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P. van Valenberg FJ, van der Heijden AG, Cutie CJ, Bhanvadia S, Keegan KA, Hampras S, Sweiti H, Maffeo JC, Jin S, Chau A, Reynolds DL, Iarossi C, Kelley A, Li X, Stromberg KA, Michiel Sedelaar J, Steenbruggen JJ, Somford DM, Alfred Witjes J. The Safety, Tolerability, and Preliminary Efficacy of a Gemcitabine-releasing Intravesical System (TAR-200) in American Urological Association-defined Intermediate-risk Non-muscle-invasive Bladder Cancer Patients: A Phase 1b Study. EUR UROL SUPPL 2024; 62:8-15. [PMID: 38585206 PMCID: PMC10998271 DOI: 10.1016/j.euros.2024.01.013] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 04/09/2024] Open
Abstract
Background and objective Patients with intermediate-risk non-muscle-invasive bladder cancer (IR NMIBC) have a high risk of recurrence and need effective therapies to reduce the risk of disease recurrence or progression. This phase 1b study (NCT02720367) assessed the safety and tolerability of TAR-200, an intravesical drug delivery system, in participants with IR NMIBC. Methods Participants with recurrent IR NMIBC were eligible. Participants received either two 7-d or two 21-d TAR-200 dosing cycles over a 4-6-wk period in a marker lesion/ablation design. TAR-200 was placed in the window between the cystoscopy showing recurrent papillary disease and the subsequent complete transurethral resection of the bladder tumour. The primary endpoint was TAR-200 safety. The secondary endpoints included TAR-200 tolerability, pharmacokinetics, and preliminary efficacy. Key findings and limitations Twelve participants received TAR-200 treatment. No TAR-200-related serious or grade ≥ 3 treatment-emergent adverse events (TEAEs) occurred. Nine participants had grade ≤ 2 TAR-200-related TEAEs, with urgency, dysuria, and haematuria being most common. Two participants refused a second dosing cycle due to urinary urgency and frequency. Insertion and removal of TAR-200 was successful in all cases. Plasma gemcitabine concentrations remained below the lower limit of detection. Five participants (42%) had complete response (CR): four had pathological CR and one had CR based on visual assessment. Conclusions and clinical implications TAR-200 appears to be safe and well tolerated, with encouraging preliminary efficacy in participants with IR NMIBC. This study lays the groundwork for the multiple phase 2 and 3 global studies that are currently on-going for TAR-200. Patient summary In this study, researchers evaluated the safety of the novel drug delivery system TAR-200 in participants with intermediate-risk non-muscle-invasive bladder cancer. They concluded that TAR-200 was safe and well tolerated with promising antitumour activity.
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Affiliation(s)
- F. Johannes P. van Valenberg
- Department of Urology, Radboudumc, Nijmegen, The Netherlands
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | | | | | | | - Kirk A. Keegan
- Janssen Research & Development, Lexington, MA, USA
- Department of Urology, Vanderbilt University, Nashville, TN, USA
| | | | | | | | - Shu Jin
- Janssen Research & Development, Lexington, MA, USA
| | | | | | | | - April Kelley
- Janssen Research & Development, Lexington, MA, USA
| | - Xiang Li
- Janssen Research & Development, Raritan, NJ, USA
| | | | | | | | - Diederik M. Somford
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
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Chau A, Markley JC. Re-attempting the procedure after an accidental dural puncture during an epidural blood patch: is there a hole in the plan? Int J Obstet Anesth 2024; 57:103953. [PMID: 37989614 DOI: 10.1016/j.ijoa.2023.103953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/21/2023] [Indexed: 11/23/2023]
Affiliation(s)
- A Chau
- University of British Columbia, Vancouver, BC, Canada.
| | - J C Markley
- University of California San Francisco, San Francisco, CA, USA
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Yamaguchi E, Ffrench O'Carroll R, Chau A, Preston R. Successful antepartum de-labelling of local anaesthetic allergy in a parturient with a self-reported allergy to amide and ester local anaesthetics. Int J Obstet Anesth 2024:103978. [PMID: 38508964 DOI: 10.1016/j.ijoa.2024.103978] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/06/2024] [Indexed: 03/22/2024]
Affiliation(s)
- E Yamaguchi
- Room 1Q72-4500 Oak Street, Vancouver BC, Canada V6H 3N1.
| | | | - A Chau
- BC Women's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - R Preston
- BC Women's Hospital, University of British Columbia, Vancouver, BC, Canada
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Chau A, Smiley R. Intrathecal morphine and delayed micturition after cesarean delivery: the rose and the thorn. Anaesth Crit Care Pain Med 2023; 42:101272. [PMID: 37419322 DOI: 10.1016/j.accpm.2023.101272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
| | - R Smiley
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, USA. https://twitter.com/RichSmileyMD
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Surasi DS, Eiber M, Maurer T, Preston MA, Helfand BT, Josephson D, Tewari AK, Somford DM, Rais-Bahrami S, Koontz BF, Bostrom PJ, Chau A, Davis P, Schuster DM, Chapin BF. Diagnostic Performance and Safety of Positron Emission Tomography with 18F-rhPSMA-7.3 in Patients with Newly Diagnosed Unfavourable Intermediate- to Very-high-risk Prostate Cancer: Results from a Phase 3, Prospective, Multicentre Study (LIGHTHOUSE). Eur Urol 2023; 84:361-370. [PMID: 37414702 DOI: 10.1016/j.eururo.2023.06.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [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: 02/13/2023] [Revised: 05/20/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Radiohybrid (rh) 18F-rhPSMA-7.3 is a novel high-affinity prostate-specific membrane antigen (PSMA)-targeting radiopharmaceutical for prostate cancer (PCa) imaging. OBJECTIVE To evaluate the diagnostic performance and safety of 18F-rhPSMA-7.3 in newly diagnosed PCa patients planned for prostatectomy. DESIGN, SETTING, AND PARTICIPANTS Data on 18F-rhPSMA-7.3 were reported from the phase 3 prospective, multicentre LIGHTHOUSE study (NCT04186819). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Patients underwent positron emission tomography/computed tomography (PET/CT) 50-70 min after an injection of 296 MBq 18F-rhPSMA-7.3. Images were interpreted locally and by three blinded independent readers. The coprimary endpoints were patient-level sensitivity and specificity for the detection of pelvic lymph node (PLN) metastases, validated using histopathology at PLN dissection. Prespecified statistical thresholds (lower bounds of 95% confidence interval [CI]) were set at 22.5% for sensitivity and 82.5% for specificity. RESULTS AND LIMITATIONS Of 372 patients screened, 352 had evaluable 18F-rhPSMA-7.3-PET/CT and 296 (99 [33%] with unfavourable intermediate-risk [UIR] and 197 [67%] with high-/very-high-risk [VHR] PCa) subsequently underwent surgery. As per the independent reads, 23-37 (7.8-13%) patients had 18F-rhPSMA-7.3-positive PLN. Seventy (24%) patients had one or more positive PLNs on histopathology. The sensitivity for PLN detection was 30% (95% CI, 19.6-42.1%) for reader 1, 27% (95% CI, 17.2-39.1%) for reader 2, and 23% (95% CI, 13.7-34.4%) for reader 3, not meeting the prespecified threshold. Specificity was 93% (95% CI, 88.8-95.9%), 94% (95% CI, 89.8-96.6%), and 97% (95% CI, 93.7-98.7%), respectively, exceeding the threshold for all readers. Specificity was high (≥92%) across both risk stratifications. Sensitivity was higher among high-risk/VHR (24-33%) than among UIR (16-21%) patients. Extrapelvic (M1) lesions were reported for 56-98/352 (16-28%) patients who underwent 18F-rhPSMA-7.3-PET/CT irrespective of surgery. Verification of these (predominantly by conventional imaging) gave a verified detection rate of 9.9-14% (positive predictive value, 51-63%). No serious adverse events were observed. CONCLUSIONS Across all risk stratifications, 18F-rhPSMA-7.3-PET/CT had high specificity, meeting the specificity endpoint. The sensitivity endpoint was not met, although higher sensitivity was noted among high-risk/VHR than among UIR patients. Overall, 18F-rhPSMA-7.3-PET/CT was well tolerated, and identified N1 and M1 disease prior to surgery in newly diagnosed PCa patients. PATIENT SUMMARY In order to select the most appropriate treatment for patients with prostate cancer, it is critical to diagnose the disease burden accurately at initial diagnosis. In this study, we investigated a new diagnostic imaging agent in a large population of men with primary prostate cancer. We found it to have an excellent safety profile and to provide clinically useful information regarding the presence of disease beyond the prostate.
