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Amankwah YS, Fleifil Y, Unruh E, Collins P, Wang Y, Vitou K, Bates A, Obaseki I, Sugoor M, Alao JP, McCarrick RM, Gewirth DT, Sahu ID, Li Z, Lorigan GA, Kravats AN. Structural transitions modulate the chaperone activities of Grp94. Proc Natl Acad Sci U S A 2024; 121:e2309326121. [PMID: 38483986 PMCID: PMC10962938 DOI: 10.1073/pnas.2309326121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/30/2024] [Indexed: 03/17/2024] Open
Abstract
Hsp90s are ATP-dependent chaperones that collaborate with co-chaperones and Hsp70s to remodel client proteins. Grp94 is the ER Hsp90 homolog essential for folding multiple secretory and membrane proteins. Grp94 interacts with the ER Hsp70, BiP, although the collaboration of the ER chaperones in protein remodeling is not well understood. Grp94 undergoes large-scale conformational changes that are coupled to chaperone activity. Within Grp94, a region called the pre-N domain suppresses ATP hydrolysis and conformational transitions to the active chaperone conformation. In this work, we combined in vivo and in vitro functional assays and structural studies to characterize the chaperone mechanism of Grp94. We show that Grp94 directly collaborates with the BiP chaperone system to fold clients. Grp94's pre-N domain is not necessary for Grp94-client interactions. The folding of some Grp94 clients does not require direct interactions between Grp94 and BiP in vivo, suggesting that the canonical collaboration may not be a general chaperone mechanism for Grp94. The BiP co-chaperone DnaJB11 promotes the interaction between Grp94 and BiP, relieving the pre-N domain suppression of Grp94's ATP hydrolysis activity. In structural studies, we find that ATP binding by Grp94 alters the ATP lid conformation, while BiP binding stabilizes a partially closed Grp94 intermediate. Together, BiP and ATP push Grp94 into the active closed conformation for client folding. We also find that nucleotide binding reduces Grp94's affinity for clients, which is important for productive client folding. Alteration of client affinity by nucleotide binding may be a conserved chaperone mechanism for a subset of ER chaperones.
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Affiliation(s)
- Yaa S. Amankwah
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
- Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH43210
| | - Yasmeen Fleifil
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | - Erin Unruh
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
- Cell, Molecular, and Structural Biology Graduate Program, Miami University, Oxford, OH45056
| | - Preston Collins
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | - Yi Wang
- Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH43210
| | - Katherine Vitou
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | - Alison Bates
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | - Ikponwmosa Obaseki
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | - Meghana Sugoor
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | - John Paul Alao
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
| | | | | | - Indra D. Sahu
- Natural Sciences Division, Campbellsville University, Campbellsville, KY42718
| | - Zihai Li
- Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH43210
| | - Gary. A. Lorigan
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
- Cell, Molecular, and Structural Biology Graduate Program, Miami University, Oxford, OH45056
| | - Andrea N. Kravats
- Department of Chemistry and Biochemistry, Miami University, Oxford, OH45056
