1
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Pandya BJ, Young C, Packnett ER, Xie B, Lillehaugen T, Block A, Bernacki K, Touya M, LeBlanc TW. Work absenteeism, disability, and lost wages among patients with acute myeloid leukemia and their caregivers: a cohort study using US administrative claims and productivity data. Expert Rev Pharmacoecon Outcomes Res 2024; 24:521-532. [PMID: 38294308 DOI: 10.1080/14737167.2024.2311305] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE We describe the impact of acute myeloid leukemia (AML) diagnosis on workplace absenteeism and disability days among patients and their caregivers. METHODS This retrospective study included adults with newly diagnosed AML (2009-2019) and adult caregivers of patients with newly diagnosed AML, identified from the US Merative™ MarketScan® Commercial Database. The Merative MarketScan Health and Productivity Management Database provided linked patient-level records of workplace absence and short-term (STD) and long-term disability (LTD) data. Endpoints included workplace absence, STD and LTD for patients and caregivers during 12 months pre-AML (baseline) and ≤3 years' follow-up, and corresponding cost of work loss. RESULTS Patient workplace absence decreased in the months post-AML diagnosis, but the number of STD and LTD leave days claimed increased significantly by sixfold and fourfold, respectively. The proportion of patients making STD leave claims increased within 4-5 months of diagnosis, while the proportion making LTD leave claims increased significantly starting from month 5. Caregiver workplace absence peaked in the first 2 months post-diagnosis and remained elevated versus baseline throughout the study. CONCLUSION AML diagnosis leads to workplace absenteeism and increased economic burden for patients with AML and their caregivers.
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Affiliation(s)
- Bhavik J Pandya
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | | | | | - Bin Xie
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | | | - Alana Block
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
| | | | - Maelys Touya
- Astellas Pharma Global Development, Inc., Northbrook, IL, USA
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LaVine N, Emmert K, Itty J, Martins-Welch D, Carney M, Block A, Burgess L, Volandes AE, Zupanc SN, Jacome S, Gromova V, Davis AD, Schwartz P, Alvarez-Suarez A, Burns E. Reaching Ambulatory Older Adults with Educational Tools: Comparative Efficacy and Cost of Varied Outreach Modalities in Primary Care. J Gen Intern Med 2023; 38:125-130. [PMID: 36217070 PMCID: PMC9550308 DOI: 10.1007/s11606-022-07808-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/13/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Providing patients with access to health information that can be obtained outside of an office visit is an important part of education, yet little is known about the effectiveness of outreach modalities to connect older adults to online educational tools. The objective was to identify the effectiveness and cost of outreach modalities providing online information about advance care planning (ACP) for older adults. METHODS Six different outreach modalities were utilized to connect patients to online educational tools (ACP video decision aids). Participants were 13,582 patients aged 65 and older of 185 primary care providers with appointments over a 30-month period within a large health system in the greater New York City area. Main outcome measures were number of online video views and costs per outreach for each modality. KEY RESULTS There were 1150 video views for 21,407 remote outreach events. Text messages, sent to the largest volume of patients (8869), had the highest outcome rate (9.6%) and were the most economical ($0.09). Characterization of phone calls demonstrated 21.7% engagement in the topic of ACP but resulted in minimal video views (<1%) and incurred the highest cost per outreach ($2.88). In-office handouts had negligible results (<1%). CONCLUSIONS Text was the most cost-effective modality to connect older adults to an online educational tool in this pragmatic trial, though overall efficacy of all modalities was low.
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Affiliation(s)
- N LaVine
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - K Emmert
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - J Itty
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - D Martins-Welch
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - M Carney
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA.,Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - A Block
- New York Medical College School of Health Sciences and Practice, Westchester, NY, USA
| | - L Burgess
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - A E Volandes
- Harvard Medical School, Boston, MA, USA.,Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.,ACP Decisions, Boston, MA, USA
| | - S N Zupanc
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - S Jacome
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - V Gromova
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | | | - A Alvarez-Suarez
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Edith Burns
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA. .,Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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Torka P, Groman A, Wong J, Baysal B, Nichols J, Kader A, Mavis C, Jani Sait S, Block A, Przespolewski E, Mohr A, Lund I, McWhite K, Kostrewa J, DeMarco J, Johnson M, Darrall A, Thomas R, Sundaram S, Ghione P, Hutson A, Hernandez‐Ilizaliturri F. A PHASE 1 STUDY OF CARFILZOMIB WITH RITUXIMAB, IFOSFAMIDE, CARBOPLATIN AND ETOPOSIDE (C‐RICE) IN TRANSPLANT‐ELIGIBLE RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA. Hematol Oncol 2021. [DOI: 10.1002/hon.83_2881] [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: 11/07/2022]
Affiliation(s)
- P. Torka
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - A. Groman
- Roswell Park Comprehensive Cancer Center Biostatistics Buffalo USA
| | - J. Wong
- Roswell Park Comprehensive Cancer Center Pathology Buffalo USA
| | - B. Baysal
- Roswell Park Comprehensive Cancer Center Pathology Buffalo USA
| | - J. Nichols
- Roswell Park Comprehensive Cancer Center Clinical Research Services Buffalo USA
| | - A. Kader
- Roswell Park Comprehensive Cancer Center Clinical Research Services Buffalo USA
| | - C. Mavis
- Roswell Park Comprehensive Cancer Center Immunology Buffalo USA
| | - S. Jani Sait
- Roswell Park Comprehensive Cancer Center Cytogenetics Buffalo USA
| | - A. Block
- Roswell Park Comprehensive Cancer Center Cytogenetics Buffalo USA
| | | | - A. Mohr
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - I. Lund
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - K. McWhite
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - J. Kostrewa
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - J. DeMarco
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - M. Johnson
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - A. Darrall
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - R.‐N. Thomas
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - S. Sundaram
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - P. Ghione
- Roswell Park Comprehensive Cancer Center Medicine Buffalo USA
| | - A. Hutson
- Roswell Park Comprehensive Cancer Center Biostatistics Buffalo USA
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Sturmheit T, Konczalla L, Temovski TS, Günther A, Brauneck F, Li J, Perez D, Jücker M, Thastrup J, Fiedler W, Wellbrock J, Kupper J, Block A. Pre-therapeutic Evaluation of Patient-Specific Responses to Immune-Checkpoint Inhibition in Colorectal Cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz450.002] [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: 11/12/2022] Open
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Block A, Liebel M, Yu R, Spector M, Sivan Y, García de Abajo FJ, van Hulst NF. Tracking ultrafast hot-electron diffusion in space and time by ultrafast thermomodulation microscopy. Sci Adv 2019; 5:eaav8965. [PMID: 31093529 PMCID: PMC6510559 DOI: 10.1126/sciadv.aav8965] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 03/21/2019] [Indexed: 05/24/2023]
Abstract
The ultrafast response of metals to light is governed by intriguing nonequilibrium dynamics involving the interplay of excited electrons and phonons. The coupling between them leads to nonlinear diffusion behavior on ultrashort time scales. Here, we use scanning ultrafast thermomodulation microscopy to image the spatiotemporal hot-electron diffusion in thin gold films. By tracking local transient reflectivity with 20-nm spatial precision and 0.25-ps temporal resolution, we reveal two distinct diffusion regimes: an initial rapid diffusion during the first few picoseconds, followed by about 100-fold slower diffusion at longer times. We find a slower initial diffusion than previously predicted for purely electronic diffusion. We develop a comprehensive three-dimensional model based on a two-temperature model and evaluation of the thermo-optical response, taking into account the delaying effect of electron-phonon coupling. Our simulations describe well the observed diffusion dynamics and let us identify the two diffusion regimes as hot-electron and phonon-limited thermal diffusion, respectively.
