hopital Bicetre, Le Kremlin-Bicetre, France
| | - Saima Ahmad
- Stroke and Interventional Neuroradiology, Lahore General Hospital, Lahore, Pakistan
| | - Umair Rashid
- Stroke and Interventional Neuroradiology, Lahore General Hospital, Lahore, Pakistan
| | | | - Seby John
- Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Emma Griffin
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - John Thornton
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | | | - Rodrigo Rivera
- Neuroradiology, Instituto de Neurocirugia Dr Asengo, Santiago, Chile
| | - Nadia Hammami
- Interventional Neuroradiology, Institut National de Neurologie, Tunis, Tunisia
| | | | | | - Huynh Le Vu
- Stroke Center, Hue Central Hospital, Hue, Thua Thien Hue, Vietnam
| | - Viet Quy Nguyen
- Stroke Center, Hue Central Hospital, Hue, Thua Thien Hue, Vietnam
| | - Steven Hetts
- Radiology, University of California San Francisco, San Francisco, California, USA.,Interventional Neuroradiology, University of California San Francisco, San Francisco, California, USA
| | - Romain Bourcier
- Neuroradiologie Diagnostique et Interventionnelle, Hôpital Guillaume & René Laennec, CHU Nantes, Nantes, France
| | - Romain Guile
- Neuroradiologie Diagnostique et Interventionnelle, Hôpital Guillaume & René Laennec, CHU Nantes, Nantes, France
| | - Melanie Walker
- Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Malveeka Sharma
- Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Don Frei
- Radiology, Swedish Medical Center, Englewood, Colorado, USA
| | - Pascal Jabbour
- Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Nabeel Herial
- Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Fawaz Al-Mufti
- Neurology, Neurosurgery, Westchester Medical Center Health Network, Valhalla, New York, USA
| | - Atilla Ozcan Ozdemir
- Stroke and Neurointervention Unit, Eskisehir OsmangaziUniversity, Eskisehir, Turkey
| | - Ozlem Aykac
- Stroke and Neurointervention Unit, Eskisehir OsmangaziUniversity, Eskisehir, Turkey
| | - Dheeraj Gandhi
- Radiology, Neurology, Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Chandril Chugh
- Interventional Neurology, MAX Superspecialty Hospital, Saket, New Delhi, India
| | - Charles Matouk
- Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Pascale Lavoie
- Neurosurgery, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, Quebec, Canada
| | - Randall Edgell
- Neurology, St Louis University School of Medicine, St Louis, Missouri, USA
| | - Andre Beer-Furlan
- Neurological Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Michael Chen
- Neurological Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Monika Killer-Oberpfalzer
- Neurology, Research Institute of Neurointervention, University Hospital Salzburg /Paracelsus Medical University, Salzburg, Austria
| | - Vitor Mendes Pereira
- Neurosurgery, Medical Imaging, Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Nicholson
- Neurosurgery, Medical Imaging, Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Vikram Huded
- Neurology, NH Mazumdar Shah Medical Center, Bangalore, India
| | - Nobuyuki Ohara
- Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Daisuke Watanabe
- Stroke and Neurovascular Surgery, IMS Tokyo-Katsushika General Hospital, Tokyo, Japan
| | - Dong Hun Shin
- Gachon University, Seongnam, Korea (the Republic of)
| | - Pedro Sc Magalhaes
- Stroke Unit, Hospital Municipal Sao Jose, Joinville, Santa Catarina, Brazil
| | - Raghid Kikano
- Interventional Neuroradiology, Lau Medical Center, Beirut, Lebanon
| | | | - Mudassir Farooqui
- Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Amal Abou-Hamden
- Neurosurgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Tatsuo Amano
- Stroke and Cerebrovascular Medicine, Kyorin University, Mitaka, Tokyo, Japan
| | - Ryoo Yamamoto
- Neurology, Yokohama Brain and Spine Center, Yokohama, Japan
| | - Adrienne Weeks
- Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elena A Cora
- Radiology, QEII Health Sciences Centre, Dalhousie University, Dalhousie, Nova Scotia, Canada
| | | | - Roberto Crosa
- Centro Endovascular Neurologico Medica Uruguaya, Montevideo, Uruguay
| | - Markus Möhlenbruch
- Neuroradiology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Simon Nagel
- Neurology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
| | - Hosam Al-Jehani
- Neurosurgery, Interventional Radiology and Critical Care Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Alkhobar, Saudi Arabia
| | - Sunil A Sheth
- Neurology, University of Texas McGovern Medical School, Houston, Texas, USA
| | | | - James E Siegler
- Neurology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | | | - Ajit S Puri
- Neurointerventional Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Anna Luisa Kuhn
- Neurointerventional Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Gianmarco Bernava
- Interventional Neuroradiology, University Hospitals Geneva, Geneva, Switzerland
| | - Paolo Machi
- Interventional Neuroradiology, University Hospitals Geneva, Geneva, Switzerland
| | - Daniel G Abud
- Interventional Neuroradiology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Octavio M Pontes-Neto
- Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Ajay K Wakhloo
- Interventional Neuroradiology, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Barbara Voetsch
- Neurology, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Eytan Raz
- Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Shadi Yaghi
- Neurology, NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Brijesh P Mehta
- Memorial Neuroscience Institute, Pembroke Pines, Florida, USA
| | - Naoto Kimura
- Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan
| | | | - Jin Soo Lee
- Ajou University Hospital, Suwon, Gyeonggi-do, South Korea
| | - Ji Man Hong
- Ajou University Hospital, Suwon, Gyeonggi-do, South Korea
| | - Robert Fahed
- Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | - Gregory Walker
- Neurology, University of Ottawa, Ottawa, Ontario, Canada
| | - Eiji Hagashi
- Cerebrovascular Medicine, Saga-ken Medical Centre Koseikan, Saga, Japan
| | - Steve M Cordina
- Neurology, Neurosurgery, Radiology, University of South Alabama, Mobile, Alabama, USA
| | - Hong Gee Roh
- Konkuk University, Gwangjin-gu, Seoul, South Korea
| | - Ken Wong
- Interventional Neuroradiology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Juan F Arenillas
- Neurology, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
| | - Mario Martinez-Galdamez
- Interventional Neuroradiology, Hospital Clínico Universitario, Universidad de Valladolid, Valladolid, Spain
| | - Jordi Blasco
- INR, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | | | - Luisa Fonseca
- Stroke Unit, Department of Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - M Luis Silva
- Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Teddy Y Wu
- Neurology, Christchurch Hospital, Christchurch, New Zealand
| | - Simon John
- Neurosurgery, Christchurch Hospital, Christchurch, New Zealand
| | - Alex Brehm
- Interventional and Diagnostic Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Marios Psychogios
- Interventional and Diagnostic Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - William J Mack
- Neurosurgery, University of Southern California, Los Angeles, California, USA
| | - Matthew Tenser
- Neurosurgery, University of Southern California, Los Angeles, California, USA
| | - Tatemi Todaka
- Neurosurgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Kumamoto, Japan
| | - Miki Fujimura
- Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan
| | | | - Jun Deguchi
- Endovascular Neurosurgery, Nara City Hospital, Nara, Nara, Japan
| | - Yuri Sugiura
- Neurology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
| | - Hiroshi Tokimura
- Neurosurgery and Stroke Center, Kagoshima City Hospital, Kagoshima, Kagoshima, Japan
| | | | - Michael Kelly
- Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Lissa Peeling
- Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Yuichi Murayama
- Neurosurgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | | | - Johnny Wong
- Neurosurgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Mohamed Teleb
- Neurosciences, Banner Desert Medical Center, Mesa, Arizona, USA
| | - Jeremy Payne
- Neurosciences, Banner Desert Medical Center, Mesa, Arizona, USA
| | - Hiroki Fukuda
- Neurology, Japanese Red Cross Matsue Hospital, Shimane, Japan
| | - Kosuke Miyake
- Neurology, Shiroyama Hospital, Habikino, Osaka, Japan
| | - Junsuke Shimbo
- Cerebrovascular Medicine, Niigata City General Hospital, Niigata, Niigata, Japan
| | | | - Masaaki Uno
- Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Japan
| | | | - Yuji Matsumaru
- Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Satoshi Yamada
- Neurology, Stroke Center and Neuroendovascular Therapy, Saiseikai Central Hospital, Minato-ku, Tokyo, Japan
| | - Ryuhei Kono
- Neurology, Kinikyo Chuo Hospital, Sapporo, Hokkaido, Japan
| | - Takuya Kanamaru
- Cerebrovascular Medicine, NTT Medical Center Tokyo, Tokyo, Japan
| | - Masafumi Morimoto
- Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Japan
| | - Junichi Iida
- Neurosurgery, Osaka General Medical Center, Osaka, Japan
| | - Vasu Saini
- Neurology, Neurosurgery, University of Miami School of Medicine, Miami, Florida, USA
| | - Dileep Yavagal
- Neurology, Neurosurgery, University of Miami School of Medicine, Miami, Florida, USA
| | - Saif Bushnaq
- Neurology, Bon Secours Mercy Health System, Toledo, Ohio, USA
| | - Wenguo Huang
- Neurology, Maoming City Hospital, Guandong, China
| | - Italo Linfante
- Interventional Neuroradiology, Endovascular Neurosurgery, Miami Cardiac & Vascular Institute, Miami, Florida, USA
| | - Jawad Kirmani
- Neurology, Hackensack Meridian Health, Edison, New Jersey, USA
| | - David S Liebeskind
- Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Ruchir Shah
- Neurology, Erlanger Medical Center, University of Tennessee, Chattanooga, Tennessee, USA
| | - Thomas G Devlin
- Neurology, Erlanger Medical Center, University of Tennessee, Chattanooga, Tennessee, USA
| | - Lee Birnbaum
- Neurology, Neurosurgery, Radiology, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Jun Luo
- Neurology, Mianyang 404 Hospital, Mianyang, Sichuan, China
| | | | - Hesham E Masoud
- Neurology, Neurosurgery, Radiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Carlos Ynigo Lopez
- Neurology, Neurosurgery, Radiology, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Brendan Steinfort
- Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Alice Ma
- Neurosurgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ameer E Hassan
- Neurosciences, The University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Amal Al Hashmi
- Central Stroke Unit, Directorate of Neuroscience, Khoula Hospital, Ministry of Health, Muscat, Oman
| | | | - Maxim Mokin
- Neurosurgery, University of South Florida, Tampa, Florida, USA
| | - Alex Chebl
- Neurology, Henry Ford Health System, Detroit, Michigan, USA
| | | | - Georgios Tsivgoulis
- Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Jane G Morris
- Neurology, Maine Medical Center, Portland, Maine, USA
| | - Clifford J Eskey
- Neuroradiology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Jesse Thon
- Neurology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Leticia Rebello
- Neurology, Hospital Universitario de Brasilia, Brasilia, Distrito Federal, Brazil
| | - Dorothea Altschul
- Neurointerventional Neurosurgery, The Valley Hospital, Ridgewood, New Jersey, USA
| | - Oriana Cornett
- Neurosciences, Stroke Program, St Joseph's University Medical Center, Paterson, New Jersey, USA
| | - Varsha Singh
- Neurosciences, Stroke Program, St Joseph's University Medical Center, Paterson, New Jersey, USA
| | - Jeyaraj Pandian
- Neurology, Christian Medical College and Hospital Ludhiana, Ludhiana, Punjab, India
| | - Anirudh Kulkarni
- Neurology, Christian Medical College and Hospital Ludhiana, Ludhiana, Punjab, India
| | - Pablo M Lavados
- Vascular Neurology Unit, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Veronica V Olavarria
- Vascular Neurology Unit, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Kenichi Todo
- Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuki Yamamoto
- Neurology, Tokushima University Hospital, Tokushima, Japan
| | | | - Serdar Geyik
- Istanbul Aydin University, Istanbul, İstanbul, Turkey
| | - Jasmine Johann
- Radiology, Swedish Medical Center, Englewood, Colorado, USA
| | - Sumeet Multani
- Neurology, Bayhealth Medical Center, Dover, Delaware, USA
| | - Artem Kaliaev
- Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Kazutaka Sonoda
- Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroyuki Hashimoto
- Division of Stroke, Department of Internal Medicine, Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Adel Alhazzani
- Neurology Division, Department of Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - David Y Chung
- Neurology, Boston Medical Center, Boston, Massachusetts, USA
| | - Stephan A Mayer
- Neurology, Neurosurgery, Westchester Medical Center Health Network, Valhalla, New York, USA
| | - Johanna T Fifi
- Neurology, Mount Sinai Health System, New York, New York, USA
| | - Michael D Hill
- Neurology, Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Hao Zhang
- Neurology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zhengzhou Yuan
- Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xianjin Shang
- Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China
| | | | - Rishi Gupta
- Neuroscience, WellStar Health System, Marietta, Georgia, USA
| | - Tudor G Jovin
- Neurology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Jean Raymond
- Neuroradiologie Interventionelle, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Osama O Zaidat
- Neurology, Bon Secours Mercy Health System, Toledo, Ohio, USA
| | - Raul G Nogueira
- Neurology, Marcus Stroke & Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
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6
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Kemper JI, Li W, Goni S, Flanagan M, Weeks A, Alfirevic Z, Bracken H, Mundle S, Goonewardene M, Ten Eikelder M, Bloemenkamp K, Rengerink KO, Kruit H, Mol BW, Palmer KR. Foley catheter vs oral misoprostol for induction of labor: individual participant data meta-analysis. Ultrasound Obstet Gynecol 2021; 57:215-223. [PMID: 33258514 DOI: 10.1002/uog.23563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To compare the effectiveness and safety of Foley catheter and oral misoprostol for induction of labor (IOL). METHODS The Cochrane Review on Mechanical Methods for Induction of Labour and Ovid MEDLINE, EMBASE via Ovid, Ovid Emcare, CINAHL Plus, ClinicalTrials.gov and Scopus, from inception to April 2019, were searched for randomized controlled trials (RCTs) comparing Foley catheter to oral misoprostol for IOL in viable singleton gestations. Eligible trials for which raw data were obtained were included and individual participant data meta-analysis was performed. Primary outcomes were vaginal birth, a composite of adverse perinatal outcome (including stillbirth, neonatal death, neonatal seizures, admission to the neonatal intensive care unit, severe respiratory compromise or meconium aspiration syndrome) and a composite of adverse maternal outcome (including admission to the intensive care unit, maternal infection, severe postpartum hemorrhage, maternal death or uterine rupture). The quality of the included RCTs was assessed using the Cochrane Risk of Bias 2 tool and the certainty of evidence was evaluated using the GRADE approach. A two-stage random-effects model was used for meta-analysis according to the intention-to-treat principle and interactions between treatment and baseline characteristics were assessed. RESULTS Of seven eligible trials, four provided individual participant data for a total of 2815 participants undergoing IOL, of whom 1399 were assigned to Foley catheter and 1416 to oral misoprostol. All four trials provided data for each of the primary outcomes in all 2815 women. Compared with those receiving oral misoprostol, Foley catheter recipients had a slightly decreased chance of vaginal birth (risk ratio (RR), 0.95 (95% CI, 0.91-0.99); I2 , 2.0%; moderate-certainty evidence). A trend towards a lower rate of composite adverse perinatal outcome was found in women undergoing IOL using a Foley catheter compared with oral misoprostol (RR, 0.71 (95% CI, 0.48-1.05); I2 , 14.9%; low-certainty evidence). Composite adverse maternal outcome did not differ between the groups (RR, 1.00 (95% CI, 0.97-1.03); I2 , 0%; moderate-certainty evidence). Meta-analyses of effect modifications did not show significant interactions between intervention and parity or gestational age for any of the primary outcomes. CONCLUSIONS For women undergoing IOL, Foley catheter is less effective than oral misoprostol, as it was associated with fewer vaginal births. However, while we found no significant difference in maternal safety, Foley catheter induction may reduce adverse perinatal outcomes. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J I Kemper
- Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
| | - W Li
- Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
| | - S Goni
- Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
| | - M Flanagan
- Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
| | - A Weeks
- Department of Women's & Children's Health, University of Liverpool, Liverpool Women's Hospital, Liverpool, UK
| | - Z Alfirevic
- Department of Women's & Children's Health, University of Liverpool, Liverpool Women's Hospital, Liverpool, UK
| | - H Bracken
- Gynuity Health Projects, New York, NY, USA
| | - S Mundle
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Nagpur, India
| | - M Goonewardene
- Department of Obstetrics & Gynaecology, University of Ruhuna, Galle, Sri Lanka
| | - M Ten Eikelder
- Leiden University Medical Center, Leiden, The Netherlands
| | - K Bloemenkamp
- Wilhelmina Children's Hospital Birth Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - K O Rengerink
- Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H Kruit
- Department of Obstetrics & Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - B W Mol
- Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
- Monash Women's, Monash Health, Melbourne, Australia
- Aberdeen Centre for Women's Health Research, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - K R Palmer
- Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
- Monash Women's, Monash Health, Melbourne, Australia
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7
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Attwood KM, Robichaud A, Westhaver LP, Castle EL, Brandman DM, Balgi AD, Roberge M, Colp P, Croul S, Kim I, McCormick C, Corcoran JA, Weeks A. Raloxifene prevents stress granule dissolution, impairs translational control and promotes cell death during hypoxia in glioblastoma cells. Cell Death Dis 2020; 11:989. [PMID: 33203845 PMCID: PMC7673037 DOI: 10.1038/s41419-020-03159-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 12/30/2022]
Abstract
Glioblastoma (GBM) is the most common primary malignant brain tumor, and it has a uniformly poor prognosis. Hypoxia is a feature of the GBM microenvironment, and previous work has shown that cancer cells residing in hypoxic regions resist treatment. Hypoxia can trigger the formation of stress granules (SGs), sites of mRNA triage that promote cell survival. A screen of 1120 FDA-approved drugs identified 129 candidates that delayed the dissolution of hypoxia-induced SGs following a return to normoxia. Amongst these candidates, the selective estrogen receptor modulator (SERM) raloxifene delayed SG dissolution in a dose-dependent manner. SG dissolution typically occurs by 15 min post-hypoxia, however pre-treatment of immortalized U251 and U3024 primary GBM cells with raloxifene prevented SG dissolution for up to 2 h. During this raloxifene-induced delay in SG dissolution, translational silencing was sustained, eIF2α remained phosphorylated and mTOR remained inactive. Despite its well-described role as a SERM, raloxifene-mediated delay in SG dissolution was unaffected by co-administration of β-estradiol, nor did β-estradiol alone have any effect on SGs. Importantly, the combination of raloxifene and hypoxia resulted in increased numbers of late apoptotic/necrotic cells. Raloxifene and hypoxia also demonstrated a block in late autophagy similar to the known autophagy inhibitor chloroquine (CQ). Genetic disruption of the SG-nucleating proteins G3BP1 and G3BP2 revealed that G3BP1 is required to sustain the raloxifene-mediated delay in SG dissolution. Together, these findings indicate that modulating the stress response can be used to exploit the hypoxic niche of GBM tumors, causing cell death by disrupting pro-survival stress responses and control of protein synthesis.