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Affiliation(s)
- Devaki Shilpa Surasi
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Matthias Eiber
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Tobias Maurer
- Martini-Klinik, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - David Josephson
- Tower Urology, Los Angeles, CA, USA; Cedars Sinai Medical Center, Los Angeles, CA, USA
| | | | - Diederik M Somford
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands; Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | | | | | - Peter J Bostrom
- Turku University Central Hospital, Turku, Finland; University of Turku, Turku, Finland
| | | | - Phillip Davis
- Blue Earth Diagnostics Inc, Monroe Township, NJ, USA
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Brian F Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Jani AB, Ravizzini GC, Gartrell BA, Siegel BA, Twardowski P, Saltzstein D, Fleming MT, Chau A, Davis P, Chapin BF, Schuster DM. Diagnostic Performance and Safety of 18F-rhPSMA-7.3 Positron Emission Tomography in Men With Suspected Prostate Cancer Recurrence: Results From a Phase 3, Prospective, Multicenter Study (SPOTLIGHT). Reply. J Urol 2023; 210:411-412. [PMID: 37350185 DOI: 10.1097/ju.0000000000003598] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Ashesh B Jani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Gregory C Ravizzini
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Barry A Siegel
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology and the Alvin J. Siteman Cancer Center, WashingtonUniversity School of Medicine, St Louis, Missouri
| | | | | | - Mark T Fleming
- Virginia Oncology Associates, US Oncology Research, Norfolk, Virginia
| | | | - Phillip Davis
- Blue Earth Diagnostics, Inc, Monroe Township, New Jersey
| | - Brian F Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
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Jani AB, Ravizzini GC, Gartrell BA, Siegel BA, Twardowski P, Saltzstein D, Fleming MT, Chau A, Davis P, Chapin BF, Schuster DM. Diagnostic Performance and Safety of 18F-rhPSMA-7.3 Positron Emission Tomography in Men With Suspected Prostate Cancer Recurrence: Results From a Phase 3, Prospective, Multicenter Study (SPOTLIGHT). J Urol 2023; 210:299-311. [PMID: 37126069 DOI: 10.1097/ju.0000000000003493] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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: 10/23/2022] [Accepted: 04/12/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE SPOTLIGHT (NCT04186845) evaluated diagnostic performance and safety of radiohybrid 18F-rhPSMA-7.3, a novel high-affinity positron emission tomography radiopharmaceutical. MATERIALS AND METHODS Men with prostate cancer recurrence underwent positron emission tomography/CT 50-70 minutes after intravenous administration of 296±20% MBq 18F-rhPSMA-7.3. To assess the coprimary end points (verified detection rate and combined region-level positive predictive value), 3 blinded, independent central readers evaluated the scans. Verified detection rate is equivalent to the overall detection rate × positive predictive value. Standard of truth was established for each patient using histopathology or confirmatory imaging. Statistical thresholds (lower bounds of the confidence intervals) of 36.5% and 62.5% were prespecified for verified detection rate and combined region-level positive predictive value, respectively. Additional end points included detection rate, verified detection rate, and combined region-level positive predictive value in patients with histopathology standard of truth, and safety. RESULTS The overall 18F-rhPSMA-7.3 detection rate among all 389 patients with an evaluable scan was 83% (majority read). Among the 366 patients (median prostate-specific antigen 1.27 ng/mL) for whom a standard of truth (histopathology [n=69]/confirmatory imaging only [n=297]) was available, verified detection rate ranged from 51% (95% CI 46.1-56.6) to 54% (95% CI 48.8-59.3), exceeding the prespecified statistical threshold. Combined region-level positive predictive value ranged from 46% (95% CI 42.0-50.3) to 60% (95% CI 55.1-65.5) across the readers, not meeting the threshold. In the subset of patients with histopathology standard of truth, the verified detection rate and combined region-level positive predictive value were both above the prespecified thresholds (majority read, 81% [95% CI 69.9-89.6] and 72% [95% CI 62.5-80.7], respectively). No significant safety concerns were identified. CONCLUSIONS 18F-rhPSMA-7.3 offers a clinically meaningful verified detection rate for localization of recurrent prostate cancer. Despite missing the coprimary end point of combined region-level positive predictive value, the totality of the data support the potential clinical utility of 18F-rhPSMA-7.3.
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Affiliation(s)
- Ashesh B Jani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Gregory C Ravizzini
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Barry A Siegel
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri
| | - Przemyslaw Twardowski
- Department of Genitourinary Oncology, John Wayne Cancer Institute, Santa Monica, California
| | | | - Mark T Fleming
- Virginia Oncology Associates, US Oncology Research, Norfolk, Virginia
| | - Albert Chau
- Blue Earth Diagnostics Ltd, Oxford, United Kingdom
| | - Phillip Davis
- Blue Earth Diagnostics Inc, Monroe Township, New Jersey
| | - Brian F Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
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Jani AB, Ravizzini GC, Gartrell BA, Siegel BA, Twardowski P, Saltzstein D, Fleming MT, Chau A, Davis P, Chapin BF, Schuster DM. Reply by Authors. J Urol 2023; 210:310-311. [PMID: 37416959 DOI: 10.1097/ju.0000000000003493.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Affiliation(s)
- Ashesh B Jani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Gregory C Ravizzini
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Barry A Siegel
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri
| | - Przemyslaw Twardowski
- Department of Genitourinary Oncology, John Wayne Cancer Institute, Santa Monica, California
| | | | - Mark T Fleming
- Virginia Oncology Associates, US Oncology Research, Norfolk, Virginia
| | - Albert Chau
- Blue Earth Diagnostics Ltd, Oxford, United Kingdom
| | - Phillip Davis
- Blue Earth Diagnostics Inc, Monroe Township, New Jersey
| | - Brian F Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
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Tyson MD, Morris D, Palou J, Rodriguez O, Mir MC, Dickstein RJ, Guerrero-Ramos F, Scarpato KR, Hafron JM, Messing EM, Cutie CJ, Maffeo JC, Raybold B, Chau A, Stromberg KA, Keegan KA. Reply by Authors. J Urol 2023; 209:900. [PMID: 37026638 DOI: 10.1097/ju.0000000000003195.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
| | | | - Juan Palou
- Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Rodriguez
- Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | - John C Maffeo
- Janssen Research & Development, Lexington, Massachusetts
| | | | | | | | - Kirk A Keegan
- Vanderbilt University Medical Center, Nashville, Tennessee
- Janssen Research & Development, Lexington, Massachusetts
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Tyson MD, Morris D, Palou J, Rodriguez O, Mir MC, Dickstein RJ, Guerrero-Ramos F, Scarpato KR, Hafron JM, Messing EM, Cutie CJ, Maffeo JC, Raybold B, Chau A, Stromberg KA, Keegan KA. Safety, Tolerability, and Preliminary Efficacy of TAR-200 in Patients With Muscle-invasive Bladder Cancer Who Refused or Were Unfit for Curative-intent Therapy: A Phase 1 Study. J Urol 2023; 209:890-900. [PMID: 37026631 DOI: 10.1097/ju.0000000000003195] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
PURPOSE Half of patients with muscle-invasive bladder cancer worldwide may not receive curative-intent therapy. Elderly or frail patients are most affected by this unmet need. TAR-200 is a novel, intravesical drug delivery system that provides sustained, local release of gemcitabine into the bladder over a 21-day dosing cycle. The phase 1 TAR-200-103 study evaluated the safety, tolerability, and preliminary efficacy of TAR-200 in patients with muscle-invasive bladder cancer who either refused or were unfit for curative-intent therapy. MATERIALS AND METHODS Eligible patients had cT2-cT3bN0M0 urothelial carcinoma of the bladder. TAR-200 was inserted for 4 consecutive 21-day cycles over 84 days. The primary end points were safety and tolerability at 84 days. Secondary end points included rates of clinical complete response and partial response as determined by cystoscopy, biopsy, and imaging; duration of response; and overall survival. RESULTS Median age of the 35 enrolled patients was 84 years, and most were male (24/35, 68.6%). Treatment-emergent adverse events related to TAR-200 occurred in 15 patients. Two patients experienced treatment-emergent adverse events leading to removal of TAR-200. At 3 months, complete response and partial response rates were 31.4% (11/35) and 8.6% (3/35), respectively, yielding an overall response rate of 40.0% (14/35; 95% CI 23.9-57.9). Median overall survival and duration of response were 27.3 months (95% CI 10.1-not estimable) and 14 months (95% CI 10.6-22.7), respectively. Progression-free rate at 12 months was 70.5%. CONCLUSIONS TAR-200 was generally safe, well tolerated, and had beneficial preliminary efficacy in this elderly and frail cohort with limited treatment options.
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Affiliation(s)
| | | | - Juan Palou
- Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Rodriguez
- Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | - John C Maffeo
- Janssen Research & Development, Lexington, Massachusetts
| | | | | | | | - Kirk A Keegan
- Vanderbilt University Medical Center, Nashville, Tennessee
- Janssen Research & Development, Lexington, Massachusetts
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van Valenberg FJP, van der Heijden T, Cutie C, Bhanvadia SK, Keegan KA, Hampras S, Sweiti H, Maffeo J, Jin S, Chau A, Reynolds D, Iarossi C, Kelley A, Li X, Stromberg K, Sedelaar M, Steenbruggen J, Somford DM, Witjes AA. Safety, tolerability, and preliminary efficacy of TAR-200 in patients with intermediate risk non–muscle-invasive bladder cancer: A phase 1 study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.505] [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: 03/16/2023] Open
Abstract
505 Background: TAR-200 is a novel intravesical drug delivery system designed to provide a continuous, slow release of gemcitabine within the bladder. Prolonged gemcitabine exposure over days, instead of hours, such as with current standard intravesical installations, may achieve more efficient and effective tumor response. We report on the safety and tolerability of TAR-200 in patients with non-muscle–invasive bladder cancer (NMIBC). Methods: In this phase 1b, open-label, prospective study, patients with a papillary recurrence after prior histologically proven, intermediate risk (IR)-NMIBC received two 1-week TAR-200 dosing cycles over a 4- to 6-week period. The study used a marker lesion/ablation design. Cystoscopy was performed to assess for recurrent papillary disease and for complete transurethral resection of the residual bladder tumor. The primary outcome was safety of TAR-200. Secondary outcomes were tolerability, pharmacokinetics, preliminary efficacy, and immunohistochemistry. Results: In total, 12 patients received TAR-200 treatment. Insertion and removal of TAR-200 was uneventful. No TAR-200-related serious adverse events (AEs) occurred. Four patients had no TAR-200-associated AEs; the remainder had varying degrees of AEs (all grade ≤2 [CTCAEv4.0]), mainly consisting of low-grade urinary urgency, urinary frequency, and dysuria, with no delay in the treatment schedule. Two patients refused a second dosing cycle due to urinary urgency and frequency. Plasma gemcitabine concentrations remained below the lower limit of detection. Five of 12 patients (42%) had complete response (CR); of these, 4 had a pathologic CR and 1 had CR based on visual assessment (with no biopsy available for pathologic assessment). Conclusions: In this small, phase 1 series, TAR-200 appears to be safe and well tolerated in patients with IR-NMIBC. Clinical trial information: NCT02720367 .