- Cell, Molecular, and Structural Biology Graduate Program, Miami University, Oxford, OH45056
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Raman B, McCracken C, Cassar MP, Moss AJ, Finnigan L, Samat AHA, Ogbole G, Tunnicliffe EM, Alfaro-Almagro F, Menke R, Xie C, Gleeson F, Lukaschuk E, Lamlum H, McGlynn K, Popescu IA, Sanders ZB, Saunders LC, Piechnik SK, Ferreira VM, Nikolaidou C, Rahman NM, Ho LP, Harris VC, Shikotra A, Singapuri A, Pfeffer P, Manisty C, Kon OM, Beggs M, O'Regan DP, Fuld J, Weir-McCall JR, Parekh D, Steeds R, Poinasamy K, Cuthbertson DJ, Kemp GJ, Semple MG, Horsley A, Miller CA, O'Brien C, Shah AM, Chiribiri A, Leavy OC, Richardson M, Elneima O, McAuley HJC, Sereno M, Saunders RM, Houchen-Wolloff L, Greening NJ, Bolton CE, Brown JS, Choudhury G, Diar Bakerly N, Easom N, Echevarria C, Marks M, Hurst JR, Jones MG, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Howard LS, Jacob J, Man WDC, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Singh SJ, Thomas DC, Toshner M, Lewis KE, Heaney LG, Harrison EM, Kerr S, Docherty AB, Lone NI, Quint J, Sheikh A, Zheng B, Jenkins RG, Cox E, Francis S, Halling-Brown M, Chalmers JD, Greenwood JP, Plein S, Hughes PJC, Thompson AAR, Rowland-Jones SL, Wild JM, Kelly M, Treibel TA, Bandula S, Aul R, Miller K, Jezzard P, Smith S, Nichols TE, McCann GP, Evans RA, Wain LV, Brightling CE, Neubauer S, Baillie JK, Shaw A, Hairsine B, Kurasz C, Henson H, Armstrong L, Shenton L, Dobson H, Dell A, Lucey A, Price A, Storrie A, Pennington C, Price C, Mallison G, Willis G, Nassa H, Haworth J, Hoare M, Hawkings N, Fairbairn S, Young S, Walker S, Jarrold I, Sanderson A, David C, Chong-James K, Zongo O, James WY, Martineau A, King B, Armour C, McAulay D, Major E, McGinness J, McGarvey L, Magee N, Stone R, Drain S, Craig T, Bolger A, Haggar A, Lloyd A, Subbe C, Menzies D, Southern D, McIvor E, Roberts K, Manley R, Whitehead V, Saxon W, Bularga A, Mills NL, El-Taweel H, Dawson J, Robinson L, Saralaya D, Regan K, Storton K, Brear L, Amoils S, Bermperi A, Elmer A, Ribeiro C, Cruz I, Taylor J, Worsley J, Dempsey K, Watson L, Jose S, Marciniak S, Parkes M, McQueen A, Oliver C, Williams J, Paradowski K, Broad L, Knibbs L, Haynes M, Sabit R, Milligan L, Sampson C, Hancock A, Evenden C, Lynch C, Hancock K, Roche L, Rees M, Stroud N, Thomas-Woods T, Heller S, Robertson E, Young B, Wassall H, Babores M, Holland M, Keenan N, Shashaa S, Price C, Beranova E, Ramos H, Weston H, Deery J, Austin L, Solly R, Turney S, Cosier T, Hazelton T, Ralser M, Wilson A, Pearce L, Pugmire S, Stoker W, McCormick W, Dewar A, Arbane G, Kaltsakas G, Kerslake H, Rossdale J, Bisnauthsing K, Aguilar Jimenez LA, Martinez LM, Ostermann M, Magtoto MM, Hart N, Marino P, Betts S, Solano TS, Arias AM, Prabhu A, Reed A, Wrey Brown C, Griffin D, Bevan E, Martin J, Owen J, Alvarez Corral M, Williams N, Payne S, Storrar W, Layton A, Lawson C, Mills C, Featherstone J, Stephenson L, Burdett T, Ellis Y, Richards A, Wright C, Sykes DL, Brindle K, Drury K, Holdsworth L, Crooks MG, Atkin P, Flockton R, Thackray-Nocera S, Mohamed A, Taylor A, Perkins E, Ross G, McGuinness H, Tench H, Phipps J, Loosley R, Wolf-Roberts R, Coetzee S, Omar Z, Ross A, Card B, Carr C, King C, Wood C, Copeland D, Calvelo E, Chilvers ER, Russell E, Gordon H, Nunag JL, Schronce J, March K, Samuel K, Burden L, Evison L, McLeavey L, Orriss-Dib L, Tarusan L, Mariveles M, Roy M, Mohamed N, Simpson N, Yasmin N, Cullinan P, Daly P, Haq S, Moriera S, Fayzan T, Munawar U, Nwanguma U, Lingford-Hughes A, Altmann D, Johnston D, Mitchell J, Valabhji