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Affiliation(s)
| | - Aaron Robichaud
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | | | - Elizabeth L Castle
- Department of Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada
| | - David M Brandman
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Aruna D Balgi
- Department of Biochemistry & Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| | - Michel Roberge
- Department of Biochemistry & Molecular Biology, University of British Columbia, Vancouver, BC, Canada
| | - Patricia Colp
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Sidney Croul
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Inhwa Kim
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Craig McCormick
- Department of Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada
| | - Jennifer A Corcoran
- Department of Microbiology, Immunology and Infectious Disease, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Adrienne Weeks
- Department of Surgery, Dalhousie University, Halifax, NS, Canada.
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada.
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
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8
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Rappoldt L, Weeks A, Ouellete R, Roy J, Taylor C, McCormick C, Attwood K, Kim I. TMOD-26. ESTABLISHING A PATIENT-DERIVED, IN-VITRO ORGANOTYPIC SLICE CULTURE MODEL OF GBM. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.976] [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: 11/12/2022] Open
Abstract
Abstract
Glioblastoma Multiforme (GBM) is the most common primary malignant brain tumour. This tumour is universally fatal with a median survival of 15 months. Driving this pathology is an extremely heterogeneic tumour and complex tumour microenvironment. GBM research is primarily conducted using immortalized or primary cell lines due to their practicality and reproducibility. However, these cell lines do not effectively recapitulate the tumour microenvironment. Mouse models address these shortcomings but are laborious and expensive. We propose to utilize a patient derived organotypic culture model of GBM as an intermediary. We have utilized this model to test genetic manipulation via lentiviral transduction and the feasibility of utilizing this model to understand patient derived extracellular vesicles (EVs). We have sectioned and cultured patient derived organotypic models for 14 days without loss of viability. To determine if these organotypic cultures are amenable to lentiviral manipulation, tissue sections were transduced with far-red fluorescent lentivirus and efficiency determined by confocal laser scanning microscopy (CLSM) and flow cytometry (FC). To determine feasibility as a model for EVs, media obtained from patient-derived organotypic cultures was analyzed by western blot, nanoparticle tracking analysis (NTA), and nanoFlow Cytometry (nFC). In the future these EVs will be compared to those found in patient serum. The model of GBM has been lentivirally transduced to express a far-red fluorescent vector in approximately 15% of the slice, quantified by CLSM and FC. EV-sized particles positive for canonical EV markers have been identified in the media by NTA, nFC and western blot. Using lentiviral-mediated genetic engineering and emerging EV science, this organotypic slice culture models yields exciting utility in GBM research. The established organotypic slice culture model will likely be a valuable tool in the study of GBM biology and EV dynamics.
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Affiliation(s)
| | | | | | - Jeremy Roy
- Atlantic Cancer Research Institute, Moncton, NB, Canada
| | | | | | | | - Inhwa Kim
- Dalhousie University, Halifax, NS, Canada
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9
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MacLean MA, Huynh TJ, Schmidt MH, Pereira VM, Weeks A. Republished: Competitive flow diversion of multiple P1 aneurysms: proposed classification. J Neurointerv Surg 2020; 12:e7. [PMID: 32571962 DOI: 10.1136/neurintsurg-2019-015581.rep] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 11/04/2022]
Abstract
We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.
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Affiliation(s)
| | - Thien J Huynh
- Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Vitor M Pereira
- Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Adrienne Weeks
- Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
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10
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MacLean MA, Huynh TJ, Schmidt MH, Pereira VM, Weeks A. Competitive flow diversion of multiple P1 aneurysms: proposed classification. BMJ Case Rep 2020; 13:13/6/e015581. [PMID: 32499293 DOI: 10.1136/bcr-2019-015581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report the case of a patient with subarachnoid hemorrhage and three aneurysms arising from the posterior communicating artery (Pcomm)-P1 complex, treated with endovascular coiling and competitive flow diversion. The largest and likely ruptured Pcomm aneurysm was treated with traditional coiling. Two smaller potentially ruptured aneurysms arose from the distal right posterior cerebral artery (PCA) P1 segment. After a failed attempt to treat with conventional flow diversion across the PCA-P1 segment, the P1 aneurysms were successfully treated with competitive flow diversion distal to the PCA-P1 segment from Pcomm to the P2 segment. Over 12 months, competitive flow diversion redirected flow to the right PCA territory via the internal carotid artery-Pcomm-P2, reducing the size of the PCA-P1 segment and obliterating the P1 aneurysms. Competitive flow diversion treatment should be considered for aneurysms occurring at the circle of Willis when traditional methods are not feasible. Herein, we introduce a novel classification for competitive flow diversion treatment.
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Affiliation(s)
| | - Thien J Huynh
- Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Vitor M Pereira
- Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Adrienne Weeks
- Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
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11
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Slade P, West H, Thomson G, Lane S, Spiby H, Edwards RT, Charles JM, Garrett C, Flanagan B, Treadwell M, Hayden E, Weeks A. STRAWB2 (Stress and Wellbeing After Childbirth): a randomised controlled trial of targeted self‐help materials to prevent post‐traumatic stress disorder following childbirth. BJOG 2020; 127:886-896. [DOI: 10.1111/1471-0528.16163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- P Slade
- Department of Psychological Sciences Institute of Health and Life Sciences University of Liverpool Liverpool UK
| | - H West
- Department of Psychological Sciences Institute of Health and Life Sciences University of Liverpool Liverpool UK
| | - G Thomson
- School of Community Health and Midwifery University of Central Lancashire Preston UK
| | - S Lane
- Centre for Medical Statistics and Health Evaluation University of Liverpool Liverpool UK
| | - H Spiby
- School of Health Sciences University of Nottingham Nottingham UK
| | - RT Edwards
- Centre for Health Economics and Medicines Evaluation Bangor University Gwynedd UK
| | - JM Charles
- Centre for Health Economics and Medicines Evaluation Bangor University Gwynedd UK
| | - C Garrett
- Lancashire Teaching Hospitals NHS Foundation Trust Preston UK
| | - B Flanagan
- Lancashire Teaching Hospitals NHS Foundation Trust Preston UK
| | | | - E Hayden
- Liverpool Women’s Hospital Foundation Trust Liverpool UK
| | - A Weeks
- Department of Women’s and Children’s Health University of Liverpool Liverpool UK
- Liverpool Women’s Hospital Foundation Trust and Liverpool Health Partners Liverpool UK
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12
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Nurmsoo S, Guida A, Wong A, Aviv RI, Demchuk A, Gladstone DJ, Flaherty ML, Dowlatshahi D, Gubitz G, Phillips SJ, Weeks A, Pickett GE, Volders D, Vandorpe R, Huynh T. Abstract WP406: Training and Validation of Deepmedic Machine Learning Tool for Automated Hematoma Segmentation and Volume Analysis on CT Using Multicenter Data. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp406] [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
Introduction:
We sought to train and validate an automated machine learning algorithm for ICH segmentation and volume calculation using multicenter data.
Methods:
An open-source 3D deep machine learning algorithm “DeepMedic” was trained using manually segmented ICH from 208 CT scans (129 patients) from the multicenter PREDICT study. The algorithm was then validated with 125 manually segmented CT scans (48 patients) from the SPOTLIGHT study. Manual segmentation was performed with Quantomo semi-automated software. ABC/2 was measured for all studies by two neuroradiologists. Accuracy of DeepMedic segmentation was assessed using the Dice similarity coefficient. Analysis was stratified by presence of IVH. Intraclass correlation (ICC) with 95% confidence intervals (CI) assessed agreement between manual vs. DeepMedic segmentation volume; and manual segmentation and ABC/2 volume. Bland-Altman charts were analyzed for ABC/2 and DeepMedic vs. manual segmentation volumes.