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Affiliation(s)
| | | | | | | | | | | | | | - John Maffeo
- Janssen Research & Development, Lexington, MA
| | - Shu Jin
- Janssen Research & Development, Lexington, MA
| | | | | | | | | | - Xiang Li
- Janssen Research & Development, Spring House, PA
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Chau A, Hofmeyr R. Hypothesis-generating procedures and unmasking novel associations in large observational studies: are we doing harm while doing good? Anaesthesia 2023; 78:9-13. [PMID: 36178605 DOI: 10.1111/anae.15877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 12/13/2022]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
| | - R Hofmeyr
- Department of Anaesthesia and Peri-operative Medicine, Groote Schuur Hospital, Cape Town, South Africa.,Department of Anaesthesia and Peri-operative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
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Prior CH, Burlinson CEG, Chau A. Emergencies in obstetric anaesthesia: a narrative review. Anaesthesia 2022; 77:1416-1429. [PMID: 36089883 DOI: 10.1111/anae.15839] [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] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
We conducted a narrative review in six areas of obstetric emergencies: category-1 caesarean section; difficult and failed airway; massive obstetric haemorrhage; hypertensive crisis; emergencies related to neuraxial anaesthesia; and maternal cardiac arrest. These areas represent significant research published within the last five years, with emphasis on large multicentre randomised trials, national or international practice guidelines and recommendations from major professional societies. Key topics discussed: prevention and management of failed neuraxial technique; role of high-flow nasal oxygenation and choice of neuromuscular drug in obstetric patients; prevention of accidental awareness during general anaesthesia; management of the difficult and failed obstetric airway; current perspectives on the use of tranexamic acid, fibrinogen concentrate and cell salvage; guidance on neuraxial placement in a thrombocytopenic obstetric patient; management of neuraxial drug errors, local anaesthetic systemic toxicity and unusually prolonged neuraxial block regression; and extracorporeal membrane oxygenation use in maternal cardiac arrest.
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Affiliation(s)
- C H Prior
- Department of Anaesthesia, West Middlesex University Hospital, London, UK
| | - C E G Burlinson
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
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Daneshmand S, Brummelhuis IS, Pohar KS, Steinberg GD, Aron M, Cutie CJ, Keegan KA, Maffeo JC, Reynolds DL, Raybold B, Chau A, Witjes JA. The safety, tolerability, and efficacy of a neoadjuvant gemcitabine intravesical drug delivery system (TAR-200) in muscle-invasive bladder cancer patients: a phase I trial. Urol Oncol 2022; 40:344.e1-344.e9. [DOI: 10.1016/j.urolonc.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/13/2022] [Accepted: 02/13/2022] [Indexed: 11/27/2022]
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Chau A, El-Boghdadly K. Analysis of paralysis: understanding the role of vocal cords in facemask ventilation. Anaesthesia 2022; 77:949-952. [PMID: 35727639 DOI: 10.1111/anae.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Affiliation(s)
- A Chau
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, BC, Canada.,Department of Anesthesia, BC Women's Hospital, Vancouver, BC, Canada.,Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada
| | - K El-Boghdadly
- Department of Anaesthesia and Peri-Operative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
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Mercadante A, Lee S, Uh K, Chau A, Truong U, Jeong A, Hata M, Law A. Impact of adherence goal awareness intervention on PDC in various settings: Does awareness help modify medication-taking behavior? Exploratory Research in Clinical and Social Pharmacy 2021; 4:100072. [PMID: 35479847 PMCID: PMC9031037 DOI: 10.1016/j.rcsop.2021.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/18/2021] [Accepted: 09/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background Interventions to improve medication adherence in chronic conditions have shown limited success or sustainability. Previous data revealed that phone calls to patients regarding adherence goal awareness resulted in significant improvement in proportion of days covered (PDC). Objectives The objective of this study was to explore specific pharmacist adherence interventions via phone in various practice settings. Methods A prospective, randomized controlled study was conducted with patients who belonged to university-associated health care settings [ambulatory care, chain store, small health plan, and federally qualified health center (FQHC)]. At each site, patients with at least one chronic medication and a calculated PDC < 0.80 were randomized into control (n=115) and intervention (n=126) groups. Control groups (C) received usual pharmacy communication while intervention groups (X) were specifically called by a pharmacist to be informed of PDC goals and their commitment to adherence. PDC values were calculated 3 to 12 months for both groups the time of intervention, then compared with each patient's respective baseline/pre-PDC. Results Data from a total of 241 patients were pooled to examine change in PDC. There was no significant difference between groups in baseline criteria or PDC. Comparing within groups, there were significant correlations between Pre- and Post-PDCs for the intervention group (X = 0.32 p < 0.05) alone. There were significant improvements from initial PDC to those calculated at the time of Post-intervention PDC within both groups, (C = 0.18 ± 0.28 p < 0.05) and (X = 0.16 ± 0.24, p < 0.05). Approximately 44% of all sampled patients reached their adherence goals (PDC ≥ 0.80) after 3–9 months. Conclusions Results suggested that patient adherence behavior may improve after any call made by pharmacy staff. This communication and attention from the pharmacy may be enough for patients to consider their medication-taking habits without the need for discussing specific goals and importance of adherence.
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Brohan J, Taylor J, West A, Albert A, Chau A. Developing an institutional focused cardiac ultrasound course for obstetric anesthesiologists. Int J Obstet Anesth 2021; 49:103233. [PMID: 34810055 DOI: 10.1016/j.ijoa.2021.103233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/11/2021] [Accepted: 10/24/2021] [Indexed: 11/25/2022]
Affiliation(s)
- J Brohan
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - J Taylor
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - A West
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - A Albert
- Women's Health Research Institute, BC Women's Hospital, Vancouver, B.C., Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, B.C., Canada.
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Sim N, Lee S, Yap HY, Tan QY, Tan J, Wong D, Chau A, Mak M, Chong TT, Tay HT. A review of the Turned-down Onto Pericapsular-tissue Hemisectioned Amputated Toe (TOPHAT) flap for wound coverage during ray amputations of the toes. Foot (Edinb) 2021; 47:101803. [PMID: 33964533 DOI: 10.1016/j.foot.2021.101803] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/07/2021] [Accepted: 04/11/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Exposure of the adjacent Metatarsal-Phalangeal Joint (MTPJ) commonly occurs after application of Topical Negative Pressure Wound Therapy (TNPWT) for a ray amputation wound. This is due to mechanical soft tissue erosion or trauma to the adjacent digital artery from direct pressure effect. This results in toe gangrene requiring a ray amputation and ultimately a larger wound bed. We describe the use of the Turned-down Onto Pericapsular-tissue Hemisectioned Amputated Toe (TOPHAT) flap - a filleted toe flap to protect the adjacent MTPJ capsule combined with a novel Negative Pressure Wound Therapy with instillation and dwell-time (NPWTi-d) dressing technique. The flap protects the adjacent joint capsule and reduces the wound burden whilst allowing the wound to benefit from TNPWT, thereby accelerating wound healing. MATERIAL AND METHODS A retrospective review was conducted of patients with toe gangrene requiring ray amputation that underwent the TOPHAT flap on in our institution from 2019 and 2020. Complications such as wound dehiscence, hematoma, flap necrosis and secondary infection were recorded. Other outcomes recorded were time taken to final skin grafting and time taken for complete wound epithelialization. RESULTS 9 patients underwent treatment with the TOPHAT flap. 2 patients had flap necrosis. 7 patients progressed to definitive skin coverage with skin grafting. One patient subsequently had progressive arterial disease despite successful skin grafting and required above knee amputation. The mean time to final skin grafting and complete wound epithelialization was 49.5 days and 107.5 days respectively. All patients were satisfied with the outcomes and were able to return to their pre-morbid function. CONCLUSIONS The TOPHAT flap has a consistent vascular supply that provides durable soft tissue coverage. It is a robust and easily reproducible technique to accelerate wound healing after ray amputations even in patients with peripheral vascular disease.
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Affiliation(s)
- N Sim
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - S Lee
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - H Y Yap
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - Q Y Tan
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - J Tan
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - D Wong
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - A Chau
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - M Mak
- Podiatry Department, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - T T Chong
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
| | - H T Tay
- Department of Vascular and Endovascular Surgery, Singapore General Hospital, Academia Level 5, Outram Road, 169608, Singapore.
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Taylor J, Chau A, Massey S. In reply. Int J Obstet Anesth 2021; 46:102966. [PMID: 33714669 DOI: 10.1016/j.ijoa.2021.102966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 10/22/2022]
Affiliation(s)
- J Taylor
- Faculty of Medicine, University of British Columbia, Vancouver, B.C., Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, B.C., Canada
| | - S Massey
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, B.C., Canada.
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Taylor J, Chau A, Gunka V, Polishchuk E, Albert A, Chen J, Massey S. The incidence of dry chlorhexidine gluconate transfer from skin to surgical gloves: a simulation and in vitro study. Int J Obstet Anesth 2020; 45:111-114. [PMID: 33334665 DOI: 10.1016/j.ijoa.2020.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/24/2020] [Accepted: 11/16/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND To prevent alcohol-based chlorhexidine from reaching the cerebrospinal fluid, it is recommended that the antiseptic solution be allowed to dry before skin palpation or puncture. However, no guidelines specify a drying time interval. Manufacturers recommend 3 min of air drying, based upon the isopropyl alcohol component. Therefore, to fill this knowledge gap, we designed a simulation study to investigate the incidence of primary chlorhexidine transfer from skin to gloves following three drying time intervals. We also investigated the incidence of secondary chlorhexidine transfer from gloves to another surface following one drying time interval. METHODS An alcohol-based chlorhexidine antiseptic solution with dye, ChloraPrep®, was applied to the skin of the lumbar region of 20 volunteers. Cotton-tipped applicators wrapped in material from gloves were taken from the application area at 3, 4, 5, and 10 min following application. Transfer of chlorhexidine from skin to gloves, and gloves to another medium, was assessed through a chemical assay that produced a color change when chlorhexidine was present on the sample. RESULTS The incidence of primary chlorhexidine transfer from skin to gloves at 3, 4 and 10 min following application was 99.5%, 99.4%, and 99.6%, respectively. The incidence of secondary chlorhexidine transfer from gloves to another surface was 68.9%. CONCLUSION Gloves are routinely contaminated with chlorhexidine during central neuraxial blockade. The high incidence of secondary transfer in our simulation suggests a pathway by which chlorhexidine may gain access to the neuraxial space.
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Affiliation(s)
- J Taylor
- Faculty of Medicine, University of British Columbia, Vancouver, B.C., Canada
| | - A Chau
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - V Gunka
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada
| | - E Polishchuk
- Department of Chemistry, University of British Columbia, Vancouver, B.C., Canada
| | - A Albert
- Women's Health Research Institute, Vancouver, B.C., Canada
| | - J Chen
- Department of Chemistry, University of British Columbia, Vancouver, B.C., Canada
| | - S Massey
- Department of Anesthesia, BC Women's Hospital, Vancouver, B.C., Canada.