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Affiliation(s)
- A. Block
- ICFO–Institut de Ciencies Fotoniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - M. Liebel
- ICFO–Institut de Ciencies Fotoniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - R. Yu
- ICFO–Institut de Ciencies Fotoniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - M. Spector
- Department of Physics, Ben-Gurion University of the Negev, 8410501 Be’er Sheva, Israel
| | - Y. Sivan
- Unit of Electrooptics Engineering, Ben-Gurion University of the Negev, 8410501 Be’er Sheva, Israel
| | - F. J. García de Abajo
- ICFO–Institut de Ciencies Fotoniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- ICREA–Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona, Spain
| | - N. F. van Hulst
- ICFO–Institut de Ciencies Fotoniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
- ICREA–Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona, Spain
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6
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Sturmheit T, Stamm H, Stange I, Köllmann S, Failla A, Thastrup J, Fiedler W, Kupper J, Block A. 3D micro-tumors for predicting individual treatment responses to immunotherapy. Eur J Cancer 2019. [DOI: 10.1016/j.ejca.2019.01.054] [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: 11/25/2022]
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Häusler A, Deeken F, Rezo A, Förstner B, Block A, Wippert PM, Rapp MA. Der Einfluss leitliniengerechter Depressionstherapie auf den Therapieerfolg in verschiedenen Settings: erste längsschnittliche Ergebnisse aus der DEPREHA Studie. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667817] [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: 10/28/2022]
Affiliation(s)
- A Häusler
- Universität Potsdam, Sozial- und Präventivmedizin, Potsdam, Deutschland
| | - F Deeken
- Universität Potsdam, Sozial- und Präventivmedizin, Potsdam, Deutschland
| | - A Rezo
- Universität Potsdam, Sozial- und Präventivmedizin, Potsdam, Deutschland
| | - B Förstner
- Universität Potsdam, Sozial- und Präventivmedizin, Potsdam, Deutschland
| | - A Block
- Universität Potsdam, Sport- und Gesundheitssoziologie, Potsdam, Deutschland
| | - PM Wippert
- Universität Potsdam, Sport- und Gesundheitssoziologie, Potsdam, Deutschland
| | - MA Rapp
- Universität Potsdam, Sozial- und Präventivmedizin, Potsdam, Deutschland
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8
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Block A, Ahmed M, Rueda N, Hernandez MC, Martinez-Cué C, Gardiner K. The GABA A α5-selective Modulator, RO4938581, Rescues Protein Anomalies in the Ts65Dn Mouse Model of Down Syndrome. Neuroscience 2018; 372:192-212. [DOI: 10.1016/j.neuroscience.2017.12.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 12/21/2022]
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9
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Götze T, Al-Batran SE, Zander T, Reichart A, Lindig U, Kleiss M, Mueller L, Bolling C, Seufferlein T, Reichardt P, Kullmann F, Eschenburg H, Schmittel A, Egger M, Block A, Pauligk C, Schmalenberg H. A multicentre, phase II study with cabazitaxel in previously treated patients with advanced or metastatic adenocarcinoma of the oesophagogastric junction and stomach (CABAGAST). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.056] [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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10
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Schmaal L, Veltman DJ, van Erp TGM, Sämann PG, Frodl T, Jahanshad N, Loehrer E, Tiemeier H, Hofman A, Niessen WJ, Vernooij MW, Ikram MA, Wittfeld K, Grabe HJ, Block A, Hegenscheid K, Völzke H, Hoehn D, Czisch M, Lagopoulos J, Hatton SN, Hickie IB, Goya-Maldonado R, Krämer B, Gruber O, Couvy-Duchesne B, Rentería ME, Strike LT, Mills NT, de Zubicaray GI, McMahon KL, Medland SE, Martin NG, Gillespie NA, Wright MJ, Hall GB, MacQueen GM, Frey EM, Carballedo A, van Velzen LS, van Tol MJ, van der Wee NJ, Veer IM, Walter H, Schnell K, Schramm E, Normann C, Schoepf D, Konrad C, Zurowski B, Nickson T, McIntosh AM, Papmeyer M, Whalley HC, Sussmann JE, Godlewska BR, Cowen PJ, Fischer FH, Rose M, Penninx BWJH, Thompson PM, Hibar DP. Subcortical brain alterations in major depressive disorder: findings from the ENIGMA Major Depressive Disorder working group. Mol Psychiatry 2016; 21:806-12. [PMID: 26122586 PMCID: PMC4879183 DOI: 10.1038/mp.2015.69] [Citation(s) in RCA: 667] [Impact Index Per Article: 83.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 03/13/2015] [Accepted: 04/01/2015] [Indexed: 11/09/2022]
Abstract
The pattern of structural brain alterations associated with major depressive disorder (MDD) remains unresolved. This is in part due to small sample sizes of neuroimaging studies resulting in limited statistical power, disease heterogeneity and the complex interactions between clinical characteristics and brain morphology. To address this, we meta-analyzed three-dimensional brain magnetic resonance imaging data from 1728 MDD patients and 7199 controls from 15 research samples worldwide, to identify subcortical brain volumes that robustly discriminate MDD patients from healthy controls. Relative to controls, patients had significantly lower hippocampal volumes (Cohen's d=-0.14, % difference=-1.24). This effect was driven by patients with recurrent MDD (Cohen's d=-0.17, % difference=-1.44), and we detected no differences between first episode patients and controls. Age of onset ⩽21 was associated with a smaller hippocampus (Cohen's d=-0.20, % difference=-1.85) and a trend toward smaller amygdala (Cohen's d=-0.11, % difference=-1.23) and larger lateral ventricles (Cohen's d=0.12, % difference=5.11). Symptom severity at study inclusion was not associated with any regional brain volumes. Sample characteristics such as mean age, proportion of antidepressant users and proportion of remitted patients, and methodological characteristics did not significantly moderate alterations in brain volumes in MDD. Samples with a higher proportion of antipsychotic medication users showed larger caudate volumes in MDD patients compared with controls. This currently largest worldwide effort to identify subcortical brain alterations showed robust smaller hippocampal volumes in MDD patients, moderated by age of onset and first episode versus recurrent episode status.