Results:
DeepMedic demonstrated high segmentation accuracy in the training cohort (median Dice 0.96; IQR 0.95 - 0.97) and in the validation cohort (median Dice 0.91; IQR 0.86 - 0.94). Dice coefficients were not significantly different between patients with IVH in the training cohort; however was significantly worse in the validation cohort in patients with IVH (Wilcoxon p<0.001). Agreement was significantly better between DeepMedic and manual segmentation (PREDICT: ICC 0.99 [95%CI 0.99 -1.00]; SPOTLIGHT: ICC 0.98 [95%CI 0.97 - 0.99]) than between ABC/2 and manual segmentation (PREDICT: ICC 0.92 [95%CI 0.89 - 0.95]; SPOTLIGHT: ICC 0.95 [95%CI 0.93-0.97]). Improved accuracy of DeepMedic was demonstrated in Bland-Altman charts (Fig 1).
Conclusion:
ICH machine learning segmentation with DeepMedic is feasible and accurate; and demonstrates greater agreement with manual segmentation compared to ABC/2 volumes. Accuracy of the machine learning algorithm however is limited in patients with IVH.
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Affiliation(s)
- Sean Nurmsoo
- Faculty of Medicine, Dalhousie Univ, Halifax, Canada
| | | | | | - Richard I Aviv
- Hurvitz Brain Sciences Rsch Program, Sunnybrook Rsch Institute and Dept of Med Imaging, Univ of Toronto, Toronto, Canada
| | - Andrew Demchuk
- Dept of Clinical Neurosciences, Cumming Sch of Medicine, Univ of Calgary, Calgary, Canada
| | - David J Gladstone
- Div of Neurology and Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Cntr and Sunnybrook Rsch Institute, Toronto, Canada
| | - Matthew L Flaherty
- Dept of Neurology and Rehabilitation Medicine, UC Gardner Neuroscience Institute, and Univ of Cincinnati, Cincinnati, OH
| | - Dar Dowlatshahi
- Ottawa Hosp Rsch Institute, and Univ of Ottawa, Ottawa, Canada
| | - Gord Gubitz
- Dept of Medicine (Neurology), Dalhousie Univ, Halifax, Canada
| | - Stephen J Phillips
- Queen Elizabeth II Health Sciences Cntr and Faculty of Medicine, Dalhousie Univ, Halifax, Canada
| | - Adrienne Weeks
- Div of Neurosurgery, Halifax Infirmary and Dalhousie Univ, Halifax, Canada
| | - Gwynedd E Pickett
- Queen Elizabeth II Health Sciences Cntr and Div of Neurosurgery, Dalhousie Univ, Halifax, NS, Canada, Halifax, Canada
| | - David Volders
- Dept of Diagnostic Radiology, Queen Elizabeth II Health Sciences Cntr, and Faculty of Medicine, Dalhousie Univ, Halifax, Canada
| | - Robert Vandorpe
- Dept of Diagnostic Radiology, QEII Health Sciences Cntr, and Faculty of Medicine, Dalhousie Univ, Halifax, Canada
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13
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Slade P, Balling K, Sheen K, Goodfellow L, Rymer J, Spiby H, Weeks A. Work-related post-traumatic stress symptoms in obstetricians and gynaecologists: findings from INDIGO, a mixed-methods study with a cross-sectional survey and in-depth interviews. BJOG 2020; 127:600-608. [PMID: 31986555 DOI: 10.1111/1471-0528.16076] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore obstetricians' and gynaecologists' experiences of work-related traumatic events, to measure the prevalence and predictors of post-traumatic stress disorder (PTSD), any impacts on personal and professional lives, and any support needs. DESIGN Mixed methods: cross-sectional survey and in-depth interviews. SAMPLE AND SETTING Fellows, members and trainees of the Royal College of Obstetricians and Gynaecologists (RCOG). METHODS A survey was sent to 6300 fellows, members and trainees of RCOG. 1095 people responded. Then 43 in-depth interviews with trauma-exposed participants were completed and analysed by template analysis. MAIN OUTCOME MEASURES Exposure to traumatic work-related events and PTSD, personal and professional impacts, and whether there was any need for support. Interviews explored the impact of trauma, what helped or hindered psychological recovery, and any assistance wanted. RESULTS Two-thirds reported exposure to traumatic work-related events. Of these, 18% of both consultants and trainees reported clinically significant PTSD symptoms. Staff of black or minority ethnicity were at increased risk of PTSD. Clinically significant PTSD symptoms were associated with lower job satisfaction, emotional exhaustion and depersonalisation. Organisational impacts included sick leave, and 'seriously considering leaving the profession'. 91% wanted a system of care. The culture in obstetrics and gynaecology was identified as a barrier to trauma support. A strategy to manage the impact of work-place trauma is proposed. CONCLUSIONS Exposure to work-related trauma is a feature of the experience of obstetricians and gynaecologists. Some will suffer PTSD with high personal, professional and organisational impacts. A system of care is needed. TWEETABLE ABSTRACT 18% of obstetrics and gynaecology doctors experience post-traumatic stress disorder after traumatic events at work.
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Affiliation(s)
- P Slade
- Institute of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - K Balling
- Institute of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - K Sheen
- Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK
| | - L Goodfellow
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - J Rymer
- Division of Women's Health, Kings' College London Faculty of Life Sciences and Medicine, London, UK
| | - H Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - A Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK.,Liverpool Women's Hospital Foundation Trust and Liverpool Health Partners, Liverpool, UK
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14
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Abstract
The purpose of national HIV surveillance is to track and summarize trends in newly diagnosed cases as an indicator of HIV transmission within Canada, and supports the development and evaluation of programs and policies for prevention, testing and delivery of care. Accurately capturing and interpreting trends in HIV diagnoses within national surveillance becomes complicated when there is movement of people within a country or when individuals are diagnosed with HIV prior to migrating to a new country. This has been identified as an issue in other countries, including Australia, New Zealand and Switzerland. The Public Health Agency of Canada (PHAC) recently assessed this in Canada after noting a rise in new HIV cases in Canada between 2014 to 2017. An environmental scan was conducted to better understand how new and previously diagnosed cases of HIV were recorded by and reported to PHAC from provincial and territorial (PT) public health authorities. It was discovered there was variation with respect to the reporting of cases who had received a new diagnosis of HIV within the province or territory, but who had previously received an HIV diagnosis from another PT or another country. Five PTs included cases previously diagnosed in another Canadian PT within the HIV surveillance data reported to PHAC and nine PTs included people who were diagnosed with HIV outside of Canada. The provincial and territorial public health authorities then reviewed HIV surveillance data from 2007 to 2017 to identify cases using a common definition of "previous HIV-positive test result". This included any case who gave a history, or had laboratory evidence, of an HIV-positive result from another PT or another country before presenting for care in the province or territory where they now resided. When these cases were subtracted from the total, a revised number of new HIV diagnoses was calculated for Canada. Re-analysis of surveillance data using this common definition for 2007 to 2017 explained more than half of the increase in HIV cases that had been documented in Canada over the last four years. In the future, national surveillance data will be calculated adopting this new common definition of a previous positive test result, in order to more accurately describe the trends in HIV transmission occurring in Canada.
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Affiliation(s)
- N Popovic
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - Q Yang
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - N Haddad
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - A Weeks
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - C Archibald
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
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15
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Abstract
BACKGROUND Human immunodeficiency virus (HIV) is a global public health issue, with an estimated 36.9 million people living with HIV in 2017. HIV has been reportable in Canada since 1985 and the Public Health Agency of Canada (PHAC) continues to monitor trends in new HIV diagnoses. OBJECTIVE The objective of this surveillance report is to provide an overview of the epidemiology of all reported diagnoses of HIV in Canada since 1985 with a focus on 2018 overall, and by geographic location, age group, sex, and exposure category. METHODS PHAC monitors HIV through the national HIV/AIDS Surveillance System, a passive, case-based system that collates nonnominal data that is voluntarily submitted by all Canadian provinces and territories. Descriptive epidemiological analyses were conducted on national data and those relating to specific populations provided by Immigration, Refugees and Citizenship Canada and the Canadian Perinatal HIV Surveillance Program. RESULTS In 2018, a total of 2,561 HIV diagnoses were reported in Canada, an increase of 8.2% compared with 2017. The national diagnosis rate increased to 6.9 per 100,000 population in 2018 from 6.5 per 100,000 population in 2017. Saskatchewan reported the highest provincial diagnosis rate at 14.9 per 100,000 population. The 30-39 year age group continued to have the highest HIV diagnosis rate at 15.4 per 100,000 population. Overall, the diagnosis rate for males continued to be higher than that of females (9.8 versus 4.0 per 100,000 population, respectively); however, females experienced a larger increase in reported cases and diagnosis rate. The gay, bisexual and other men who have sex with men (gbMSM) exposure category continued to represent the highest proportion of all reported adult cases (41.4%), though the proportion has decreased over time. Five perinatal HIV transmissions were documented, three were related to the mother not receiving perinatal antiretroviral therapy prophylaxis. CONCLUSION The number and rate of reported HIV cases in Canada increased in 2018, gbMSM continued to account for the largest exposure category and the number and rate of reported HIV cases among women increased. PHAC will continue to work with its national partners to refine the collection, analysis and publication of national data to better understand the burden of HIV in Canada.