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Manceau G, Sabbagh C, Mege D, Lakkis Z, Bege T, Tuech JJ, Benoist S, Lefèvre JH, Karoui M, Bridoux V, Venara A, Beyer‐Berjot L, Codjia T, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Rullier E, Tresallet C, Tetard O, Rivier P, Fayssal E, Collard M, Moszkowicz D, Lupinacci R, Peschaud F, Etienne JC, Loge L, Bege T, Corte H, D’Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, Villeon B, Pautrat K, Eveno C, Abdalla S, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Panis Y, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K, Voron T, Parc Y. Colon sparing resection versus extended colectomy for left-sided obstructing colon cancer with caecal ischaemia or perforation: a nationwide study from the French Surgical Association. Colorectal Dis 2020; 22:1304-1313. [PMID: 32368856 DOI: 10.1111/codi.15111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 02/08/2023]
Abstract
AIM It is not known whether patients with obstructive left colon cancer (OLCC) with caecal ischaemia or diastatic perforation (defined as a blowout of the caecal wall related to colonic overdistension) should undergo a (sub)total colectomy (STC) or an ileo-caecal resection with double-barrelled ileo-colostomy. We aimed to compare the results of these two strategies. METHOD From 2000 to 2015, 1220 patients with OLCC underwent surgery by clinicians who were members of the French Surgical Association. Of these cases, 201 (16%) were found to have caecal ischaemia or diastatic perforation intra-operatively: 174 patients (87%) underwent a STC (extended colectomy group) and 27 (13%) an ileo-caecal resection with double-end stoma (colon-sparing group). Outcomes were compared retrospectively. RESULTS In the extended colectomy group, 95 patients (55%) had primary anastomosis and 79 (45%) had a STC with an end ileostomy. In the colon-sparing group, 10 patients (37%) had simultaneous resection of their primary tumour with segmental colectomy and an anastomosis which was protected by a double-barrelled ileo-colostomy. The demographic data for the two groups were comparable. Median operative time was longer in the STC group (P = 0.0044). There was a decrease in postoperative mortality (7% vs 12%, P = 0.75) and overall morbidity (56% vs 67%, P = 0.37) including surgical (30% vs 40%, P = 0.29) and severe complications (17% vs 27%, P = 0.29) in the colon-sparing group, although these differences did not reach statistical significance. Cumulative morbidity included all surgical stages and the rate of permanent stoma was 66% and 37%, respectively, with no significant difference between the two groups. Overall survival and disease-free survival were similar between the two groups. CONCLUSION The colon-sparing strategy may represent a valid and safe alternative to STC in OLCC patients with caecal ischaemia or diastatic perforation.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - D Mege
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - T Bege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - J J Tuech
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - S Benoist
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - J H Lefèvre
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Sorbonne Université, Paris, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Prior C, Sims K, Seligman K, Jackson S, Chau A. Peripartum management of a parturient with type 1C (clearance) von Willebrand disease. Int J Obstet Anesth 2020; 44:112-115. [PMID: 32942216 DOI: 10.1016/j.ijoa.2020.08.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 11/25/2022]
Abstract
Peripartum replacement of factor VIII and von Willebrand factor is not usually required in type 1 von Willebrand disease, as the levels of endogenous factors tend to increase to within the normal range as a physiological change of pregnancy. However, there is wide heterogeneity of genotypes and phenotypes associated with type 1 von Willebrand disease. Here, we describe the anesthetic management of a parturient with type 1C von Willebrand disease, a subtype characterized by decreased plasma von Willebrand factor survival.
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Affiliation(s)
- C Prior
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada.
| | - K Sims
- Adult Bleeding Disorders Program of British Columbia, St Paul's Hospital, Vancouver, BC, Canada
| | - K Seligman
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - S Jackson
- Adult Bleeding Disorders Program of British Columbia, St Paul's Hospital, Vancouver, BC, Canada; Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Chau
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
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Solanki AA, Savir-Baruch B, Liauw SL, Michalski J, Tward JD, Vapiwala N, Teoh EJ, Adler LP, Andriole GL, Belkoff LH, Burzon D, Chau A, Dato P, Duan F, Farwell M, Fogelson S, Gardiner P, Hanna L, Hoffman JM, Intenzo C, Josephson D, Kaminetsky J, Kipper M, Kostakoglu L, Krynyckyi B, Linder KE, Mahmood U, Marques H, Mankoff D, McConathy J, Melnick J, Miller MP, Oh W, Philips S, Rose J, Savir-Baruch B, Schuster DM, Siegel BA, Stevens DJ, Tewari A, Twardowski P, Ward P, Wasserman M, Weick S, (Michael) Yu JQ. 18F-Fluciclovine Positron Emission Tomography in Men With Biochemical Recurrence of Prostate Cancer After Radical Prostatectomy and Planning to Undergo Salvage Radiation Therapy: Results from LOCATE. Pract Radiat Oncol 2020; 10:354-362. [DOI: 10.1016/j.prro.2020.05.007] [Citation(s) in RCA: 3] [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: 04/06/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
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Au K, Shippam W, Chau A. Gastric insufflation and high-flow nasal oxygenation in obstetric patients: a reply. Anaesthesia 2020; 75:1262-1263. [PMID: 32584422 DOI: 10.1111/anae.15059] [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: 11/30/2022]
Affiliation(s)
- K Au
- British Columbia Women's Hospital, Vancouver, BC, Canada
| | - W Shippam
- British Columbia Women's Hospital, Vancouver, BC, Canada
| | - A Chau
- British Columbia Women's Hospital, Vancouver, BC, Canada
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Scarsbrook AF, Bottomley D, Teoh EJ, Bradley KM, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook GJ, Warbey VS, Han S, Leung HY, Chau A, Miller MP, Gleeson FV. Effect of 18F-Fluciclovine Positron Emission Tomography on the Management of Patients With Recurrence of Prostate Cancer: Results From the FALCON Trial. Int J Radiat Oncol Biol Phys 2020; 107:316-324. [PMID: 32068113 DOI: 10.1016/j.ijrobp.2020.01.050] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/17/2019] [Accepted: 01/31/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Early and accurate localization of lesions in patients with biochemical recurrence (BCR) of prostate cancer may guide salvage therapy decisions. The present study, 18F-Fluciclovine PET/CT in biochemicAL reCurrence Of Prostate caNcer (FALCON; NCT02578940), aimed to evaluate the effect of 18F-fluciclovine on management of men with BCR of prostate cancer. METHODS AND MATERIALS Men with a first episode of BCR after curative-intent primary therapy were enrolled at 6 UK sites. Patients underwent 18F-fluciclovine positron emission tomography/computed tomography (PET/CT) according to standardized procedures. Clinicians documented management plans before and after scanning, recording changes to treatment modality as major and changes within a modality as other. The primary outcome measure was record of a revised management plan postscan. Secondary endpoints were evaluation of optimal prostate specific antigen (PSA) threshold for detection, salvage treatment outcome assessment based on 18F-fluciclovine-involvement, and safety. RESULTS 18F-Fluciclovine was well tolerated in the 104 scanned patients (median PSA = 0.79 ng/mL). Lesions were detected in 58 out of 104 (56%) patients. Detection was broadly proportional to PSA level; ≤1 ng/mL, 1 out of 3 of scans were positive, and 93% scans were positive at PSA >2.0 ng/mL. Sixty-six (64%) patients had a postscan management change (80% after a positive result). Major changes (43 out of 66; 65%) were salvage or systemic therapy to watchful waiting (16 out of 66; 24%); salvage therapy to systemic therapy (16 out of 66; 24%); and alternative changes to treatment modality (11 out of 66, 17%). The remaining 23 out of 66 (35%) management changes were modifications of the prescan plan: most (22 out of 66; 33%) were adjustments to planned brachytherapy/radiation therapy to include a 18F-fluciclovine-guided boost. Where 18F-fluciclovine guided salvage therapy, the PSA response rate was higher than when 18F-fluciclovine was not involved (15 out of 17 [88%] vs 28 out of 39 [72%]). CONCLUSIONS 18F-Fluciclovine PET/CT located recurrence in the majority of men with BCR, frequently resulting in major management plan changes. Incorporating 18F-fluciclovine PET/CT into treatment planning may optimize targeting of recurrence sites and avoid futile salvage therapy.
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Affiliation(s)
- Andrew F Scarsbrook
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; University of Leeds, Leeds, United Kingdom.