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Affiliation(s)
- L Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands,Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, P.O. Box 74077, Amsterdam 1070 BB, The Netherlands. E-mail:
| | - D J Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - P G Sämann
- Max Planck Institute of Psychiatry, Munich, Germany
| | - T Frodl
- Department of Psychiatry, University of Regensburg, Regensburg, Germany,Department of Psychiatry, University of Dublin, Trinity College, Dublin, Ireland
| | - N Jahanshad
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - E Loehrer
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands,Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - W J Niessen
- Departments of Radiology and Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands,Imaging Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - M W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands,Departments of Radiology and Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands,Departments of Radiology and Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands,Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - H J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany,Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany,Helios Hospital Stralsund, Stralsund, Germany
| | - A Block
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - K Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - D Hoehn
- Max Planck Institute of Psychiatry, Munich, Germany
| | - M Czisch
- Max Planck Institute of Psychiatry, Munich, Germany
| | - J Lagopoulos
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, Camperdown, Australia
| | - S N Hatton
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, Camperdown, Australia
| | - I B Hickie
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, Camperdown, Australia
| | - R Goya-Maldonado
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center, Goettingen, Germany
| | - B Krämer
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center, Goettingen, Germany
| | - O Gruber
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center, Goettingen, Germany
| | - B Couvy-Duchesne
- NeuroImaging Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,School of Psychology, University of Queensland, Brisbane, QLD, Australia,Center for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - M E Rentería
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - L T Strike
- NeuroImaging Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,School of Psychology, University of Queensland, Brisbane, QLD, Australia,Center for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - N T Mills
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia
| | - G I de Zubicaray
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - K L McMahon
- Center for Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - S E Medland
- Quantitative Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - N G Martin
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - N A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - M J Wright
- NeuroImaging Genetics, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - G B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - G M MacQueen
- Department of Psychiatry, Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - E M Frey
- Department of Psychiatry, University of Regensburg, Regensburg, Germany
| | - A Carballedo
- Department of Psychiatry and Institute of Neuroscience, University of Dublin, Trinity College Dublin, Dublin, Ireland
| | - L S van Velzen
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M J van Tol
- University of Groningen, University Medical Center Groningen, NeuroImaging Center, Groningen, The Netherlands
| | - N J van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - I M Veer
- Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H Walter
- Department of Psychiatry and Psychotherapy, Division of Mind and Brain Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Schnell
- Department of General Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
| | - E Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - C Normann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - D Schoepf
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - B Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - M Papmeyer
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - B R Godlewska
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - P J Cowen
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - F H Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité Universitätsmedizin, Berlin, Germany,Institute for Social Medicine, Epidemology and Health Economics, Charité Universitätsmedizin, Berlin, Germany
| | - M Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité Universitätsmedizin, Berlin, Germany,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - P M Thompson
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - D P Hibar
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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11
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Schmaal L, Veltman DJ, van Erp TGM, Sämann PG, Frodl T, Jahanshad N, Loehrer E, Vernooij MW, Niessen WJ, Ikram MA, Wittfeld K, Grabe HJ, Block A, Hegenscheid K, Hoehn D, Czisch M, Lagopoulos J, Hatton SN, Hickie IB, Goya-Maldonado R, Krämer B, Gruber O, Couvy-Duchesne B, Rentería ME, Strike LT, Wright MJ, de Zubicaray GI, McMahon KL, Medland SE, Gillespie NA, Hall GB, van Velzen LS, van Tol MJ, van der Wee NJ, Veer IM, Walter H, Schramm E, Normann C, Schoepf D, Konrad C, Zurowski B, McIntosh AM, Whalley HC, Sussmann JE, Godlewska BR, Fischer FH, Penninx BWJH, Thompson PM, Hibar DP. Response to Dr Fried & Dr Kievit, and Dr Malhi et al. Mol Psychiatry 2016; 21:726-8. [PMID: 26903270 PMCID: PMC4876636 DOI: 10.1038/mp.2016.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- L Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - D J Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - P G Sämann
- Max Planck Institute of Psychiatry, Neuroimaging Research Group, Munich, Germany
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany
- Department of Psychiatry, Trinity College, University of Dublin, Dublin, Ireland
| | - N Jahanshad
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - E Loehrer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MS, USA
| | - M W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - W J Niessen
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - H J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- Helios Hospital Stralsund, Stralsund, Germany
| | - A Block
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - K Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - D Hoehn
- Max Planck Institute of Psychiatry, Neuroimaging Research Group, Munich, Germany
| | - M Czisch
- Max Planck Institute of Psychiatry, Neuroimaging Research Group, Munich, Germany
| | - J Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - S N Hatton
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - I B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - R Goya-Maldonado
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Gerog-August-University, Goettingen, Germany
| | - B Krämer
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Gerog-August-University, Goettingen, Germany
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B Couvy-Duchesne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - M E Rentería
- Department of Genetic Epidemiology, Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - L T Strike
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - M J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - G I de Zubicaray
- Faculty of Health, The Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - K L McMahon
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - S E Medland
- Department of Quantitative Genetics, Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - G B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - L S van Velzen
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M-J van Tol
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Neuroimaging Center, Groningen, The Netherlands
| | - N J van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - I M Veer
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - E Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Psychiatric University Clinic, Basel, Switzerland
| | - C Normann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - D Schoepf
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakoniklinikum, Rotenburg, Germany
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - B Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, UK
| | - B R Godlewska
- Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - F H Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité Universitätsmedizin, Berlin, Germany
- Institute for Social Medicine, Epidemology and Health Economics, Charité Universitätsmedizin, Berlin, Germany
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - P M Thompson
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - D P Hibar
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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Patel R, Block A, Harkenrider M, Roeske J. SU-E-J-188: Theoretical Estimation of Margin Necessary for Markerless Motion Tracking. Med Phys 2015. [DOI: 10.1118/1.4924274] [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: 11/07/2022] Open
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13
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Roeske J, Patel R, Campana M, Panfil J, Surucu M, Block A, Harkenrider M. Hybrid Dual Energy (HDE) Fluoroscopy for Real-Time Tracking of Lung Tumors. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Block A, Etrich C, Limboeck T, Bleckmann F, Soergel E, Rockstuhl C, Linden S. Bloch oscillations in plasmonic waveguide arrays. Nat Commun 2014; 5:3843. [PMID: 24815591 DOI: 10.1038/ncomms4843] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 04/09/2014] [Indexed: 11/09/2022] Open
Abstract
The combination of modern nanofabrication techniques and advanced computational tools has opened unprecedented opportunities to mold the flow of light. In particular, discrete photonic structures can be designed such that the resulting light dynamics mimics quantum mechanical condensed matter phenomena. By mapping the time-dependent probability distribution of an electronic wave packet to the spatial light intensity distribution in the corresponding photonic structure, the quantum mechanical evolution can be visualized directly in a coherent, yet classical wave environment. On the basis of this approach, several groups have recently observed discrete diffraction, Bloch oscillations and Zener tunnelling in different dielectric structures. Here we report the experimental observation of discrete diffraction and Bloch oscillations of surface plasmon polaritons in evanescently coupled plasmonic waveguide arrays. The effective external potential is tailored by introducing an appropriate transverse index gradient during nanofabrication of the arrays. Our experimental results are in excellent agreement with numerical calculations.