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Affiliation(s)
- N Haddad
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - A Robert
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - A Weeks
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - N Popovic
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - W Siu
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
| | - C Archibald
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON
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16
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Freeman A, Bakker S, Weeks A, Diolaiti M, Quigley D, Chapman J, Chen L, Ashworth A. Differential cell surface protein expression in response to PARP inhibition in mutant isogenic ovarian and breast cancer cells using a novel proteomic technique. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.121] [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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17
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Weeks A. Book Review: Management of the Operating Room. International Anesthesiology Clinics. Anaesth Intensive Care 2019. [DOI: 10.1177/0310057x9802600619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Robichaud A, Roberge M, Balgi A, McCormick C, Weeks A. CSIG-18. RALOXIFENE SENSITIZES GLIOBLASTOMA CELLS TO HYPOXIA-INDUCED DEATH THROUGH INHIBITION OF RNA STRESS GRANULE DISSOLUTION. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.212] [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: 11/13/2022] Open
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19
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Collins P, Cannings-John R, Bruynseels D, Mallaiah S, Dick J, Elton C, Weeks A, Sanders J, Aawar N, Townson J, Hood K, Hall J, Harding K, Gauntlett R, Collis R. Viscoelastometry guided fresh frozen plasma infusion for postpartum haemorrhage: OBS2, an observational study. Br J Anaesth 2017; 119:422-434. [DOI: 10.1093/bja/aex245] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 12/22/2022] Open
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20
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Sharieff W, Mulroy L, Weeks A, Mansoor S, Pahil R, Islam MU. Scalp Seeding Post Craniotomy and Radiosurgery for Solitary Brain Metastasis: A Case Report and Systematic Review. Cureus 2017; 9:e1083. [PMID: 28405533 PMCID: PMC5384848 DOI: 10.7759/cureus.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Radiosurgery is being increasingly used post craniotomy for brain metastasis, instead of whole-brain radiation. We report a case of scalp metastasis following craniotomy and radiosurgery, along with a systematic review of the literature. METHODS Our patient was a 70-year-old male who presented with a scalp metastasis, two years after craniotomy and radiosurgery, for a solitary brain metastasis from esophageal carcinoma. Using Medline® (United States National Library of Medicine, Bethesda, MD), we performed a systematic review of the literature to identify cases of isolated scalp metastases following craniotomy for brain lesions. RESULTS The scalp metastasis was in close proximity to the craniotomy site. Workup did not show any other site of active disease. Biopsy confirmed it to be a metastasis from esophageal carcinoma. The literature review did not yield any case of isolated scalp metastasis following craniotomy and whole-brain radiotherapy or radiosurgery. However, it yielded six cases of isolated scalp metastases following craniotomy for primary brain tumors. CONCLUSION Isolated scalp metastasis has not been reported following craniotomy and whole-brain radiotherapy for brain metastases. Our patient likely had surgical seeding during craniotomy. These surgically implanted cells could not be ablated because the radiosurgery treatment volume does not cover the surgical tract. Further research is needed to identify risk factors for surgical seeding.
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Affiliation(s)
- Waseem Sharieff
- Department of Radiation Oncology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
| | - Liam Mulroy
- Radiation Oncology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
| | - Adrienne Weeks
- Neurosurgery, Capital Health District Authority, Dalhousie University
| | - Samina Mansoor
- Pathology, Capital Health District Authority, Dalhousie University
| | - Rajbir Pahil
- Oncology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
| | - Muhammad U Islam
- Radiology, Dalhousie University, Cape Breton Cancer Centre, Sydney NS
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21
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Weeks A, Whitehouse S, Robichaud A, Agnihotri S, Smith C, Rutka J. CSIG-23. CYTOPLASMIC RNA STRESS GRANULES: A PUTATIVE TRANSLATIONAL MECHANISM OF mTOR REGULATION IN GLIOBLASTOMA. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.184] [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: 11/14/2022] Open
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22
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Yip C, Weeks A, Cook G, Landau D, Goh V. PO-0989: Hypoxic and perfusion effects of Trastuzumab in a HER2+ oesophageal adenocarcinoma xenograft model. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32239-3] [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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23
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Boyle NB, Lawton C, Arkbåge K, West SG, Thorell L, Hofman D, Weeks A, Myrissa K, Croden F, Dye L. Stress responses to repeated exposure to a combined physical and social evaluative laboratory stressor in young healthy males. Psychoneuroendocrinology 2016; 63:119-27. [PMID: 26441230 DOI: 10.1016/j.psyneuen.2015.09.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 12/25/2022]
Abstract
Repeated exposure to homotypic laboratory psychosocial stressors typically instigates rapid habituation in hypothalamic-pituitary-adrenal (HPA) axis-mediated stress responses in humans. However, emerging evidence suggests the combination of physical stress and social evaluative threat may be sufficient to attenuate this response habituation. Neuroendocrine, cardiovascular and subjective stress responses following repeated exposure to a combined physical and social evaluative stress protocol were assessed to examine the habituation response dynamic in this context. The speech task of the Trier social stress test (TSST; Kirschbaum et al., 1993) and the socially evaluated cold pressor task (SECPT; Schwabe et al., 2008) were administered in a combined stressor protocol. Salivary cortisol, cardiovascular and subjective stress responses to a non-stress control and repeat stressor exposure separated by six weeks were examined in males (N=24) in a crossover manner. Stressor exposure resulted in significant elevations in all stress parameters. In contrast to the commonly reported habituation in cortisol response, a comparable post-stress response was demonstrated. Cortisol, heart rate and subjective stress responses were also characterised by a heightened response in anticipation to repeated stress exposure. Blood pressure responses were comparatively uniform across repeated exposures. Findings suggest a combined physical and social evaluative stressor is a potentially useful method for study designs that require repeated presentation of a homotypic stressor.
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Affiliation(s)
- N B Boyle
- School of Psychology, University of Leeds, LS2 9JT, UK.
| | - C Lawton
- School of Psychology, University of Leeds, LS2 9JT, UK
| | - K Arkbåge
- Arla Strategic Innovation Centre, Arla Foods, Stockholm, Sweden
| | - S G West
- Department of Biobehavioral Health, Pennsylvania State University, USA
| | - L Thorell
- Arla Strategic Innovation Centre, Arla Foods, Stockholm, Sweden
| | - D Hofman
- School of Psychology, University of Leeds, LS2 9JT, UK
| | - A Weeks
- School of Psychology, University of Leeds, LS2 9JT, UK
| | - K Myrissa
- School of Psychology, University of Leeds, LS2 9JT, UK
| | - F Croden
- School of Psychology, University of Leeds, LS2 9JT, UK
| | - L Dye
- School of Psychology, University of Leeds, LS2 9JT, UK
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24
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Green L, Knight M, Seeney FM, Hopkinson C, Collins PW, Collis RE, Simpson N, Weeks A, Stanworth SS. The epidemiology and outcomes of women with postpartum haemorrhage requiring massive transfusion with eight or more units of red cells: a national cross-sectional study. BJOG 2015; 123:2164-2170. [PMID: 26694742 DOI: 10.1111/1471-0528.13831] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To ascertain the incidence of massive transfusion (MT) in obstetrics in the UK, and describe its management and clinical outcomes. DESIGN A population-based cross-sectional study conducted through the UK Obstetric Surveillance System (UKOSS). SETTINGS All UK hospitals with consultant-led maternity units. POPULATION Any pregnant woman at ≥20 weeks of gestation receiving ≥8 units of red blood cells within 24 hours of giving birth, from July 2012 to June 2013. METHODS Prospective case identification through the monthly mailing of UKOSS. RESULTS We identified 181 women who had undergone MT, making the estimated incidence of MT associated with postpartum haemorrhage (PPH) 23 per 100 000 maternities (95% confidence interval 19-26) per year. The median estimated blood loss was 6 l (interquartile range 4.5-8.0 l). The majority of women presented outside working hours (63%), 40% had had previous caesarean sections and 3% had normal vaginal births without risk factors. The main cause for MT was uterine atony (40%) and the main mode of birth was caesarean section (69%). Of the 181 women, 15 received >20 units of red blood cells. In total, 45% of women underwent hysterectomy, and among all causes of PPH, placenta accreta had the highest hysterectomy rate. Two women died, 82% were admitted to intensive care/high-dependency units, and 28% developed major morbidities. CONCLUSION Massive transfusion due to PPH is associated with high rates of morbidity and hysterectomy. Clinical and research efforts should focus on approaches to recognise and optimise timely resuscitation and management of these severe cases. TWEETABLE ABSTRACT Massive transfusion due to postpartum haemorrhage is associated with high rates of morbidity and hysterectomy.