| | | | | | - Kevin M Bradley
- PETIC, Wales Research and Diagnostic PET Imaging Centre, Cardiff, United Kingdom
| | - Heather Payne
- University College London Hospitals, NHS Foundation Trust, London, United Kingdom
| | - Asim Afaq
- University College London Hospitals, NHS Foundation Trust, London, United Kingdom
| | - Jamshed Bomanji
- University College London Hospitals, NHS Foundation Trust, London, United Kingdom
| | - Nicholas van As
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sue Chua
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Peter Hoskin
- Mount Vernon Cancer Centre, London, United Kingdom
| | | | - Gary J Cook
- King's College London and Guy's & St Thomas' PET Centre, St Thomas' Hospital, London, United Kingdom
| | - Victoria S Warbey
- King's College London and Guy's & St Thomas' PET Centre, St Thomas' Hospital, London, United Kingdom
| | - Sai Han
- West of Scotland PET Centre, Gartnavel General Hospital, Glasgow, United Kingdom
| | - Hing Y Leung
- Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom; CRUK Beatson Institute, Glasgow, United Kingdom
| | - Albert Chau
- Blue Earth Diagnostics, Oxford, United Kingdom
| | | | - Fergus V Gleeson
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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Chau A, Farber M. Do quantitative blood loss measurements and postpartum hemorrhage protocols actually make a difference? Yes, no, and maybe. Int J Obstet Anesth 2020; 42:1-3. [DOI: 10.1016/j.ijoa.2020.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/17/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
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Au K, Shippam W, Taylor J, Albert A, Chau A. Determining the effective pre‐oxygenation interval in obstetric patients using high‐flow nasal oxygen and standard flow rate facemask: a biased‐coin up–down sequential allocation trial. Anaesthesia 2020; 75:609-616. [DOI: 10.1111/anae.14995] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2019] [Indexed: 12/14/2022]
Affiliation(s)
- K. Au
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
| | - W. Shippam
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
| | - J. Taylor
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
| | - A. Albert
- Women's Health Research Institute Vancouver BC Canada
| | - A. Chau
- British Columbia Women's Hospital University of British Columbia Vancouver BC Canada
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Shippam W, Preston R, Douglas J, Chau A. Redefining endpoints with apnoeic oxygenation in pregnancy – better the devil you know than the devil you don't? Anaesthesia 2019; 74:1621-1622. [DOI: 10.1111/anae.14882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- W. Shippam
- British Columbia Women's Hospital Vancouver Canada
| | - R. Preston
- British Columbia Women's Hospital Vancouver Canada
| | - J. Douglas
- British Columbia Women's Hospital Vancouver Canada
| | - A. Chau
- British Columbia Women's Hospital Vancouver Canada
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Chau A, Petroni D. M104 INTERFERENCE OF INTERFERON BETA-1A WITH VENOM IMMUNOTHERAPY IN A PATIENT WITH MULTIPLE SCLEROSIS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.143] [Citation(s) in RCA: 1] [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: 11/25/2022]
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Bottomley D, Scarsbrook A, Teoh E, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook G, Chau A, Miller M, Gleeson F. Impact of Positron Emission Tomography (PET) with 18F-Fluciclovine on Management of Patients with Recurrence of Prostate Cancer: Results from the Falcon Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.128] [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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Manceau G, Mege D, Bridoux V, Lakkis Z, Venara A, Voron T, De Angelis N, Ouaissi M, Sielezneff I, Karoui M, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Tresallet C, Tetard O, Regimbeau JM, Sabbagh C, Rivier P, Fayssal E, Collard M, Moszkowicz D, Peschaud F, Etienne JC, loge L, Beyer L, Bege T, Corte H, D'Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Lefevre JH, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, De la Villeon B, Pautrat K, Eveno C, Brouquet A, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K. Thirty-day mortality after emergency surgery for obstructing colon cancer: survey and dedicated score from the French Surgical Association. Colorectal Dis 2019; 21:782-790. [PMID: 30884089 DOI: 10.1111/codi.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
Abstract
AIM The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. METHOD From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30-day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. RESULTS A total of 1983 patients were included. Thirty-day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right-sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30-day postoperative mortality was 0.80. CONCLUSION Thirty-day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - D Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - V Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - A Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - T Voron
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint Antoine Hospital, Sorbonne Université, Paris, France
| | - N De Angelis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Henri Mondor Hospital, Université Paris-Est (UEP), Créteil, France
| | - M Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - I Sielezneff
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
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Andriole GL, Kostakoglu L, Chau A, Duan F, Mahmood U, Mankoff DA, Schuster DM, Siegel BA. The Impact of Positron Emission Tomography with 18F-Fluciclovine on the Treatment of Biochemical Recurrence of Prostate Cancer: Results from the LOCATE Trial. J Urol 2019; 201:322-331. [PMID: 30179618 DOI: 10.1016/j.juro.2018.08.050] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The prospective, multicenter LOCATE (F Fluciclovine [FACBC] PET/CT in Patients with Rising PSA after Initial Prostate Cancer Treatment) trial assessed the impact of positron emission tomography/computerized tomography with F-fluciclovine on treatment plans in patients with biochemical recurrence of prostate cancer after primary therapy with curative intent. MATERIALS AND METHODS Men who had undergone curative intent treatment of histologically confirmed prostate cancer but who were suspected to have recurrence based on rising prostate specific antigen levels were enrolled prospectively. Each man had negative or equivocal findings on standard of care imaging. F-fluciclovine positron emission tomography/computerized tomography was performed according to standardized protocols. Treating physicians completed a questionnaire regarding the patient treatment plan before and after scanning, recording changes to the treatment modality (eg salvage radiotherapy to systemic androgen deprivation therapy) as major and changes in a modality (eg modified radiotherapy fields) as other. RESULTS Between June 2016 and May 2017, 213 evaluable patients with a median age of 67 years and median prostate specific antigen 1.00 ng/ml were enrolled in study. F-fluciclovine avid lesions were detected in 122 of the 213 patients (57%). Overall 126 of the 213 patients (59%) had a change in management after the scan, which were major in 98 of 126 (78%) and in 88 (70%) were informed by positive positron emission tomography/computerized tomography findings. The most frequent major changes were from salvage or noncurative systemic therapy to watchful waiting (32 of 126 cases or 25%), from noncurative systemic therapy to salvage therapy (30 of 126 or 24%) and from salvage therapy to noncurative systemic therapy (11 of 126 or 9%). CONCLUSIONS F-fluciclovine positron emission tomography/computerized tomography detected 1 or more recurrence sites in the majority of men with biochemical recurrence, frequently resulting in major changes to management plans. Future studies will be planned to determine whether a management change leads to improved outcomes.
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Affiliation(s)
- Gerald L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
| | - Lale Kostakoglu
- Division of Nuclear Medicine and Molecular Imaging, Icahn School of Medicine, Mount Sinai, New York, New York
| | - Albert Chau
- Blue Earth Diagnostics, Oxford, United Kingdom
| | - Fenghai Duan
- Department of Biostatistics and Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Umar Mahmood
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - David A Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Barry A Siegel
- Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
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Shippam W, Preston R, Douglas J, Taylor J, Albert A, Chau A. High-flow nasal oxygen vs. standard flow-rate facemask pre-oxygenation in pregnant patients: a randomised physiological study. Anaesthesia 2019; 74:450-456. [DOI: 10.1111/anae.14567] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 12/18/2022]
Affiliation(s)
- W. Shippam
- British Columbia Women's Hospital; Vancouver BC Canada
| | - R. Preston
- British Columbia Women's Hospital; Vancouver BC Canada
| | - J. Douglas
- University of British Columbia; Vancouver BC Canada
| | - J. Taylor
- British Columbia Women's Hospital; Vancouver BC Canada
| | - A. Albert
- Women's Health Research Institute; Vancouver BC Canada
| | - A. Chau
- British Columbia Women's Hospital; Vancouver BC Canada
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Miller M, Langen KJ, Prasad V, Yakushev I, Gerber J, Bronzel M, Meyer T, Chau A, Stevens D, Chisholm D, Kluge A. NIMG-01. A BLINDED IMAGE EVALUATION STUDY TO DETERMINE THE DIAGNOSTIC EFFICACY OF 18F-FLUCICLOVINE PET, AS AN ADJUNCT TO MRI IMAGING, IN ADULTS WITH GLIOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.730] [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: 11/12/2022] Open
Affiliation(s)
- Matthew Miller
- Blue Earth Diagnostics (BED), Oxford, England, United Kingdom
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-3, -4), Forschungszentrum Juelich, Juelich, Germany
| | - Vikas Prasad
- Department of Nuclear Medicine and Theranostic Group, Uniklinik Ulm, Ulm, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Johannes Gerber
- Neuroradiology, University Hospital Carl Gustav Carus, Dresden, Germany
| | | | | | - Albert Chau
- Blue Earth Diagnostics (BED), Oxford, England, United Kingdom
| | - Dan Stevens
- Blue Earth Diagnostics (BED), Oxford, England, United Kingdom
| | - Diane Chisholm
- Blue Earth Diagnostics (BED), Oxford, England, United Kingdom
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Abstract
Sepsis remains a leading cause of maternal morbidity and mortality. Recognition and treatment of maternal sepsis are often delayed due to the physiological adaptations of pregnancy and vague or absent signs and symptoms during its initial presentation. Over the past decade, our understanding of sepsis has evolved and maternal early warning systems have been developed in an effort to help providers promptly identify and stratify parturients who are at risk. In addition, new consensus definitions and care bundles have recently been published by the World Health Organization and the Surviving Sepsis Campaign to facilitate earlier recognition and timely management of sepsis. In this narrative review, we summarize the available evidence about sepsis and provide an overview of the research efforts focused on maternal sepsis to date. Controversies and challenges surrounding the anesthetic management of parturients with sepsis or at risk of developing sepsis during pregnancy or the puerperium will be highlighted.
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Affiliation(s)
- C E G Burlinson
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - D Sirounis
- Division of Critical Care Medicine, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - K R Walley
- Division of Critical Care Medicine, Department of Medicine, St. Paul's Hospital, Vancouver, BC, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - A Chau
- Department of Anesthesia, British Columbia Women's Hospital, Vancouver, BC, Canada; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada.