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Holzhüter J, Rösch T, Block A, Lohse AW, Lüth S. [A 44-year-old woman with hereditary nonpolyposis colon carcinoma: screening examinations for non-colonic tumors]. Internist (Berl) 2013; 54:353-8. [PMID: 23392234 DOI: 10.1007/s00108-012-3224-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A 44-year-old woman presented in March 2010 for surveillance esophagogastroduodenoscopy (EGD). In October 2004, rectal cancer had been diagnosed and treated by resection of the rectum with adjuvant chemotherapy. A diagnosis of hereditary nonpolyposis colon carcinoma (HNPCC) was established on the basis of the Amsterdam II criteria. Due to a lack of clear guidelines we decided to perform annual systematic surveillance examinations of the stomach and the most frequent tumor manifestations. Until 2009, extracolonic tumors were not observed in the patient. In March 2010, EGD showed a discrete erosive lesion in the gastric antrum, which was biopsied. Most notably, the histopathological examination revealed a poorly differentiated mucinous adenocarcinoma. Due to the poor differentiation, we decided against technically possible, endoscopic resection. The patient underwent subtotal gastrectomy and is still doing fine 28 months after surgery. This case prompted us to evaluate our surveillance approach in HNPCC patients and to review the literature.
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Affiliation(s)
- J Holzhüter
- I. Medizinische Klinik, Zentrum für Innere Medizin, Universitätsklinikum Hamburg, Martinistr. 52, 20246, Hamburg, Deutschland.
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Abstract
Dual energy (DE) imaging consists of obtaining kilovoltage (kV) x-ray images at two different diagnostic energies and performing a weighted subtraction of these images. A third image is then produced that highlights soft tissue. DE imaging has been used by radiologists to aid in the detection of lung malignancies. However, it has not been used clinically in radiotherapy. The goal of this study is to assess the feasibility of performing DE imaging using a commercial on-board imaging system. Both a simple and an anthropomorphic phantom were constructed for this analysis. Planar kV images of the phantoms were obtained using varied imaging energies and mAs. Software was written to perform DE subtraction using empirically determined weighting factors. Tumor detectability was assessed quantitatively using the signal-difference-to-noise ratio (SDNR). Overall DE subtraction suppressed high density objects in both phantoms. The optimal imaging technique, providing the largest SDNR with a dose less than our reference technique was 140 kVp, 1.0 mAs and 60 kVp, 3.2 mAs. Based on this analysis, DE subtraction imaging is feasible using a commercial on-board imaging system and may improve the visualization of tumors in lung cancer patients undergoing image-guided radiotherapy.
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Affiliation(s)
- M A Hoggarth
- Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL 60153, USA
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17
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Alten R, Bingham CO, Cohen S, Calabrese L, Curtis JR, Block A, Fay J, Kelly S, Luo A, Wong D, Genovese MC. SAT0001 Antibody Response to Pneumococcal and Influenza Vaccination in Patients With RA Receiving Subcutaneous Abatacept. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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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Bray T, Hoggarth M, Luce J, Lin J, Block A, Nagda S, Roeske J. Prospective Evaluation of Dual-energy Imaging in Patients Undergoing Image Guided Radiation Therapy for Lung Cancer: Initial Clinical Results. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.016] [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: 11/17/2022]
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Lordick F, Sehouli J, Vergote I, Rosenberg P, Schneeweiss A, Block A, Salat C, Scambia G, Berton-Rigaud D, Wimberger P. Maintenance of Quality of Life in Patients with Malignant Ascites During Treatment with the Trifunctional Antibody Catumaxomab: Results from the Phase III B Casimas Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)34144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Luce J, Hoggarth M, Lin J, Block A, Roeske J. SU-E-J-91: FFT Based Medical Image Registration Using a Graphics Processing Unit (GPU). Med Phys 2012; 39:3673. [DOI: 10.1118/1.4734927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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21
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Hoggarth M, Luce J, Bray T, Block A, Roeske J. SU-E-J-44: Dual Energy Subtraction Imaging to Improve Tumor Visibility at Oblique Angles. Med Phys 2012; 39:3662. [DOI: 10.1118/1.4734879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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22
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Luce J, James G, Hoggarth M, Lin J, Block A, Roeske J. SU-E-J-93: Fourier Transform-Based Medical Image Registration. Med Phys 2012; 39:3673-3674. [DOI: 10.1118/1.4734929] [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: 11/07/2022] Open
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Abstract
BACKGROUND Rupture of an abdominal aortic aneurysm (rAAA) is associated with a high mortality both before and after admission to hospital. In spite of the use of expensive intensive medical therapeutic interventions 30 - 50 % of the operated patients still die. The ASA score is one of the most used scores world-wide. Use of the Glasgow aneurysm score (GAS) and the Hardman index (HI) is frequently reported in the literature to predict survival after surgical management of rAAA. With regard to the comorbidity factor severity score (CSS) no evaluated data on the mortality in cases of rAAA are available. On the basis of our own patient collective we intended to assess to what extent the risk score could give an answer to the question of therapeutic options. METHODS In a retrospective study (7/1998 - 8/2007), 94 patients (m : f = 78 : 16) were assessed after operative management of rAAA. The validity of preoperative risk assessments on the basis of the ASA score, the CSS, the GAS and the HI with regard to intra- or postoperative death in the initial hospitalisation period was examined. Sensitivity and specificity of the score systems were determined by receiver operating characteristics (ROC) analyses. RESULTS The age of the patients was 72.3 ± 9.5 years (mean ± SD). Thirty-five (37.2 %) patients died in the immediate postoperative period. The areas under the receiver operating characteristics curves for ASA, GAS, HI and CSS were 0.598, 0.787, 0.742 and 0.614, respectively. CONCLUSIONS This study revealed clear differences in the prognostic predictions of the various scores. In accord with the literature, no score gave a 100 % positive result with regard to mortality. Thus, an individual decision or, respectively, a therapeutic option cannot be reached with the help of the investigated scores. Further parameters need to be evaluated in order to make decisions about postoperative therapy.
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Affiliation(s)
- M Gawenda
- Universität zu Köln, Klinik und Poliklinik für Gefäßchirurgie, Köln, Deutschland.