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Affiliation(s)
- L Green
- Barts Health NHS Trust & NHS Blood and Transplant, London, UK.,Blizzard Institute, Queen Mary University of London, London, UK
| | - M Knight
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - F M Seeney
- Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK
| | - C Hopkinson
- Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK
| | - P W Collins
- Arthur Bloom Haemophilia Centre, Cardiff University, Cardiff, UK
| | - R E Collis
- Department of Anaesthetics, Cardiff and Vale University Health Board, Cardiff, UK
| | - Nab Simpson
- Department of Women's and Children's Health, University of Leeds, Leeds, UK
| | - A Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - S S Stanworth
- NHS Blood and Transplant, Oxford & Oxford University Hospitals NHS Trust, Oxford, UK
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25
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Mahajan A, Cook G, Goh V, Basu S, Thakur M, Weeks A. Role of molecular functional imaging in present era of evidence based cancer medicine: to image or to imagine? Cancer Imaging 2015. [PMCID: PMC4601737 DOI: 10.1186/1470-7330-15-s1-p10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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26
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Weeks A, Li T, Mann P, Gelesko S, Cheng A, Potter B, Bell R, Dierks E, Bui T. Gun shot wounds to the head and neck region among trauma patients – 5-year experience at Legacy Emanuel Medical Center. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.379] [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: 11/16/2022]
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27
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Fry RA, Fry LE, Weeks A. Substance use disorder amongst Australian and New Zealand anaesthetic trainees: an analysis of 30 years of data. Anaesth Intensive Care 2015; 43:530. [PMID: 26099770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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28
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Downe S, Finlayson K, Melvin C, Spiby H, Ali S, Diggle P, Gyte G, Hinder S, Miller V, Slade P, Trepel D, Weeks A, Whorwell P, Williamson M. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG 2015; 122:1226-34. [PMID: 25958769 PMCID: PMC4690197 DOI: 10.1111/1471-0528.13433] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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] [Accepted: 03/17/2015] [Indexed: 01/19/2023]
Abstract
Objective (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design Multi-method randomised control trial (RCT). Setting Three NHS Trusts. Population Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation. Tweetable abstract Going to 2 prenatal self-hypnosis groups didn't reduce labour epidural use but did reduce birth fear & anxiety postnatally at < £5 per woman.
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Affiliation(s)
- S Downe
- Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK
| | - K Finlayson
- Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK
| | - C Melvin
- Women & Children's Health Research Team, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
| | - H Spiby
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - S Ali
- Department of Health Sciences, University of York, York, UK
| | - P Diggle
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - G Gyte
- Cochrane Pregnancy and Childbirth Group, Department of Women and Childrens' Health, Liverpool Women's NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - S Hinder
- RaFT Research, Clitheroe, Lancashire, UK
| | - V Miller
- University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - P Slade
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - D Trepel
- Department of Health Sciences, University of York, York, UK
| | - A Weeks
- Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | - P Whorwell
- Centre for Gastrointestinal Sciences, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - M Williamson
- Women & Children's Health Research Team, East Lancashire Hospitals NHS Trust, Burnley General Hospital, Burnley, UK
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Abstract
Postpartum haemorrhage (PPH) remains a major cause of maternal deaths worldwide, and is estimated to cause the death of a woman every 10 minutes. This review presents the latest clinical advice, including new evidence on controlled cord traction, misoprostol, and oxytocin. The controversy around the diagnosis of PPH, the limitations of universal prophylaxis, and novel ways to provide obstetric first aid are also presented. It ends with a call to develop high-quality front-line obstetric services that can deal rapidly with unexpected haemorrhages as well as minimising blood loss at critical times: major abruption, placenta praevia, and caesarean for prolonged labour.
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Affiliation(s)
- A Weeks
- Sanyu Research Unit, Department of Women's and Children's Health, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK
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30
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Hui L, Bethune M, Weeks A, Kelley J, Hayes L. Repeated failed non-invasive prenatal testing owing to low cell-free fetal DNA fraction and increased variance in a woman with severe autoimmune disease. Ultrasound Obstet Gynecol 2014; 44:242-243. [PMID: 24862357 DOI: 10.1002/uog.13418] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 05/12/2014] [Indexed: 06/03/2023]
Affiliation(s)
- L Hui
- Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, VIC, Australia; Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, VIC, Australia
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Turkel-Parrella D, Manoel AL, Marotta TR, Montanera W, Sarma D, Bharatha A, Kaderali Z, Weeks A, Effendi K, Ben-Israel D, Spears J. Abstract T P310: The Acute Carotid Clinic: A Paradigmatic Shift to Facilitate Reduced Wait Times for Carotid Artery Stenting in Ontario. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.tp310] [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
Introduction:
North American guidelines on stroke prevention recommend carotid artery revascularization for symptomatic carotid disease within 2 weeks of the index event. Achieving this benchmark has proven historically challenging in the context of the universal coverage afforded by the Ontario Health Insurance Plan (OHIP), which is the sole provider of healthcare in Ontario (approximately 13.5 million people). Recent literature has indicated that wait times for carotid revascularization are unacceptably high. We sought to examine how the implementation of a dedicated Acute Carotid Clinic (ACC) in a Canadian academic stroke center would impact this public health dilemma.
Methods:
Retrospective analysis was preformed on 48 consecutive patients with symptomatic carotid artery disease who underwent endovascular treatment (carotid stenting) via the Acute Carotid Clinic’s expedited evaluation process over a 13-month period (July 2012 to July 2013). All patients were triaged based on direct physician referral with concurrent vascular imaging demonstrating high-grade carotid stenosis in the appropriate vessel. Patients were not placed on wait lists, and seen urgently.
Results:
The average time from consultation to revascularization was under 1 week (mean time 6.7 days). Historical controls of average wait times in Ontario for Carotid Endartarectomy have been previously published at 25.7 days. The percentage of patients who achieved revascularization within 2 weeks of the index event was 38%. Previously published series from Ontario for Carotid Endartarectomy showed 8 to 30% of patients were revascularized within 2 weeks of the index event.
Conclusion:
The paradigm of an Acute Carotid Clinic could allow for the rapid triage, assessment, and treatment of symptomatic carotid disease for the 13.5 million residents of Ontario. Adoption of this paradigm by other centers in Ontario could significantly reduce the burden of cerebrovascular disease in the province. Further research and government wide initiatives could be aimed at increasing the awareness of referring physicians to this expedited evaluation process.
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32
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Seol HJ, Chang JH, Yamamoto J, Romagnuolo R, Suh Y, Weeks A, Agnihotri S, Smith CA, Rutka JT. Overexpression of CD99 Increases the Migration and Invasiveness of Human Malignant Glioma Cells. Genes Cancer 2013; 3:535-49. [PMID: 23486730 DOI: 10.1177/1947601912473603] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 12/02/2012] [Indexed: 01/03/2023] Open
Abstract
The malignant glioma is the most common primary human brain tumor, and its migration and invasiveness away from the primary tumor mass are considered a leading cause of tumor recurrence and treatment failure. Recently, gene expression profiling revealed that the transmembrane glycoprotein CD99 is more highly expressed in malignant glioma than in normal brain. Although its function is not completely understood, CD99 is implicated in cell adhesion and migration in a variety of different cell types. CD99 has wild-type and splice variant isoforms. Previous studies have shown that wild-type CD99 may be an oncosuppressor in some tumors, distinct from the role of the splice variant isoform. In this study, our data reveal that only wild-type CD99 is expressed in human glioma cells and tissues. Using a tissue microarray, we validated that gliomas demonstrate higher expression of CD99 compared with nonneoplastic brain. To assess the role of CD99 in glioma migration and invasion, we inhibited CD99 expression by siRNA and demonstrated decreased glioma migration and invasion. In contrast, when CD99 was overexpressed in glioma cells, we observed enhancement of cell migration and invasiveness. An orthotopic brain tumor model demonstrates that CD99 overexpression significantly increases invasiveness and decreases survival rate. Interestingly, Rac activity was decreased and Rho activity was increased in CD99 overexpressing glioma cells, and the proportion of amoeboid cells to mesenchymal cells was significantly increased. Taken together, our findings suggest that CD99 may play an important role in the migration and invasion of human gliomas independent of Akt, ERK, or JNK signaling pathways. Moreover, CD99 might be involved in amoeboid-mesenchymal transition in glioma migration. CD99 may be an important future target to inhibit migration and invasion, especially in CD99-expressing gliomas.
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Affiliation(s)
- Ho Jun Seol
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, Canada ; Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (R.O.K.)
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33
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Nagai S, Moreno O, Smith CA, Ivanchuk S, Romagnuolo R, Golbourn B, Weeks A, Seol HJ, Rutka JT. Role of the cofilin activity cycle in astrocytoma migration and invasion. Genes Cancer 2012; 2:859-69. [PMID: 22593798 DOI: 10.1177/1947601911431839] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 11/10/2011] [Indexed: 01/09/2023] Open
Abstract
The cofilin pathway plays a central role in the regulation of actin polymerization and the formation of cell membrane protrusions that are essential for cell migration. Overexpression of cofilin has been linked to the aggressiveness of a variety of different cancers. In these cancers, the phosphorylation of cofilin at Ser3 is a key regulatory mechanism modulating cofilin activity. The activation status of cofilin has been directly linked to tumor invasion. Accordingly, in this study, we examined the expression of cofilin and its activation status in astrocytoma cell lines and astrocytic tumors. We show that cofilin expression was increased and correlated with increasing grade malignant astrocytoma. In addition, both cofilin and LIMK had elevated expression in astrocytoma cell lines. Knockdown of cofilin by siRNA altered astrocytoma cell morphology and inhibited astrocytoma migration and invasion. Conversely, overexpression of a cofilin phosphorylation mutant in an in vivo intracranial xenograft model resulted in a more highly invasive phenotype than those xenographs expressing wild-type cofilin. Animals harboring astrocytomas stably expressing the cofilin phosphorylation mutant (cofilin-S3A) demonstrated marked local invasiveness and spread across the corpus callosum to the contralateral hemisphere in all animals. Taken together, these data indicate that the cofilin activity pathway may represent a novel therapeutic target to diminish the invasion of these highly malignant tumors.