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Cleveland H, Hernandez J, Ashton D, Chau A, Nagaraj A, Pimpalwar S. 3:36 PM Abstract No. 115 Portal vein recanalizations in pediatric liver transplant patients: single-center experience. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.131] [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] Open
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Teoh EJ, Bottomley DM, Scarsbrook A, Payne H, Afaq A, Bomanji J, Van As N, Chua S, Hoskin P, Chambers A, Cook GJ, Warbey VS, Chau A, Ward P, Miller MP, Stevens DJ, Wilson L, Gleeson FV. The FALCON trial: Impact of 18F-fluciclovine PET/CT on clinical management choices for men with biochemically recurrent prostate cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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
165 Background: Detection of the extent of local recurrence and of metastases in biochemical recurrence (BCR) of prostate cancer facilitates selection of appropriate treatment. The FALCON trial (NCT02578940) assessed the impact of 18F-fluciclovine PET/CT on the clinical management of men with BCR of prostate cancer following initial radical therapy. Methods: Men being considered for curative-intent salvage therapy following first BCR were recruited at 6 UK sites. Management plans were documented prior to and following 18F-fluciclovine PET/CT imaging. Post-scan changes to treatment modality such as salvage radiotherapy [RT] to systemic therapy were classed as ‘major’, while changes within a modality (e.g. modified RT fields) were classed as ‘other’. A pre-planned interim analysis of the first 85 patients was conducted; recruitment was to be stopped for efficacy if the number of treatment changes was > 45 (52.9%; 97.5% CI: 40.3–62.3%), or for futility if ≤ 8 (9.4%, 97.5% CI: 3.6–18.9%). Results: The 85 enrolled patients were a mean 4.8 y post-initial diagnosis, with a median age of 67 y and median PSA of 0.63ng/mL. Twelve (14.1%) had a Gleason score ≤ 6, 60 (70.6%) had a score of 7 and 13 (15.3%) had a score ≥ 8. Most (56; 65.9%) had previously undergone radical prostatectomy (RP), with 27 having received RT (± other therapy). The majority of those imaged (52; 61.2%) had a change in management (CIM) post-scan (Table). Recruitment was subsequently stopped as the pre-specified condition defining overwhelming efficacy was met. Conclusions: This prospective trial shows 18F-fluciclovine PET/CT has substantial impact on clinical decisions for men with a first BCR of prostate cancer after curative-intent primary therapy. Clinical trial information: NCT02578940. [Table: see text]
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Affiliation(s)
- Eugene Jueren Teoh
- Oxford University Hospitals/ NHS Foundation Trust, Oxford, United Kingdom
| | | | | | | | - Asim Afaq
- University College London, London, United Kingdom
| | | | - Nick Van As
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sue Chua
- Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Peter Hoskin
- Mount Vernon Cancer Centre, London, United Kingdom
| | | | | | | | - Albert Chau
- Blue Earth Diagnostics, Oxford, United Kingdom
| | | | | | | | - Lynn Wilson
- Blue Earth Diagnostics, Oxford, United Kingdom
| | - Fergus V. Gleeson
- Oxford University Hospitals/ NHS Foundation Trust, Oxford, United Kingdom
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Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Teoh EJ, Bottomley D, Scarsbrook A, Payne H, Afaq A, Bomanji J, van As N, Chua S, Hoskin P, Chambers A, Cook GJ, Warbey VS, Chau A, Ward P, Miller MP, Stevens DJ, Wilson L, Gleeson FV, Scheidhauer K, Seidl C, Autenrieth M, Bruchertseifer F, Apostolidis C, Kurtz F, Horn T, Pfob C, Schwaiger M, Gschwend J, D'Alessandria C, Morgenstern A, Uprimny C, Kroiss A, Decristoforo C, von Guggenberg E, Nilica B, Horninger W, Virgolini I, Rasul S, Poetsch N, Woehrer A, Preusser M, Mitterhauser M, Wadsak W, Widhalm G, Mischkulnig M, Hacker M, Traub-Weidinger T, Wright CL, Binzel K, Wuthrick EJ, Miller ED, Maniawski P, Zhang J, Knopp MV, Rep S, Hocevar M, Vaupotic J, Zdesar U, Zaletel K, Lezaic L, Mairinger S, Filip T, Sauberer M, Flunkert S, Wanek T, Stanek J, Okamura N, Langer O, Kuntner C, Fornito MC, Balzano R, Di Martino V, Cacciaguerra S, Russo G, Seifert D, Kleinova M, Cepa A, Ralis J, Hanc P, Lebeda O, Mosa M, Vandenberghe S, Mikhaylova E, Borys D, Viswanath V, Stockhoff M, Efthimiou N, Caribe P, Van Holen R, Karp JS, Binzel K, Zhang J, Wright CL, Maniawski P, Knopp MV, Haller PM, Farhan C, Piackova E, Jäger B, Knoll P, Kiss A, Podesser BK, Wojta J, Huber K, Mirzaei S, Traxl A, Komposch K, Glitzner E, Wanek T, Mairinger S, Sibilia M, Langer O, Fornito MC, Russello M, Russo G, Balzano R, Sorko S, Gallowitsch HJ, Kohlfuerst S, Matschnig S, Rieser M, Sorschag M, Lind P, Ležaič L, Rep S, Žibert J, Frelih N, Šuštar S, Binzel K, Adelaja A, Wright CL, Scharre D, Zhang J, Knopp MV, Baum RP, Langbein T, Singh A, Shahinfar M, Schuchardt C, Volk GF, Kulkarni HR, Fornito MC, Cacciaguerra S, Balzano R, Di Martino GV, Russo G, Thomson WH, Kudlacek M, Karik M, Farhan C, Rieger H, Pokieser W, Glaser K, Mirzaei S, Petz V, Tugendsam C, Buchinger W, Schmoll-Hauer B, Schenk IP, Rudolph K, Krebs M, Zettinig G, Zoufal V, Wanek T, Krohn M, Mairinger S, Stanek J, Sauberer M, Filip T, Pahnke J, Langer O, Weitzer F, Pernthaler B, Salamon S, Aigner R, Koranda P, Henzlová L, Kamínek M, Váchalová M, Bachleda P, Summer D, Garousi J, Oroujeni M, Mitran B, Andersson KG, Vorobyeva A, Löfblom JN, Orlova A, Tolmachev V, Decristoforo C, Kaeopookum P, Summer D, Orasch T, Lechner B, Petrik M, Novy Z, Rangger C, Haas H, Decristoforo C. Abstracts of the 33rd International Austrian Winter Symposium : Zell am See, Austria. 24-27 January 2018. EJNMMI Res 2018; 8:5. [PMID: 29362999 PMCID: PMC5780335 DOI: 10.1186/s13550-017-0354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E J Teoh
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - D Bottomley
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Scarsbrook
- The Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Payne
- University College London, London, UK
| | - A Afaq
- University College London, London, UK
| | - J Bomanji
- University College London, London, UK
| | - N van As
- The Royal Marsden NHS Foundation Trust, London, UK
| | - S Chua
- The Royal Marsden NHS Foundation Trust, London, UK
| | - P Hoskin
- Mount Vernon Cancer Centre, London, UK
| | | | - G J Cook
- King's College London, London, UK
| | | | - A Chau
- Blue Earth Diagnostics, Oxford, UK
| | - P Ward
- Blue Earth Diagnostics, Oxford, UK
| | | | | | - L Wilson
- Blue Earth Diagnostics, Oxford, UK
| | - F V Gleeson
- Departments of Radiology and Nuclear Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K Scheidhauer
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - C Seidl
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Autenrieth
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | | | | | - F Kurtz
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - T Horn
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C Pfob
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - M Schwaiger
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | - J Gschwend
- TU München, Klinikum rechts der Isar, Urologie, München, Germany
| | - C D'Alessandria
- TU München, Klinikum rechts der Isar, Nuklearmedizin, München, Germany
| | | | - C Uprimny
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - A Kroiss
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - E von Guggenberg
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - B Nilica
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - W Horninger
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - I Virgolini
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 32, 6020, Innsbruck, Austria
| | - S Rasul
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - N Poetsch
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - A Woehrer
- Clinical Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Preusser
- Clinical University of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - M Mitterhauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - W Wadsak
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
- CBmed GmbH, Center for Biomarker Research in Medicine, Graz, Austria
| | - G Widhalm
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Mischkulnig
- Clinical University of Neuro-surgery, Medical University of Vienna, Vienna, Austria
| | - M Hacker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - T Traub-Weidinger
- Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - C L Wright
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - K Binzel
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - E J Wuthrick
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - E D Miller
- Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - P Maniawski
- Clinical Science, Philips Healthcare, Cleveland, OH, USA
| | - J Zhang
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation, The Ohio State University, Columbus, OH, USA
| | - Sebastijan Rep
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marko Hocevar
- Department of Oncological Surgery, Oncology Institute Ljubljana, Ljubljana, Slovenia
| | | | - Urban Zdesar
- Institute of Occupational Safety Ljubljana, Ljubljana, Slovenia
| | - Katja Zaletel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Luka Lezaic
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Mairinger
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - Thomas Filip
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sauberer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Flunkert
- Neuropharmacology, QPS Austria GmbH, Grambach, Austria
| | - T Wanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - N Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - O Langer
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - C Kuntner
- Biomedical Systems, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - V Di Martino
- Nuclear Medicine Department PET/TC center Arnas Garibaldi Catania, Catania, Italy
| | - S Cacciaguerra
- Pediatric Surgery Department Arnas Garibaldi Catania, Catania, Italy
| | - G Russo
- H. Pharmacy Department Arnas Garibaldi Catania, Catania, Italy
| | - D Seifert
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Kleinova
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - A Cepa
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - J Ralis
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - P Hanc
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - O Lebeda
- Nuclear Physics Institute of the CAS, Rez, Czech Republic
| | - M Mosa
- Charles university Faculty of Science Prague, Prague, Czech Republic
| | - S Vandenberghe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | | | - D Borys
- Silesian University of Technology Gliwice, Gliwice, Poland
| | - V Viswanath
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - M Stockhoff
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - N Efthimiou
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - P Caribe
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - R Van Holen
- MEDISIP research group, Ghent University, Ghent, Belgium
| | - J S Karp
- PET instrumentation group, Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - P M Haller
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - C Farhan
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - E Piackova
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
| | - B Jäger
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - P Knoll
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Kiss
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - B K Podesser
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Biomedical Research, Medical University of Vienna, Vienna, Austria
| | - J Wojta
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria
| | - K Huber
- 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Chest Pain Unit, Wilhelminenhospital Vienna, Vienna, Austria
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
- Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - S Mirzaei
- Department of Nuclear Medicine with PET-Center, Wilhelminenhospital, Vienna, Austria
| | - A Traxl
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - K Komposch
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Glitzner
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - T Wanek
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - S Mairinger
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Sibilia
- Institute of Cancer Research, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - O Langer
- Center for Health & Bioresources, Biomedical Systems, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - M C Fornito
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - M Russello
- Liver Unit ARNAS Garibaldi, Catania, Italy
| | - G Russo
- H.Pharmacy Department ARNAS Garibaldi, Catania, Italy
| | - R Balzano