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Pestana JOM, Grinyo JM, Vanrenterghem Y, Becker T, Campistol JM, Florman S, Garcia VD, Kamar N, Lang P, Manfro RC, Massari P, Rial MDC, Schnitzler MA, Vitko S, Duan T, Block A, Harler MB, Durrbach A. Three-year outcomes from BENEFIT-EXT: a phase III study of belatacept versus cyclosporine in recipients of extended criteria donor kidneys. Am J Transplant 2012; 12:630-9. [PMID: 22300431 DOI: 10.1111/j.1600-6143.2011.03914.x] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recipients of extended-criteria donor (ECD) kidneys have poorer long-term outcomes compared to standard-criteria donor kidney recipients. We report 3-year outcomes from a randomized, phase III study in recipients of de novo ECD kidneys (n = 543) assigned (1:1:1) to either a more intensive (MI) or less intensive (LI) belatacept regimen, or cyclosporine. Three hundred twenty-three patients completed treatment by year 3. Patient survival with a functioning graft was comparable between groups (80% in MI, 82% in LI, 80% in cyclosporine). Mean calculated GFR (cGFR) was 11 mL/min higher in belatacept-treated versus cyclosporine-treated patients (42.7 in MI, 42.2 in LI, 31.5 mL/min in cyclosporine). More cyclosporine-treated patients (44%) progressed to GFR <30 mL/min (chronic kidney disease [CKD] stage 4/5) than belatacept-treated patients (27-30%). Acute rejection rates were similar between groups. Posttransplant lymphoproliferative disorder (PTLD) occurrence was higher in belatacept-treated patients (two in MI, three in LI), most of which occurred during the first 18 months; four additional cases (3 in LI, 1 in cyclosporine) occurred after 3 years. Tuberculosis was reported in two MI, four LI and no cyclosporine patients. In conclusion, at 3 years after transplantation, immunosuppression with belatacept resulted in similar patient survival, graft survival and acute rejection, with better renal function compared with cyclosporine. As previously reported, PTLD and tuberculosis were the principal safety findings associated with belatacept in this study population.
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Affiliation(s)
- J O Medina Pestana
- Department of Medicine, Division of Nephrology, Hospital do Rim e Hipertensão, University of Sao Paulo, Brazil
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Crespo M, Collado S, Mir M, Hurtado S, Cao H, Barbosa F, Serra C, Hidalgo C, Faura A, Garcia de Lomas J, Montero M, Horcajada JP, Puig JM, Pascual J, Ulusal Okyay G, Uludag K, Sozen H, Arman D, Dalgic A, Guz G, Fraile P, Garcia-Cosmes P, Rosado C, Gonzalez C, Tabernero JM, Costa C, Saldan A, Astegiano S, Terlizzi ME, Messina M, Bergallo M, Segoloni G, Cavallo R, Schwarz A, Grosshennig A, Heim A, Broecker V, Haller H, Linnenweber S, Liborio AB, Mendoza TR, Esmeraldo RM, Oliveira MLMB, Nogueira Paes FJV, Silva Junior GB, Daher EF, Hodgson K, Baharani J, Fenton A, Baharani J, Mjoen G, Hartmann A, Reisaeter A, Midtvedt K, Dahle DO, Holdaas H, Shabir S, Lukacik P, Bevins A, Basnayake K, Bental A, Hughes RG, Cockwell P, Burrows R, Hutchison CA, Varma P, Kumar A, Hooda A, Badwal S, Barrios C, Mir M, Crespo M, Fumado L, Frances A, Puig JM, Horcajada JP, Arango O, Pascual J, Pawlik A, Chudek J, Kolonko A, Wilk J, Jalowiecki P, Wiecek A, Teplan V, Kralova-Lesna I, Mahrova A, Racek J, tollova M, Maggisano V, Caracciolo V, Solazzo A, Montanari M, Della Grotta F, Nakazawa D, Nishio S, Nakagaki T, Ishikawa Y, Ito M, Shibazaki S, Shimoda N, Miura M, Morita K, Nonomura K, Koike T, Locsey L, Seres I, Sztanek F, Harangi M, Padra J, Asztalos L, Paragh G, Rodriguez-Reimundes E, Soler-Pujol G, Diaz CH, Davalos-Michel M, Vilches AR, Laham G, Mjoen G, Stavem K, Midtvedt K, Norby G, Holdaas H, Tutal E, Canver B, Can S, Sezer S, Colak T, Kolonko A, Chudek J, Wiecek A, Paschoalin R, Barros X, Duran C, Torregrosa JV, Crespo M, Mir M, Barrios C, Faura A, Tellez E, Marin M, Puig JM, Pascual J, Smalcelj R, Smalcelj A, Claes K, Petit T, Bammens B, Kuypers D, Naesens M, Vanrenterghem Y, Evenepoel P, Gerhart MK, Colbus S, Seiler S, Grun O, Fliser D, Heine GH, Vincenti F, Grinyo J, Larsen C, Medina Pestana J, Vanrenterghem Y, Dong Y, Thomas D, Charpentier B, Luna E, Martinez R, Cerezo I, Ferreira F, Cubero J, Villa J, Martinez C, Garcia C, Rodrigo E, Santos L, Pinera C, Quintela E, Ruiz JC, Fernandez-Fresnedo G, Palomar R, Gomez-Alamillo C, Martin de Francisco AL, Arias M, Grinyo J, Nainan G, del Carmen Rial M, Steinberg S, Vincenti F, Dong Y, Thomas D, Kamar N, Durrbach A, Grinyo J, Vanrenterghem Y, Becker T, Florman S, Lang P, del Carmen Rial M, Schnitzler M, Duan T, Block A, Medina Pestana J, Sawosz M, Cieciura T, Durlik M, Perkowska A, Sikora P, Beck B, De Mauri A, Brambilla M, Stratta P, Chiarinotti D, De Leo M, Attou S, Arzour H, Boudrifa N, Mekhlouf N, Gaouar A, Merazga S, Kalem K, Haddoum F. Transplantation: clinical studies. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.43] [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: 11/12/2022] Open
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26
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Durrbach A, Pestana JM, Pearson T, Vincenti F, Garcia VD, Campistol J, Rial MDC, Florman S, Block A, Di Russo G, Xing J, Garg P, Grinyó J. A phase III study of belatacept versus cyclosporine in kidney transplants from extended criteria donors (BENEFIT-EXT study). Am J Transplant 2010; 10:547-57. [PMID: 20415898 DOI: 10.1111/j.1600-6143.2010.03016.x] [Citation(s) in RCA: 387] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recipients of extended criteria donor (ECD) kidneys are at increased risk for graft dysfunction/loss, and may benefit from immunosuppression that avoids calcineurin inhibitor (CNI) nephrotoxicity. Belatacept, a selective costimulation blocker, may preserve renal function and improve long-term outcomes versus CNIs. BENEFIT-EXT (Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial-EXTended criteria donors) is a 3-year, Phase III study that assessed a more (MI) or less intensive (LI) regimen of belatacept versus cyclosporine in adult ECD kidney transplant recipients. The co-primary endpoints at 12 months were composite patient/graft survival and a composite renal impairment endpoint. Patient/graft survival with belatacept was similar to cyclosporine (86% MI, 89% LI, 85% cyclosporine) at 12 months. Fewer belatacept patients reached the composite renal impairment endpoint versus cyclosporine (71% MI, 77% LI, 85% cyclosporine; p = 0.002 MI vs. cyclosporine; p = 0.06 LI vs. cyclosporine). The mean measured glomerular filtration rate was 4-7 mL/min higher on belatacept versus cyclosporine (p = 0.008 MI vs. cyclosporine; p = 0.1039 LI vs. cyclosporine), and the overall cardiovascular/metabolic profile was better on belatacept versus cyclosporine. The incidence of acute rejection was similar across groups (18% MI; 18% LI; 14% cyclosporine). Overall rates of infection and malignancy were similar between groups; however, more cases of posttransplant lymphoproliferative disorder (PTLD) occurred in the CNS on belatacept. ECD kidney transplant recipients treated with belatacept-based immunosuppression achieved similar patient/graft survival, better renal function, had an increased incidence of PTLD, and exhibited improvement in the cardiovascular/metabolic risk profile versus cyclosporine-treated patients.