J, Price L, Molyneaux PL, Thwaites RS, Walsh S, Frankel A, Lightstone L, Wilkins M, Willicombe M, McAdoo S, Touyz R, Guerdette AM, Warwick K, Hewitt M, Reddy R, White S, McMahon A, Hoare A, Knighton A, Ramos A, Te A, Jolley CJ, Speranza F, Assefa-Kebede H, Peralta I, Breeze J, Shevket K, Powell N, Adeyemi O, Dulawan P, Adrego R, Byrne S, Patale S, Hayday A, Malim M, Pariante C, Sharpe C, Whitney J, Bramham K, Ismail K, Wessely S, Nicholson T, Ashworth A, Humphries A, Tan AL, Whittam B, Coupland C, Favager C, Peckham D, Wade E, Saalmink G, Clarke J, Glossop J, Murira J, Rangeley J, Woods J, Hall L, Dalton M, Window N, Beirne P, Hardy T, Coakley G, Turtle L, Berridge A, Cross A, Key AL, Rowe A, Allt AM, Mears C, Malein F, Madzamba G, Hardwick HE, Earley J, Hawkes J, Pratt J, Wyles J, Tripp KA, Hainey K, Allerton L, Lavelle-Langham L, Melling L, Wajero LO, Poll L, Noonan MJ, French N, Lewis-Burke N, Williams-Howard SA, Cooper S, Kaprowska S, Dobson SL, Marsh S, Highett V, Shaw V, Beadsworth M, Defres S, Watson E, Tiongson GF, Papineni P, Gurram S, Diwanji SN, Quaid S, Briggs A, Hastie C, Rogers N, Stensel D, Bishop L, McIvor K, Rivera-Ortega P, Al-Sheklly B, Avram C, Faluyi D, Blaikely J, Piper Hanley K, Radhakrishnan K, Buch M, Hanley NA, Odell N, Osbourne R, Stockdale S, Felton T, Gorsuch T, Hussell T, Kausar Z, Kabir T, McAllister-Williams H, Paddick S, Burn D, Ayoub A, Greenhalgh A, Sayer A, Young A, Price D, Burns G, MacGowan G, Fisher H, Tedd H, Simpson J, Jiwa K, Witham M, Hogarth P, West S, Wright S, McMahon MJ, Neill P, Dougherty A, Morrow A, Anderson D, Grieve D, Bayes H, Fallon K, Mangion K, Gilmour L, Basu N, Sykes R, Berry C, McInnes IB, Donaldson A, Sage EK, Barrett F, Welsh B, Bell M, Quigley J, Leitch K, Macliver L, Patel M, Hamil R, Deans A, Furniss J, Clohisey S, Elliott A, Solstice AR, Deas C, Tee C, Connell D, Sutherland D, George J, Mohammed S, Bunker J, Holmes K, Dipper A, Morley A, Arnold D, Adamali H, Welch H, Morrison L, Stadon L, Maskell N, Barratt S, Dunn S, Waterson S, Jayaraman B, Light T, Selby N, Hosseini A, Shaw K, Almeida P, Needham R, Thomas AK, Matthews L, Gupta A, Nikolaidis A, Dupont C, Bonnington J, Chrystal M, Greenhaff PL, Linford S, Prosper S, Jang W, Alamoudi A, Bloss A, Megson C, Nicoll D, Fraser E, Pacpaco E, Conneh F, Ogg G, McShane H, Koychev I, Chen J, Pimm J, Ainsworth M, Pavlides M, Sharpe M, Havinden-Williams M, Petousi N, Talbot N, Carter P, Kurupati P, Dong T, Peng Y, Burns A, Kanellakis N, Korszun A, Connolly B, Busby J, Peto T, Patel B, Nolan CM, Cristiano D, Walsh JA, Liyanage K, Gummadi M, Dormand N, Polgar O, George P, Barker RE, Patel S, Price L, Gibbons M, Matila D, Jarvis H, Lim L, Olaosebikan O, Ahmad S, Brill S, Mandal S, Laing C, Michael A, Reddy A, Johnson C, Baxendale H, Parfrey H, Mackie J, Newman J, Pack J, Parmar J, Paques K, Garner L, Harvey A, Summersgill C, Holgate D, Hardy E, Oxton J, Pendlebury J, McMorrow L, Mairs N, Majeed N, Dark P, Ugwuoke R, Knight S, Whittaker S, Strong-Sheldrake S, Matimba-Mupaya W, Chowienczyk P, Pattenadk D, Hurditch E, Chan F, Carborn H, Foot H, Bagshaw J, Hockridge J, Sidebottom J, Lee JH, Birchall K, Turner K, Haslam L, Holt L, Milner L, Begum M, Marshall M, Steele N, Tinker N, Ravencroft P, Butcher R, Misra S, Walker S, Coburn Z, Fairman A, Ford A, Holbourn A, Howell A, Lawrie A, Lye A, Mbuyisa A, Zawia A, Holroyd-Hind B, Thamu B, Clark C, Jarman C, Norman C, Roddis C, Foote D, Lee E, Ilyas F, Stephens G, Newell H, Turton H, Macharia I, Wilson I, Cole J, McNeill J, Meiring J, Rodger J, Watson J, Chapman K, Harrington K, Chetham