- Nuclear Medicine Department PET/TC Center ARNAS Garibaldi, Catania, Italy
| | - S Sorko
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - H J Gallowitsch
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Kohlfuerst
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - S Matschnig
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Rieser
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - M Sorschag
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - P Lind
- Department of Nuclear Medicine and Endocrinology, PET/CT Center, Klinikum Klagenfurt, Klagenfurt, Austria
| | - L Ležaič
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Rep
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - J Žibert
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - N Frelih
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - S Šuštar
- Departments of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - K Binzel
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - A Adelaja
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - C L Wright
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - D Scharre
- Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Zhang
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - M V Knopp
- Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - R P Baum
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - T Langbein
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - A Singh
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M Shahinfar
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - C Schuchardt
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - G F Volk
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - H R Kulkarni
- Theranostics Center for Molecular Radiotherapy and Molecular ImagZentralklinik Bad Berka, Bad Berka, Germany
| | - M C Fornito
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | | | - R Balzano
- Nuclear Medicine Department Arnas Garibaldi, Catania, Italy
| | - G V Di Martino
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - G Russo
- Pharmacy H. Department Arnas Garibaldi, Catania, Italy
| | - W H Thomson
- Physics and Nuclear Medicine, City Hospital, Birmingham, UK
| | - M Kudlacek
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - M Karik
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - C Farhan
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - H Rieger
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - W Pokieser
- Institute of Pathology and Microbiology, Wilhelminenspital, Vienna, Austria
| | - K Glaser
- Department of Viceral and General Surgery, Wilhelminenspital, Vienna, Austria
| | - S Mirzaei
- Institute of Nuclear Medicine with PET-Center, Wilhelminenspital, Vienna, Austria
| | - V Petz
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - C Tugendsam
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - W Buchinger
- Schilddrueseninstitut Gleisdorf, Gleisdorf, Austria
| | - B Schmoll-Hauer
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Krankenanstalt Rudolfstiftung, Vienna, Austria
| | - I P Schenk
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Department of Nuclear Medicine, Sozialmedizinisches Zentrum Hietzing, Vienna, Austria
| | - K Rudolph
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - M Krebs
- Schilddruesenpraxis Josefstadt, Vienna, Austria
- Clinical Division of Endocrinology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - G Zettinig
- Schilddruesenpraxis Josefstadt, Vienna, Austria
| | - V Zoufal
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Wanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - M Krohn
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - S Mairinger
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Stanek
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - M Sauberer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - T Filip
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
| | - J Pahnke
- Department of Neuro-/Pathology, University of Oslo (UiO) and Oslo University Hospital (OUS), Oslo, Norway
| | - O Langer
- Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Seibersdorf, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - F Weitzer
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - B Pernthaler
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - S Salamon
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - R Aigner
- Meduni Graz, Univ. Klinik für Radiologie, Abteilung für Nuklearmedizin, Graz, Austria
| | - P Koranda
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - L Henzlová
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - M Kamínek
- Department of Nuclear Medicine, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - Mo Váchalová
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - P Bachleda
- Department of Vascular and Transplantation Surgery, University Hospital Olomouc and Palacky University, Olomouc, Czech Republic
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - J Garousi
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - M Oroujeni
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - B Mitran
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - K G Andersson
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Vorobyeva
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - J N Löfblom
- Division of Protein Technology, KTH Royal Institute of Technology, SE-10691, Stockholm, Sweden
| | - A Orlova
- Division of Molecular Imaging, Department of Medicinal Chemistry, Uppsala University, SE-751 83, Uppsala, Sweden
| | - V Tolmachev
- Institute of Immunology, Genetic and Pathology, Uppsala University, SE-75185, Uppsala, Sweden
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - P Kaeopookum
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
- Research and Development Division, Thailand Institute of Nuclear Technology, Nakhonnayok, Thailand
| | - D Summer
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - T Orasch
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - B Lechner
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - M Petrik
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - Z Novy
- Faculty of Medicine and Dentistry, Institute of Molecular and Translation Medicine, Palacky University, Olomouc, Czech Republic
| | - C Rangger
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - H Haas
- Division of Molecular Biology, Biocenter, Medical University Innsbruck, Innsbruck, Austria
| | - C Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
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Chau A, Jongco A. P266 Allogenic hematopoietic stem cell transplant in a patient with mast cell activation syndrome. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.182] [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: 10/18/2022]
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Chau A, Fang Y, Wong A, Yu R, Woo J. SOCIAL CONNECTIONS MEDIATE THE ASSOCIATION BETWEEN FRAILTY AND MEANING IN LIFE FOR OLDER PEOPLE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2027] [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: 11/13/2022] Open
Affiliation(s)
- A. Chau
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Y. Fang
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - A. Wong
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - R. Yu
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - J. Woo
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Teutsch P, Opel R, Chau A, Cayton J, Akins D, Lim M. 0279 SLEEP AND BEHAVIORAL PHENOTYPE OF A COMBINED MOUSE MODEL OF TBI AND PTSD. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.278] [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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Miller MP, Kostakoglu L, Pryma D, Yu JQ, Chau A, Perlman E, Clarke B, Rosen D, Ward P. Reader Training for the Restaging of Biochemically Recurrent Prostate Cancer Using 18F-Fluciclovine PET/CT. J Nucl Med 2017; 58:1596-1602. [PMID: 28385791 DOI: 10.2967/jnumed.116.188375] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 12/08/2016] [Accepted: 03/22/2017] [Indexed: 12/18/2022] Open
Abstract
18F-Fluciclovine is a novel PET/CT tracer. This blinded image evaluation (BIE) sought to demonstrate that, after limited training, readers naïve to 18F-fluciclovine could interpret 18F-fluciclovine images from subjects with biochemically recurrent prostate cancer with acceptable diagnostic performance and reproducibility. The primary objectives were to establish individual readers' diagnostic performance and the overall interpretation (2/3 reader concordance) compared with standard-of-truth data (histopathology or clinical follow-up) and to evaluate interreader reproducibility. Secondary objectives included comparison to the expert reader and assessment of intrareader reproducibility. Methods:18F-Fluciclovine PET/CT images (n = 121) and corresponding standard-of-truth data were collected from 110 subjects at Emory University using a single-time-point static acquisition starting 5 min after injection of approximately 370 MBq of 18F-fluciclovine. Three readers were trained using standardized interpretation methodology and subsequently evaluated the images in a blinded manner. Analyses were conducted at the lesion, region (prostate, including bed and seminal vesicle, or extraprostatic, including all lymph nodes, bone, or soft-tissue metastasis), and subject level. Results: Lesion-level overall positive predictive value was 70.5%. The readers' positive predictive value and negative predictive value were broadly consistent with each other and with the onsite read. Sensitivity was highest for readers 1 and 2 (68.5% and 63.9%, respectively) whereas specificity was highest for reader 3 (83.6%). Overall, prostate-level sensitivity was high (91.4%), but specificity was moderate (48.7%). Interreader agreement was 94.7%, 74.4%, and 70.3% for the lesion, prostate, and extraprostatic levels, respectively, with associated Fleiss' κ-values of 0.54, 0.50, and 0.57. Intrareader agreement was 97.8%, 96.9%, and 99.1% at the lesion level; 100%, 100%, and 91.7% in the prostate region; and 83.3%, 75.0%, and 83.3% in the extraprostatic region for readers 1, 2, and 3, respectively. Concordance between the BIE and the onsite reader exceeded 75% for each reader at the lesion, region, and subject levels. Conclusion: Specific training in the use of standardized interpretation methodology for assessment of 18F-fluciclovine PET/CT images enables naïve readers to achieve acceptable diagnostic performance and reproducibility when staging recurrent prostate cancer.
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Affiliation(s)
| | - Lale Kostakoglu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Daniel Pryma
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jian Qin Yu
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Albert Chau
- Blue Earth Diagnostics (BED), Oxford, United Kingdom
| | - Eric Perlman
- American College of Radiology, Philadelphia, Pennsylvania; and
| | - Bonnie Clarke
- Society of Nuclear Medicine and Molecular Imaging Clinical Trials Network, Reston, Virginia
| | - Donald Rosen
- American College of Radiology, Philadelphia, Pennsylvania; and
| | - Penelope Ward
- Blue Earth Diagnostics (BED), Oxford, United Kingdom
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Zanoni L, Nanni C, Bach-Gansmo T, Bogsrud TV, Nieh P, Kieboom J, Korsan KA, Sletten H, Tade FI, Odewole O, Ward P, Chau A, Goodman M, Fanti S, Schuster DM, Willoch F. Multisite experience of fluciclovine ( 18F) PET/CT imaging in biochemically recurrent prostate cancer: Impact of clinical factors and intersite variation. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.6_suppl.163] [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: 11/20/2022] Open
Abstract
163 Background: Fluciclovine (18F) is an FDA-approved positron emission tomography/computerized tomography (PET/CT) tracer in clinical use for the detection and localization of biochemically recurrent (BCR) prostate cancer. Here, we report the impact of clinical factors and study site on its performance. Methods: In total, 596 subjects with BCR prostate cancer underwent fluciclovine (18F) PET/CT scanning at four sites in Italy, Norway and USA. Detection Rates (DR), including region level analyses, were stratified by prostate specific antigen (PSA) levels, PSA doubling time (PSAdt), Gleason score (GS), and by investigator/site. Extra-prostatic disease was defined as all positivity outside of residual prostate, prostate bed and seminal vesicles. Results: Fluciclovine (18F) PET/CT was positive in 67.7% (403/595) of subjects. Positive findings were detected in the prostate/bed and pelvic lymph node regions in 38.7% (232/599) and 32.6% (194/596) of scans, respectively. Metastatic involvement outside the pelvis was found in 26.2% (155/591) of scans. Generally, DR increased with increasing baseline PSA (Table 1). While subject level DR did not vary significantly with PSAdt (DR = 60-69% across all categories), a positive extra-prostatic scan was more likely in patients with shorter PSAdt (DR = 52%, 48%, 37% and 28% for PSAdt <3, 3-<6, 6-<12 and >12 months, respectively). Among 361 subjects for whom baseline GS was available, scores ≥9 were associated with the highest extra-prostatic DR (55%) compared with 23% in patients with GS ≤6. Inter-site variations in acquisition protocols may have impacted DR at low baseline PSA values; with subject level DR at PSA >0.2-0.5 ng/ml = 20%, 38%, 46% and 73% at site A, B, C and D, respectively. Conclusions: Fluciclovine (18F) can detect and localize BCR prostate cancer in a wide range of subjects and, with appropriate imaging protocols, has a clinically useful DR at PSA <0.5 ng/ml. Clinical trial information: NCT02443571. [Table: see text]