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Affiliation(s)
- A Durrbach
- Bicêtre Hospital, Kremlin Bicêtre, IFRNT, Université Paris sud, France.
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Block A, Mewes A, Bauer R, Rohn R, Mathias K. Ändern irregulärte Patientenatmungsbewegungen im Vergleich zu periodischen Bewegungen die Artefakte im 4D CT? ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252638] [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: 10/19/2022]
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Block A, Vockelmann C, Mehrens C, Waletzko O, Nörtersheuser T, Rohn R, Mathias K. Hat die Dichtemodifikation durch atmungs-induzierte Bewegungen im retrospektiven 4D-CT einen Einfluss auf die berechnete Dosisverteilung im Bestrahlungsplan? ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ruperto N, Lovell DJ, Li T, Paz E, Horneff G, Huppertz HI, Deslandre CJ, Minden K, Punaro M, Nunez AF, Sigal L, Block A, Covucci A, Martini A, Giannini EH. Reduction in missed school days and improvement in parent activity participation in children with juvenile idiopathic arthritis treated with abatacept. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334150 DOI: 10.1186/1546-0096-6-s1-p86] [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: 12/05/2022] Open
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Ruperto N, Lovell DJ, Li T, Quartier P, Chavez J, Huemer C, Kivitz A, Blanco F, Foeldvari I, Hofer M, Sigal L, Block A, Covucci A, Martini A, Giannini EH. Abatacept treatment improves health-related quality of life, pain, and sleep quality in juvenile idiopathic arthritis patients. Pediatr Rheumatol Online J 2008. [PMCID: PMC3334149 DOI: 10.1186/1546-0096-6-s1-p85] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Iwanski GB, Block A, Keller G, Muench J, Claus S, Fiedler W, Bokemeyer C. Esophageal squamous cell carcinoma presenting with extensive skin lesions: a case report. J Med Case Rep 2008; 2:115. [PMID: 18426583 PMCID: PMC2365965 DOI: 10.1186/1752-1947-2-115] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Accepted: 04/21/2008] [Indexed: 01/30/2023] Open
Abstract
Introduction Esophageal squamous cell carcinoma (ESCC) is the most common histological subtype of cancer in the upper and middle esophagus and is characterized by a high rate of mortality. The incidence of esophageal cancer varies greatly among regions of the world and occurs at a high frequency in Asia and South America. Case presentation In our department, a 51-year-old man was diagnosed with ESCC after presenting with extensive disseminated skin nodules. Biopsy of the nodules showed metastatic ESCC. Cutaneous manifestations of esophageal neoplasia are very rare and are mainly described for esophageal adenocarcinoma (EADC). Here we report a very uncommon case of extensive skin metastases of ESCC. Conclusion Early biopsies of suspicious skin lesions are important and should be performed in patients with unclear symptoms such as weight loss or dysphagia and especially in patients with a history of cancer, since they can reveal the existence of a distant malignant disease leading to diagnosis and prompt therapy.
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Affiliation(s)
- G B Iwanski
- Department of Internal Medicine, Oncology and Hematology, University Hospital Hamburg, Eppendorf, Martinistrasse, Hamburg, Germany.
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Block A, Vockelmann C, Mewes A, Waletzko O, Rohn R, Mathias K. Dosis und Bildqualität eines retrospektiven 4D-CT: Eine dynamische Phantomstudie. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1074013] [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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Mathias K, Block A, Waletzko O, Vockelmann C, Rohn R. 4D-CT bei atemgetriggerten Bestrahlungen. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1074021] [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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Mathias K, Block A, Vockelmann C, Waletzko O, Rohn R. Bildgebung für die herzschonende atemgetriggerte Bestrahlung des Mammakarzinoms. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073634] [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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Padmanabhan A, Block A, Sait S, Ford LA, O'Connor TL, Moysich KB, Baer MR. Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) following a diagnosis of breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7051] [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: 11/20/2022] Open
Abstract
7051 Background: Increasing use of chemotherapy and radiation therapy in breast cancer patients in the adjuvant setting heightens concern about therapy-related AML and MDS. Little is known about the characteristics of these disorders following breast cancer. Methods: Roswell Park Cancer Institute (RPCI) patients with diagnoses of MDS or AML by French-American-British Group or World Health Organization criteria following breast cancer were retrospectively reviewed. Results: 34 women were identified between 1983 and 2006. 10 (29%) were also diagnosed with additional malignancies, including non-Hodgkin lymphoma (NHL), bladder, colon, lung, uterine and thyroid cancers, Ewing sarcoma and angiosarcoma. 23 of 31 patients (74%) with family histories documented had first-degree relatives with cancers, including breast, lung, colon, stomach, pancreas, prostate, renal, melanoma, esophagus, thyroid, Hodgkin lymphoma and leukemia, compared to a 45% prevalence of first-degree relatives with cancer among 1982 control RPCI breast cancer patients (p= 0.001). Median age at breast cancer diagnosis was 58 (range, 37–85) years. Among the 29 patients with known treatment, 25 (86%) had received radiation therapy, 13 (45%) had received chemotherapy, including alkylating agents in all 13 (45%) and topoisomerase II inhibitors in 8(28%), while 4 (14%) had received no adjuvant therapy. Median age at AML/MDS diagnosis was 70 (range, 46–90) years. 26 patients had AML and 8 MDS, of whom 4 progressed to AML. Karyotypes were complex in 10 (29%), involved 11q23 rearrangements in 6 (18%), were favorable, normal and unknown in 5 each (45%), and had miscellaneous single structural abnormalities in 3 (9%); they did not strictly correlate with treatment received. Median survival (months) was 1 for complex karyotype, 6 for 11q23 translocation and 40 for favorable karyotype patients. Conclusions: The incidence of other cancers and of cancers in family members was unexpectedly high in breast cancer patients with AML and MDS, in the absence of known genetic syndromes, suggesting genetic polymorphisms predisposing to multiple cancers. Cytogenetic abnormalities included complex, 11q23 and favorable karyotypes, and survival reflected karyotypes. No significant financial relationships to disclose.