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Affiliation(s)
- Shoichi Nagai
- Department of Neurosurgery, University of Toyama, Toyama, Japan
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Weeks A, Okolowsky N, Golbourn B, Ivanchuk S, Smith C, Rutka JT. ECT2 and RASAL2 mediate mesenchymal-amoeboid transition in human astrocytoma cells. Am J Pathol 2012; 181:662-74. [PMID: 22683310 DOI: 10.1016/j.ajpath.2012.04.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 04/04/2012] [Accepted: 04/10/2012] [Indexed: 11/28/2022]
Abstract
Malignant astrocytomas are highly invasive brain tumors. The Rho family of cytoskeletal GTPases are key regulators of astrocytoma migration and invasion; expression of the guanine nucleotide exchange factor ECT2 is elevated in primary astrocytomas and predicts both survival and malignancy. Mice bearing orthotopically implanted astrocytoma cells with diminished ECT2 levels following ECT2 knockdown exhibit longer survival. Although ECT2 is normally expressed in the nucleus, we show that ECT2 is aberrantly localized to the cytoplasm in both astrocytoma cell lines and primary human astrocytomas, and colocalizes with RAC1 and CDC42 at the leading edge of migrating astrocytoma cells. Inhibition of ECT2 expression by RNA interference resulted in decreased RAC1 and CDC42 activity, but no change in RHO activity, suggesting that ECT2 is capable of activating these pro-migratory Rho family members. ECT2 overexpression in astrocytoma cells resulted in a transition to an amoeboid phenotype that was abolished with the ROCK inhibitor, Y-27632. Cytoplasmic fractionation of astrocytoma cells followed by ECT2 immunoprecipitation and mass spectrometry were used to identify protein-binding partners that modulate the activity of ECT2 toward RAC1 and RHO/ROCK. We identified RASAL2 as an ECT2-interacting protein that regulates RHO activity in astrocytoma cells. RASAL2 knockdown leads to a conversion to an amoeboid phenotype. Our studies reveal that ECT2 has a novel role in mesenchymal-amoeboid transition in human astrocytoma cells.
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Affiliation(s)
- Adrienne Weeks
- Division of Neurosurgery, Department of Surgery, Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Hu YL, De Lay M, Rose SD, Carbonell WS, Aghi MK, Rose SD, Carbonell WS, De Lay M, Hu YL, Paquette J, Tokuyasu T, Tsao S, Chaumeil M, Ronen S, Aghi MK, Matlaf LA, Soroceanu L, Cobbs C, Soroceanu L, Matlaf L, Harkins L, Cobbs C, Garzon-Muvdi T, Rhys CA, Smith C, Kim DH, Kone L, Farber H, An S, Levchenko A, Quinones-Hinojosa A, Lemke D, Pfenning PN, Sahm F, Klein AC, Kempf T, Schnolzer M, Platten M, Wick W, Smith SJ, Rahman R, Rahman C, Barrow J, Macarthur D, Rose F, Grundy RG, Kaley TJ, Huse J, Karimi S, Rosenblum M, Omuro A, DeAngelis LM, de Groot JF, Kong LY, Wei J, Wang T, Piao Y, Liang J, Fuller GN, Qiao W, Heimberger AB, Jhaveri N, Cho H, Torres S, Wang W, Schonthal A, Petasis N, Louie SG, Hofman F, Chen TC, Yamada R, Sumual S, Buljan V, Bennett MR, McDonald KL, Weiler M, Pfenning PN, Thiepold AL, Jestaedt L, Gronych J, Dittmann LM, Jugold M, Kosch M, Combs SE, von Deimling A, Weller M, Bendszus M, Platten M, Wick W, Kwiatkowska A, Paulino V, Tran NL, Symons M, Stockham AL, Borden E, Peereboom D, Hu Y, Chaturbedi A, Hamamura M, Mark E, Zhou YH, Abbadi S, Guerrero-Cazares H, Pistollato F, Smith CL, Ruff W, Puppa AD, Basso G, Quinones-Hinojosa A, Monje M, Freret ME, Masek M, Fisher PG, Haddix T, Vogel H, Kijima N, Hosen N, Kagawa N, Hashimoto N, Fujimoto Y, Kinoshita M, Sugiyama H, Yoshimine T, Anneke N, Bob H, Pieter W, Arend H, William L, Eoli M, Calleri A, Cuppini L, Anghileri E, Pellegatta S, Prodi E, Bruzzone MG, Bertolini F, Finocchiaro G, Zhu D, Hunter SB, Vertino PM, Van Meir EG, Cork SM, Kaur B, Cooper L, Saltz JH, Sandberg EM, Van Meir EG, Burrell K, Hill R, Zadeh G, Parker JJ, Dionne K, Massarwa R, Klaassen M, Niswander L, Kleinschmidt-DeMasters BK, Waziri A, Jalali S, Wataya T, Salehi F, Croul S, Gentili F, Zadeh G, Jalali S, Foltz W, Burrell K, Lee JI, Agnihorti S, Menard C, Chung C, Zadeh G, Torres S, Jhaveri N, Wang W, Schonthal AH, Louie SG, Hofman FM, Chen TC, Elena P, Faivre G, Demopoulos A, Taillibert S, Rosenblum M, Omuro A, Kirsch M, Martin KD, Bertram A, uckermann O, Leipnitz E, Weigel P, Temme A, Schackert G, Geiger K, Gerstner E, Jennings D, Chi AS, Plotkin S, Kwon SJ, Pinho M, Polaskova P, Batchelor TT, Sorensen AG, Hossain MB, Gururaj AE, Cortes-Santiago N, Gabrusiewicz K, Yung WKA, Fueyo J, Gomez-Manzano C, Gil OD, Noticewala S, Ivkovic S, Esencay M, Zagzagg D, Rosenfeld S, Bruce JN, Canoll P, Chang JH, Seol HJ, Weeks A, Smith CA, Rutka JT, Georges J, Samuelson G, Misra A, Joy A, Huang Y, McQuilkin M, Yoshihiro A, Carpenter D, Butler L, Feuerstein B, Murphy SF, Vaghaiwalla T, Wotoczek-Obadia M, Albright R, Mack D, Lawn S, Henderson F, Jung M, Dakshanamurthy S, Brown M, Forsyth P, Brem S, Sadr MS, Maret D, Sadr ES, Siu V, Alshami J, Trinh G, Denault JS, Faury D, Jabado N, Nantel A, Del Maestro R. ANGIOGENESIS AND INVASION. Neuro Oncol 2011; 13:iii1-iii9. [PMCID: PMC3222963 DOI: 10.1093/neuonc/nor147] [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: 09/01/2023] Open
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Adams E, Lewis-Jones I, Alfirevic Z, MacDonald R, Dawood F, Mallaiah S, Djabatey E, Parkinson D, Farquharson R, Patrick D, Fowler G, Turner M, Hapangama D, Wauchob T, Kingsland C, Weeks A, Kingston R, Kirwan J. 18 Liverpool consultants reply. West J Med 2009. [DOI: 10.1136/bmj.b4981] [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: 11/03/2022]
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Carew M, Schiffer M, Umina P, Weeks A, Hoffmann A. Molecular markers indicate that the wheat curl mite, Aceria tosichella Keifer, may represent a species complex in Australia. Bull Entomol Res 2009; 99:479-86. [PMID: 19224660 DOI: 10.1017/s0007485308006512] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The wheat curl mite (WCM), Aceria tosichella Keifer, is an eriophyoid pest of cereals, and the vector responsible for transmitting wheat streak mosaic virus. Several authors have suggested cryptic species of this mite identified through morphological variation, but this has never been conclusively demonstrated. Here, we use the mitochondrial 16S rRNA gene and two nuclear markers (internal transcribed spacer 1 and adenine nucleotide translocase) to show that WCM from Australia consists of at least two separate lineages that may represent putative species. In our study, both WCM variants were widespread and the only eriophyoids found on wheat varieties. The WCM variants were also found on alternate host plants, including some plants not known to host WCM. These results have implications for the control of this pest within Australian cereal crops.
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Affiliation(s)
- M Carew
- Centre for Environmental Stress and Adaptation Research, Department of Zoology, University of Melbourne, Victoria, Australia.