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Affiliation(s)
- Lucia Zanoni
- Nuclear Medicine, Azienda ospedaliero-universitaria di Bologna, Policlinico Sant'OrsolaMalpighi, Bologna, Italy
| | - Christina Nanni
- Nuclear Medicine, Azienda ospedaliero-universitaria di Bologna, Policlinico Sant'OrsolaMalpighi, Bologna, Italy
| | | | - Trond V Bogsrud
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Jesse Kieboom
- Department of Nuclear Medicine and Radiology, Aleris Healthcare, Oslo, Norway
| | | | - Heidi Sletten
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Funmilayo I Tade
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | - Oluwaseun Odewole
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA
| | - Penny Ward
- Blue Earth Diagnostics, Oxford, United Kingdom
| | - Albert Chau
- Blue Earth Diagnostics, Oxford, United Kingdom
| | - Mark Goodman
- Department of Radiology and Imaging Sciences, Atlanta, GA
| | - Stefano Fanti
- Nuclear Medicine Unit, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - David M. Schuster
- Nuclear Medicine and Molecular Imaging, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA
| | - Frode Willoch
- Institute of Basic Medical Sciences of The Faculty of Medicine, University of Oslo, Oslo, Norway
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Chau A, Kukreja K, Hernandez J, Pimpalwar S, Ashton D. Myth busting the stigma of portable primary placement tunneled femoral vein central lines in children. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.592] [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: 11/24/2022] Open
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Bach-Gansmo T, Nanni C, Nieh PT, Zanoni L, Bogsrud TV, Sletten H, Korsan KA, Kieboom J, Tade FI, Odewole O, Chau A, Ward P, Goodman MM, Fanti S, Schuster DM, Willoch F. Multisite Experience of the Safety, Detection Rate and Diagnostic Performance of Fluciclovine ( 18F) Positron Emission Tomography/Computerized Tomography Imaging in the Staging of Biochemically Recurrent Prostate Cancer. J Urol 2016; 197:676-683. [PMID: 27746282 DOI: 10.1016/j.juro.2016.09.117] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [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: 09/09/2016] [Indexed: 01/16/2023]
Abstract
PURPOSE Sensitive detection of cancer foci in men experiencing biochemical recurrence following initial treatment of prostate cancer is of great clinical significance with a possible impact on subsequent treatment choice. We describe a multisite experience of the efficacy and safety of the positron emission tomography/computerized tomography agent fluciclovine (18F) after biochemical recurrence. MATERIALS AND METHODS A total of 596 patients underwent fluciclovine (18F) positron emission tomography/computerized tomography at 4 clinical sites. Detection rate determinations were stratified by the baseline prostate specific antigen value. Diagnostic performance was assessed against a histological reference standard in 143 scans. RESULTS The subject level fluciclovine (18F) positron emission tomography/computer tomography detection rate was 67.7% (403 of 595 scans). Positive findings were detected in the prostate/bed and pelvic lymph node regions in 38.7% (232 of 599) and 32.6% of scans (194 of 596), respectively. Metastatic involvement outside the pelvis was detected in 26.2% of scans (155 of 591). The subject level detection rate in patients in the lowest quartile for baseline prostate specific antigen (0.79 ng/ml or less) was 41.4% (53 of 128). Of these patients 13 had involvement in the prostate/bed only, 16 had pelvic lymph node involvement without distant disease and 24 had distant metastases. The positive predictive value of fluciclovine (18F) positron emission tomography/computerized tomography scanning for all sampled lesions was 62.2%, and it was 92.3% and 71.8% for extraprostatic and prostate/bed involvement, respectively. Fluciclovine (18F) was well tolerated and the safety profile was not altered following repeat administration. CONCLUSIONS Fluciclovine (18F) is well tolerated and able to detect local and distant prostate cancer recurrence across a wide range of prostate specific antigen values.
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Affiliation(s)
- Tore Bach-Gansmo
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
| | - Cristina Nanni
- Nuclear Medicine, Azienda ospedaliero-universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Peter T Nieh
- Department of Urology, Emory University, Atlanta, Georgia
| | - Lucia Zanoni
- Nuclear Medicine, Azienda ospedaliero-universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Tronde Velde Bogsrud
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Heidi Sletten
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - J Kieboom
- Department of Nuclear Medicine and Radiology, Aleris Healthcare, Oslo, Norway
| | - Funmilayo I Tade
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Oluwaseun Odewole
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Albert Chau
- Blue Earth Diagnostics, Oxford, United Kingdom
| | | | - Mark M Goodman
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Stefano Fanti
- Nuclear Medicine, Azienda ospedaliero-universitaria di Bologna, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - David M Schuster
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Frode Willoch
- Department of Nuclear Medicine and Radiology, Aleris Healthcare, Oslo, Norway; Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Bach-Gansmo T, Nanni C, Nieh P, Zanoni L, Bogsrud T, Sletten H, Korsan K, Kieboom J, Chau A, Ward P, Willoch F, Goodman M, Fanti S, Schuster D. Staging of Biochemically Relapsing Prostate Cancer Using the Positron Emission Tomography Tracer Fluciclovine F18. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Chau A, Frasson M, Debove C, Maggiori L, Panis Y. Colonic prolapse after intersphincteric resection for very low rectal cancer: a report of 12 cases. Tech Coloproctol 2016; 20:701-5. [PMID: 27631305 DOI: 10.1007/s10151-016-1522-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/12/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are no published data concerning management of patients with exteriorized colonic prolapse (CP) after intersphincteric rectal resection (ISR) and side-to-end coloanal manual anastomosis (CAA) for very low rectal cancer. The aim of the present study was to report our experience in 12 consecutive cases of CP following ISR with CAA. METHODS From 2006 to 2014, all patients with very low rectal cancer who developed CP after ISR and CAA were reviewed. Demographic and surgical data, prolapse symptoms and treatment were recorded. Postoperative morbidity, functional outcomes and results after prolapse surgery were recorded. RESULTS Twelve out of 143 patients (8 %) who underwent ISR with side-to-end CAA for low rectal cancer presented CP: 7/107 ISR (7 %) with partial resection of the internal anal sphincter (IAS) and 5/36 ISR (14 %) with subtotal or total resection of the IAS (NS). CP was diagnosed after a median of 6 months (range 2-72 months) after ISR. All patients with CP suffered from pain and fecal incontinence. Median Wexner fecal incontinence score before surgery was 16.5 (range 12-20). Three patients refused reoperation. Nine patients underwent transanal surgery with prolapse resection (including colonic stump and side-to-end anastomosis) and new end-to-end CAA (with posterior myorraphy in 4 cases). After a median follow-up of 30 months (range 8-87 months), 3/9 patients (33 %) had CP recurrence: One with very poor function was treated by abdominoperineal resection and definitive stoma. The 2 others were successfully reoperated on transanally. Median Wexner fecal incontinence score after CP surgery was 9 (range 0-20). No CP recurrence was noted for the 6 other patients, and function improved in all cases. Thus, at the end of follow-up, 8/9 patients (89 %) had no recurrence after surgery. CONCLUSIONS We believe surgery must be attempted in these patients who develop CP after ISR with CAA for very low rectal cancer in order to improve function and symptoms. A transanal approach with CP resection and new end-to-end anastomosis appeared to be safe and effective. Larger studies are needed to confirm our results.
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Affiliation(s)
- A Chau
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France
| | - M Frasson
- Coloproctology Unit, University Hospital La Fe, Valencia, Spain
| | - C Debove
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France
| | - L Maggiori
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France
| | - Y Panis
- Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif, Hôpital Beaujon - Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, 92110, Clichy, France.
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Chau A, Markley J, Juang J, Tsen L. Cytokines in the perinatal period – Part I. Int J Obstet Anesth 2016; 26:39-47. [DOI: 10.1016/j.ijoa.2015.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/28/2015] [Accepted: 12/22/2015] [Indexed: 01/18/2023]
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Chau A, Markley J, Juang J, Tsen L. Cytokines in the perinatal period – Part II. Int J Obstet Anesth 2016; 26:48-58. [DOI: 10.1016/j.ijoa.2015.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/28/2015] [Accepted: 12/22/2015] [Indexed: 11/29/2022]
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Hogeveen J, Bird G, Chau A, Krueger F, Grafman J. Acquired alexithymia following damage to the anterior insula. Neuropsychologia 2016; 82:142-148. [PMID: 26801227 PMCID: PMC4752907 DOI: 10.1016/j.neuropsychologia.2016.01.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/06/2016] [Accepted: 01/17/2016] [Indexed: 12/31/2022]
Abstract
Alexithymia is a subclinical condition characterized by impaired awareness of one's emotional states, which has profound effects on mental health and social interaction. Despite the clinical significance of this condition, the neurocognitive impairment(s) that lead to alexithymia remain unclear. Recent theoretical models suggest that impaired anterior insula (AI) functioning might be involved in alexithymia, but conclusive evidence for this hypothesis is lacking. We measured alexithymia levels in a large sample of brain-injured patients (N=129) and non-brain-injured control participants (N=33), to determine whether alexithymia can be acquired after pronounced damage to the AI. Alexithymia levels were first analysed as a function of group, with patients separated into four groups based on AI damage: patients with >15% damage to AI, patients with <15% damage to AI, patients with no damage to AI, and healthy controls. An ANOVA revealed that alexithymia levels varied across groups (p=0.009), with >15% AI damage causing higher alexithymia relative to all other groups (all p<0.01). Next, a multiple linear regression model was fit with the degree of damage to AI, the degree of damage to a related region (the anterior cingulate cortex, ACC), and the degree of damage to the whole brain as predictor variables, and alexithymia as the dependent variable. Critically, increased AI damage predicted increased alexithymia after controlling for the other two regressors (ACC damage; total lesion volume). Collectively, our results suggest that pronounced AI damage causes increased levels of alexithymia, providing critical evidence that this region supports emotional awareness.
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Affiliation(s)
- J Hogeveen
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - G Bird
- MRC Social, Genetic, and Developmental Psychology Centre, King's College London, London, United Kingdom; Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - A Chau
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA
| | - F Krueger
- Molecular Neuroscience Department, George Mason University, Fairfax, VA, USA; Department of Psychology, George Mason University, Fairfax, VA, USA
| | - J Grafman
- Cognitive Neuroscience Laboratory, Rehabilitation Institute of Chicago, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Neurology, Feinberg School of Medicine, Northwestern University, USA.
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