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Affiliation(s)
- A. Padmanabhan
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - A. Block
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - S. Sait
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - L. A. Ford
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - T. L. O'Connor
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - K. B. Moysich
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
| | - M. R. Baer
- Roswell Park Cancer Institute, Wiliamsville, NY; Roswell Park Cancer Institute, Buffalo, NY
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Block A. 4D-Bestrahlungsplan für intrafraktionelle Organbewegungen in der Strahlentherapie. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977234] [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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Block A. Molekulare Bildgebung. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
BACKGROUND Surgeons performing revision arthroplasties of the hip and knee are confronted with a growing number of patients with extensive loss of bone stock. Implantation of a total femur prosthesis is a possible method of treatment of such patients. The purpose of this study was to assess the functional outcomes and the complications associated with total femur replacements used in revision arthroplasty. METHODS We evaluated the results associated with 100 total femur prostheses that had been implanted during revision arthroplasty in 100 consecutive patients without infection. The mean duration of follow-up was five years. The prosthesis was implanted because of a complication of a total hip replacement in seventy-seven patients, because of a complication of a total knee replacement in four, and because of a complication affecting the diaphysis of the femur in nineteen. Thirty-nine patients had sustained a periprosthetic fracture, usually in combination with loosening of the prosthesis, before the revision. The radiographs made at the time of the latest follow-up were evaluated for signs of loosening and material failure. The preoperative and postoperative function of the hip and knee was assessed according to the Enneking score. Five patients were lost to follow-up. RESULTS Sixty-five patients (68%) had no complications. Deep infection was found in twelve patients (13%); dislocation, in six (6%); material failure, in three (3%); patellar problems, in two (2%); and peroneal nerve palsy, in one (1%). The mean preoperative Enneking score for hip function was 1.25 points, and it improved to 3.29 points postoperatively. The mean Enneking score for knee function was 2.09 points preoperatively and 3.29 points postoperatively. CONCLUSIONS We believe that the total femur prosthesis is a useful implant for patients with extensive bone loss at revision arthroplasty. While the infection rate was high, the overall functional results for both the hip and the knee were rated as better than good with the Enneking classification.
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Affiliation(s)
- C Friesecke
- Endo-Klinik, Holstenstrasse 2, 22767 Hamburg, Germany.
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Block A, Bauer R. 184 An analysing software for determining the parameters for respiration-gated radiotherapy. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81161-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Block A, Skamel H, Heilsberg G, Keffel F, Mathias K. 350 Commissioning and implementation of respirationgated radiotherapy: The Dortmund experience. Radiother Oncol 2005. [DOI: 10.1016/s0167-8140(05)81326-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Franck S, Block A, von Bloh W, Bounama C, Garrido I, Schellnhuber HJ. Planetary habitability: is Earth commonplace in the Milky Way? Naturwissenschaften 2001; 88:416-26. [PMID: 11729808 DOI: 10.1007/s001140100257] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Is there life beyond planet Earth? This is one of the grand enigmas which humankind tries to solve through scientific research. Recent progress in astronomical measurement techniques has confirmed the existence of a multitude of extra-solar planets. On the other hand, enormous efforts are being made to assess the possibility of life on Mars. All these activities have stimulated several investigations about the habitability of cosmic bodies. The habitable zone (HZ) around a given central star is defined as the region within which an Earth-like planet might enjoy the moderate surface temperatures required for advanced life forms. At present, there are several models determining the HZ. One class of models utilises climate constraints for the existence of liquid water on a planetary surface. Another approach is based on an integrated Earth system analysis that relates the boundaries of the HZ to the limits of photosynthetic processes. Within the latter approach, the evolution of the HZ for our solar system over geological time scales is calculated straightforwardly, and a convenient filter can be constructed that picks the candidates for photosynthesis-based life from all the extra-solar planets discovered by novel observational methods. These results can then be used to determine the average number of planets per planetary system that are within the HZ. With the help of a segment of the Drake equation, the number of "Gaias" (i.e. extra-solar terrestrial planets with a globally acting biosphere) is estimated. This leads to the thoroughly educated guess that there should exist half a million Gaias in the Milky Way.
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Affiliation(s)
- S Franck
- Potsdam Institute for Climate Impact Research (PIK), PF 60 12 03, 14412 Potsdam, Germany.
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Freund CT, Tong XW, Block A, Contant CF, Kieback DG, Rowley DR, Lerner SP. Adenovirus-mediated suicide gene therapy for bladder cancer: comparison of the cytomegalovirus- and Rous sarcoma virus-promoter. Anticancer Res 2000; 20:2811-6. [PMID: 11062688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND To compare efficacy and toxicity of the human cytomegalovirus-immediate-early (CMV) promoter and the Rous-sarcoma-virus (RSV) promoter to express thymidine kinase (tk) for adenovirus-mediated suicide gene therapy of experimental bladder cancer in vivo and in vitro. MATERIALS AND METHODS In vitro: 3 human (5637, RT-4 and TCC-SUP) and one murine (MBT-2) bladder cancer cell line were exposed to ADV/RSV-tk or ADV/CMV-tk vectors and cell survival was determined. In vivo: Subcutaneous tumors were established and adenovirus vectors were injected 10 days later. RESULTS In vitro: ADV/CMV-tk was up to 4 times more potent in terms of cell killing than ADV/RSV-tk. In vivo: ADV/CMV-tk had a three-fold higher antitumor potency per viral particle as compared to ADV/RSV-tk. Higher doses of ADV/CMV-tk caused treatment-associated hepatotoxicity. CONCLUSIONS Our results confirm the efficacy of adenovirus-mediated tk suicide gene therapy in the treatment of experimental bladder cancer. Dose-related toxicity was greater with the use of ADV/CMV-tk, but lower doses achieved the same efficacy as ADV/RSV-tk.
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Affiliation(s)
- C T Freund
- Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA
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Block A, Freund CT, Chen SH, Nguyen KP, Finegold M, Windler E, Woo SL. Gene therapy of metastatic colon carcinoma: regression of multiple hepatic metastases by adenoviral expression of bacterial cytosine deaminase. Cancer Gene Ther 2000; 7:438-45. [PMID: 10766350 DOI: 10.1038/sj.cgt.7700131] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Colon carcinoma accounts for 20% of deaths due to malignancies in the Western world. Once metastases occur, therapeutic options are limited, with an approximate 5-year survival of only 5%. To investigate the potential of new gene therapeutic approaches, a hepatic micrometastasis model of colon carcinoma in BALB/c mice was established. Inoculation of syngeneic MCA26 colon carcinoma cells into the spleens of 18- to 20-week-old mice resulted in the formation of multiple hepatic metastases. Selective transduction of developing hepatic metastases was demonstrated using a beta-galactosidase-expressing recombinant adenovirus. Cytosine deaminase (CD) can metabolize 5-fluorocytosine into the chemotherapeutic reagent 5-fluorouracil (5FU). The antitumoral potential of this suicide gene therapy approach was explored by systemic application of a recombinant replication-deficient adenovirus encoding for the bacterial CD gene under the control of the cytomegalovirus promoter (Ad.CMV-CD). Injection into the tail vein of tumor-bearing mice resulted in delayed tumor growth with significant reduction in hepatic metastases. The potential of this experimental approach for possible future clinical applications was evaluated by investigating adenoviral transduction efficiency, 5FU sensitivity, and 5-fluorocytosine-dependent Ad.CMV-CD toxicity in a variety of human colon cancer cell lines. Although the murine cell lines MCA26 and CC36 were highly sensitive to 5FU, the human colon cancer cell lines showed a 1-100 times higher resistance to 5FU. Specific Ad.CMV-CD toxicity correlates with 5FU toxicity. Transduction efficiency in human colon carcinoma cell lines was shown to be 10-1700 times higher compared with murine cell lines, thus compensating for 5FU resistance. In conclusion, suicide gene therapy using CD may be promising as an adjuvant treatment regimen for hepatic micrometastases of human colon carcinoma.