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Deole N, Weeks A. O214 A short survey of doses of misoprostol used in obstetrics. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60586-5] [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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Asherson P, Zhou K, Anney RJL, Franke B, Buitelaar J, Ebstein R, Gill M, Altink M, Arnold R, Boer F, Brookes K, Buschgens C, Butler L, Cambell D, Chen W, Christiansen H, Feldman L, Fleischman K, Fliers E, Howe-Forbes R, Goldfarb A, Heise A, Gabriëls I, Johansson L, Lubetzki I, Marco R, Medad S, Minderaa R, Mulas F, Müller U, Mulligan A, Neale B, Rijsdijk F, Rabin K, Rommelse N, Sethna V, Sorohan J, Uebel H, Psychogiou L, Weeks A, Barrett R, Xu X, Banaschewski T, Sonuga-Barke E, Eisenberg J, Manor I, Miranda A, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Thompson M, Faraone SV. A high-density SNP linkage scan with 142 combined subtype ADHD sib pairs identifies linkage regions on chromosomes 9 and 16. Mol Psychiatry 2008; 13:514-21. [PMID: 18180756 DOI: 10.1038/sj.mp.4002140] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [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: 01/07/2023]
Abstract
As part of the International Multi-centre ADHD Genetics project we completed an affected sibling pair study of 142 narrowly defined Diagnostic and Statistical Manual of Mental Disorders, fourth edition combined type attention deficit hyperactivity disorder (ADHD) proband-sibling pairs. No linkage was observed on the most established ADHD-linked genomic regions of 5p and 17p. We found suggestive linkage signals on chromosomes 9 and 16, respectively, with the highest multipoint nonparametric linkage signal on chromosome 16q23 at 99 cM (log of the odds, LOD=3.1) overlapping data published from the previous UCLA (University of California, Los Angeles) (LOD>1, approximately 95 cM) and Dutch (LOD>1, approximately 100 cM) studies. The second highest peak in this study was on chromosome 9q22 at 90 cM (LOD=2.13); both the previous UCLA and German studies also found some evidence of linkage at almost the same location (UCLA LOD=1.45 at 93 cM; German LOD=0.68 at 100 cM). The overlap of these two main peaks with previous findings suggests that loci linked to ADHD may lie within these regions. Meta-analysis or reanalysis of the raw data of all the available ADHD linkage scan data may help to clarify whether these represent true linked loci.
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Affiliation(s)
- P Asherson
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.
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Gemzell-Danielsson K, Ho P, Gómez Ponce de León R, Weeks A, Winikoff B. Misoprostol to treat missed abortion in the first trimester. Int J Gynaecol Obstet 2007; 99 Suppl 2:S182-5. [DOI: 10.1016/j.ijgo.2007.09.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Alfirevic Z, Blum J, Walraven G, Weeks A, Winikoff B. Prevention of postpartum hemorrhage with misoprostol. Int J Gynaecol Obstet 2007; 99 Suppl 2:S198-201. [DOI: 10.1016/j.ijgo.2007.09.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Affiliation(s)
- A Weeks
- University of Liverpool, Liverpool, UK
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Blum J, Alfirevic Z, Walraven G, Weeks A, Winikoff B. Treatment of postpartum hemorrhage with misoprostol. Int J Gynaecol Obstet 2007; 99 Suppl 2:S202-5. [DOI: 10.1016/j.ijgo.2007.09.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Blum J, Winikoff B, Gemzell-Danielsson K, Ho PC, Schiavon R, Weeks A. Treatment of incomplete abortion and miscarriage with misoprostol. Int J Gynaecol Obstet 2007; 99 Suppl 2:S186-9. [PMID: 17961569 DOI: 10.1016/j.ijgo.2007.09.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A literature review was conducted to determine whether misoprostol is an effective treatment for incomplete abortion and, if so, to recommend an appropriate regimen. All English language articles published before October 2007 using misoprostol in at least one of the study arms were reviewed to determine the efficacy of misoprostol when used to treat incomplete abortion in the first trimester. All available unpublished data previously presented at international scientific meetings were also reviewed. Sufficient evidence was found in support of misoprostol as a safe and effective means of non-surgical uterine evacuation. A single dose of misoprostol 600 microg oral is recommended for treatment of incomplete abortion in women presenting with a uterine size equivalent to 12 weeks gestation.
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Affiliation(s)
- J Blum
- Gynuity Health Projects, New York, NY 10010, USA.
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Abstract
OBJECTIVE The main objective of this study was to pave the way towards proactive, continuous assessment of individuals and hospitals by demonstrating the application of evidence-based competency standards in maternity care using statistical performance monitoring. DESIGN Retrospective study using data routinely collected by a large maternity hospital. SETTING A large teaching hospital. POPULATION Clinicians who routinely perform either amniocentesis or ventouse deliveries. METHOD As a 'proof of principle', we have used statistical process control (SPC) charts to compare the observed complication rates for amniocentesis and ventouse delivery with the expected complication rates based on published data. MAIN OUTCOME MEASURES The recorded complication rates for amniocentesis and ventouse delivery. RESULTS The SPC charts identified significant variation in complication rates within the team and showed the ways in which prospective data can be used to provide continuous feedback to individuals on their performance. CONCLUSION The study shows that statistical performance monitoring and, in particular, the use of control charts can be a valuable tool in the continuous assessment of individuals and the healthcare service being provided. The control charts provide a more immediate indication of current performance and provide an alternative to performance-based league tables for the presentation of yearly performance data.
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Affiliation(s)
- S Lane
- Centre for Medical Statistics and Health Evaluation, University of Liverpool, Liverpool, UK.
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47
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Ginjaume M, Bolognese-Milsztajn T, Luszik-Bhadra M, Vanhavere F, Wahl W, Weeks A. Overview of active personal dosemeters for individual monitoring in the European Union. Radiat Prot Dosimetry 2007; 125:261-6. [PMID: 16980319 DOI: 10.1093/rpd/ncl136] [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: 05/11/2023]
Abstract
In 2001, the European Radiation Dosimetry Group, EURADOS, started a working group on 'Harmonisation of Individual Monitoring in Europe and the Dissemination of Information on New Techniques in this Field'. Within this group, one of the projects consisted of analysing the status of active personal dosemeters (APDs) in Europe. This paper reviews the regulatory requirements for APDs in 15 EU member states and summarises the main characteristics of commercial and new developments in this field. In particular, it focuses on the comparison of APD performance and standard passive dosimetry systems. Based on this information, an evaluation is initiated to establish why several countries are reluctant to accept APDs for dose records.
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Affiliation(s)
- M Ginjaume
- Institute of Energy Technology, Technical University of Catalonia, Barcelona E-08028, Spain.
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Brookes K, Xu X, Chen W, Zhou K, Neale B, Lowe N, Anney R, Aneey R, Franke B, Gill M, Ebstein R, Buitelaar J, Sham P, Campbell D, Knight J, Andreou P, Altink M, Arnold R, Boer F, Buschgens C, Butler L, Christiansen H, Feldman L, Fleischman K, Fliers E, Howe-Forbes R, Goldfarb A, Heise A, Gabriëls I, Korn-Lubetzki I, Johansson L, Marco R, Medad S, Minderaa R, Mulas F, Müller U, Mulligan A, Rabin K, Rommelse N, Sethna V, Sorohan J, Uebel H, Psychogiou L, Weeks A, Barrett R, Craig I, Banaschewski T, Sonuga-Barke E, Eisenberg J, Kuntsi J, Manor I, McGuffin P, Miranda A, Oades RD, Plomin R, Roeyers H, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Thompson M, Faraone SV, Asherson P. The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder: association signals in DRD4, DAT1 and 16 other genes. Mol Psychiatry 2006; 11:934-53. [PMID: 16894395 DOI: 10.1038/sj.mp.4001869] [Citation(s) in RCA: 431] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, starting in early childhood and persisting into adulthood in the majority of cases. Family and twin studies have demonstrated the importance of genetic factors and candidate gene association studies have identified several loci that exert small but significant effects on ADHD. To provide further clarification of reported associations and identify novel associated genes, we examined 1,038 single-nucleotide polymorphisms (SNPs) spanning 51 candidate genes involved in the regulation of neurotransmitter pathways, particularly dopamine, norepinephrine and serotonin pathways, in addition to circadian rhythm genes. Analysis used within family tests of association in a sample of 776 DSM-IV ADHD combined type cases ascertained for the International Multi-centre ADHD Gene project. We found nominal significance with one or more SNPs in 18 genes, including the two most replicated findings in the literature: DRD4 and DAT1. Gene-wide tests, adjusted for the number of SNPs analysed in each gene, identified associations with TPH2, ARRB2, SYP, DAT1, ADRB2, HES1, MAOA and PNMT. Further studies will be needed to confirm or refute the observed associations and their generalisability to other samples.
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Affiliation(s)
- K Brookes
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, London, UK
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Weeks A. Book Review: Clinical Anesthesiology. Anaesth Intensive Care 2006. [DOI: 10.1177/0310057x0603400326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- A. Weeks
- Alfred Hospital, Melbourne, Victoria
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