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Affiliation(s)
- A Block
- Department of Medicine, University Hospital Eppendorf, Hamburg, Germany.
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Abstract
FeLV infection is still considered to account for most disease-related deaths in pet cats. Different treatment attempts with various drugs were performed in the past but none resulted in healing or complete virus elimination. Therefore, it caused a sensation when Horber and Mayr [Horber, D., Mayr, B., 1991. Prax. 19, 311-314; Horber, D., Schnabl, W., Mayr, B., 1992. Tierarztl. Umschau 47, 556-560; Mayr, B., Horber, D., 1992. Kleintierprax. 37, 515-518] published that they were able to cure 80 to 100% FeLV-infected cats from viremia by using an immunomodulating compound. Articles in cat breeder and cat owner journals appeared assuming that obviously there is a rescue for FeLV-infected cats suffering from this deadly infection. The immunomodulator [Buttner, M., 1993. Comp. Immun. Microbiol. Infect. Dis. 18, 1-10] used in those studies was the so-called 'paramunity inducer' PIND-ORF (Baypamun, Bayer, Leverkusen, Germany) consisting of inactivated parapox ovis virus. Since that time, Baypamun is the most commonly used drug for treatment of FeLV infection in Germany and other European countries. Four placebo-controlled double-blind trials were performed to determine the therapeutic efficacy of Baypamun and other compounds in naturally FeLV-infected cats under controlled conditions.
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Affiliation(s)
- K Hartmann
- I. Medizinische Tierklinik, Ludwig-Maximilians-Universität München, Munich, Germany.
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Katz SD, Radin M, Graves T, Hauck C, Block A, LeJemtel TH. Effect of aspirin and ifetroban on skeletal muscle blood flow in patients with congestive heart failure treated with Enalapril. Ifetroban Study Group. J Am Coll Cardiol 1999; 34:170-6. [PMID: 10400007 DOI: 10.1016/s0735-1097(99)00180-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the acute and chronic effects of cyclooxygenase inhibition with aspirin and thromboxane A2 receptor blockade with ifetroban on the chronic vasodilating effects of enalapril in the skeletal muscle circulation of patients with heart failure. BACKGROUND Angiotensin-converting enzyme inhibition and antiplatelet therapy with aspirin independently reduce the risk for subsequent nonfatal coronary events in survivors of myocardial infarction. The safety of the combined administration of angiotensin-converting enzyme inhibitors and aspirin has been questioned due to their divergent effects on the vascular synthesis of vasodilating prostaglandins. METHODS Forearm blood flow (ml/min/100 ml) at rest and during rhythmic handgrip exercise and after transient arterial occlusion was determined by strain gauge plethysmography before and 4 h and six weeks after combined administration of enalapril with either aspirin, ifetroban or placebo in a multicenter, double-blind, randomized trial of 62 patients with mild to moderate heart failure. RESULTS Before randomization, forearm hemodynamics were similar in the three treatment groups except for increased resting forearm blood flow and decreased resting forearm vascular resistance in the aspirin group when compared with the placebo group. After combined administration of enalapril and study drug for 4 h and six weeks, changes from prerandomization values of mean arterial pressure, forearm blood flow and forearm vascular resistance at rest, during handgrip exercise and after transient arterial occlusion did not differ among the three treatment groups. CONCLUSIONS These findings demonstrate that the vasodilating effects of enalapril in the skeletal muscle circulation of patients with heart failure are not critically dependent on prostaglandin pathways.
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Affiliation(s)
- S D Katz
- Columbia Presbyterian Medical Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
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Abstract
A seizure warning device might allow some individuals with partial seizures to protect themselves against consequences of seizures, but a prerequisite is the ability to take volitional action in response to a warning. The authors reviewed consecutive seizures in their epilepsy monitoring unit to determine whether patients could squeeze an event bulb, as instructed, at the start of their seizure. Only complex partial seizures with EEG changes and with the patient on camera were analyzed. Data were obtained from 77 patients, 42 with scalp monitoring and 35 with depth electrodes. Forty-seven percent had a left-hemisphere focus, 42% a right-hemisphere focus, and 11% multifocal seizures. The seizure focus was temporal in 68%. A magnetic resonance imaging consistent with mesial temporal sclerosis was seen in 29% of patients. Overall, 44% of the patients made at least one attempt to reach for the event bulb at the start of their seizures. Among the 72% of patients who gave a history of auras, 53% were able to press the event bulb compared to 20% with no history of auras (P = 0.016). EEG changes occurred a mean of 2.9+/-30.5 seconds after reaching for the bulb for scalp-recorded seizures (n = 20), and 16.2+/-13.7 seconds before behavior for depth-recorded seizures (n = 14, difference significant at P = 0.02). Neither seizure focus nor seizure laterality influenced the ability to press the event bulb. The authors conclude that nearly half of individuals with complex partial seizures can take volitional motor action at the start of their seizure. A method to enhance the intensity and timeliness of a seizure warning would not be wasted.
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Affiliation(s)
- A Block
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona 85013-4496, USA
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Bonnekoh B, Greenhalgh DA, Chen SH, Bickenbach J, Block A, Rich SS, Krieg T, Woo SL, Roop DR. Adenovirus-mediated ex vivo immunogene and in vivo combination gene therapy strategies induce a systemic anti-tumor immune defense in the mouse B16 melanoma model. Adv Exp Med Biol 1999; 451:335-43. [PMID: 10026893 DOI: 10.1007/978-1-4615-5357-1_52] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- B Bonnekoh
- Department of Cell Biology, Baylor College of Medicine Houston, Texas 77030, USA.
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Abstract
Two placebo-controlled double-blind trials were performed to determine the therapeutic efficacy of the paramunity inducer, Baypamun in feline leukemia virus (FeLV)-infected cats under controlled conditions. In the first study, 120 cats were involved; 60 cats were treated with Baypamun and 60 with a placebo preparation of virus-free cell culture medium. Dosage and administration of the drug over a 7-week period were performed according to the instructions given by the company. Remission of viremia occurred in 12% and 7% of the cats treated with Baypamun and placebo, respectively. This difference was not statistically significant. In the second study, 30 naturally infected cats were treated in a placebo-controlled double-blind trial. In total, 20 immunological, clinical, laboratory, and virological parameters were examined. No statistically significant differences could be demonstrated between Baypamun and placebo application. Therefore, FeLV infection was not influenced by Baypamun treatment.
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Affiliation(s)
- K Hartmann
- I. Medizinische Tierklinik, Ludwig-Maximilians-Universität, Munich, Germany
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