L, Hesselden L, Nwafor L, Dixon M, Plowright M, Wade P, Gregory R, Lenagh R, Stimpson R, Megson S, Newman T, Cheng Y, Goodwin C, Heeley C, Sissons D, Sowter D, Gregory H, Wynter I, Hutchinson J, Kirk J, Bennett K, Slack K, Allsop L, Holloway L, Flynn M, Gill M, Greatorex M, Holmes M, Buckley P, Shelton S, Turner S, Sewell TA, Whitworth V, Lovegrove W, Tomlinson J, Warburton L, Painter S, Vickers C, Redwood D, Tilley J, Palmer S, Wainwright T, Breen G, Hotopf M, Dunleavy A, Teixeira J, Ali M, Mencias M, Msimanga N, Siddique S, Samakomva T, Tavoukjian V, Forton D, Ahmed R, Cook A, Thaivalappil F, Connor L, Rees T, McNarry M, Williams N, McCormick J, McIntosh J, Vere J, Coulding M, Kilroy S, Turner V, Butt AT, Savill H, Fraile E, Ugoji J, Landers G, Lota H, Portukhay S, Nasseri M, Daniels A, Hormis A, Ingham J, Zeidan L, Osborne L, Chablani M, Banerjee A, David A, Pakzad A, Rangelov B, Williams B, Denneny E, Willoughby J, Xu M, Mehta P, Batterham R, Bell R, Aslani S, Lilaonitkul W, Checkley A, Bang D, Basire D, Lomas D, Wall E, Plant H, Roy K, Heightman M, Lipman M, Merida Morillas M, Ahwireng N, Chambers RC, Jastrub R, Logan S, Hillman T, Botkai A, Casey A, Neal A, Newton-Cox A, Cooper B, Atkin C, McGee C, Welch C, Wilson D, Sapey E, Qureshi H, Hazeldine J, Lord JM, Nyaboko J, Short J, Stockley J, Dasgin J, Draxlbauer K, Isaacs K, Mcgee K, Yip KP, Ratcliffe L, Bates M, Ventura M, Ahmad Haider N, Gautam N, Baggott R, Holden S, Madathil S, Walder S, Yasmin S, Hiwot T, Jackson T, Soulsby T, Kamwa V, Peterkin Z, Suleiman Z, Chaudhuri N, Wheeler H, Djukanovic R, Samuel R, Sass T, Wallis T, Marshall B, Childs C, Marouzet E, Harvey M, Fletcher S, Dickens C, Beckett P, Nanda U, Daynes E, Charalambou A, Yousuf AJ, Lea A, Prickett A, Gooptu B, Hargadon B, Bourne C, Christie C, Edwardson C, Lee D, Baldry E, Stringer E, Woodhead F, Mills G, Arnold H, Aung H, Qureshi IN, Finch J, Skeemer J, Hadley K, Khunti K, Carr L, Ingram L, Aljaroof M, Bakali M, Bakau M, Baldwin M, Bourne M, Pareek M, Soares M, Tobin M, Armstrong N, Brunskill N, Goodman N, Cairns P, Haldar P, McCourt P, Dowling R, Russell R, Diver S, Edwards S, Glover S, Parker S, Siddiqui S, Ward TJC, Mcnally T, Thornton T, Yates T, Ibrahim W, Monteiro W, Thickett D, Wilkinson D, Broome M, McArdle P, Upthegrove R, Wraith D, Langenberg C, Summers C, Bullmore E, Heeney JL, Schwaeble W, Sudlow CL, Adeloye D, Newby DE, Rudan I, Shankar-Hari M, Thorpe M, Pius R, Walmsley S, McGovern A, Ballard C, Allan L, Dennis J, Cavanagh J, Petrie J, O'Donnell K, Spears M, Sattar N, MacDonald S, Guthrie E, Henderson M, Guillen Guio B, Zhao B, Lawson C, Overton C, Taylor C, Tong C, Mukaetova-Ladinska E, Turner E, Pearl JE, Sargant J, Wormleighton J, Bingham M, Sharma M, Steiner M, Samani N, Novotny P, Free R, Allen RJ, Finney S, Terry S, Brugha T, Plekhanova T, McArdle A, Vinson B, Spencer LG, Reynolds W, Ashworth M, Deakin B, Chinoy H, Abel K, Harvie M, Stanel S, Rostron A, Coleman C, Baguley D, Hufton E, Khan F, Hall I, Stewart I, Fabbri L, Wright L, Kitterick P, Morriss R, Johnson S, Bates A, Antoniades C, Clark D, Bhui K, Channon KM, Motohashi K, Sigfrid L, Husain M, Webster M, Fu X, Li X, Kingham L, Klenerman P, Miiler K, Carson G, Simons G, Huneke N, Calder PC, Baldwin D, Bain S, Lasserson D, Daines L, Bright E, Stern M, Crisp P, Dharmagunawardena R, Reddington A, Wight A, Bailey L, Ashish A, Robinson E, Cooper J, Broadley A, Turnbull A, Brookes C, Sarginson C, Ionita D, Redfearn H, Elliott K, Barman L, Griffiths L, Guy Z, Gill R, Nathu R, Harris E, Moss P, Finnigan J, Saunders K, Saunders P, Kon S, Kon SS, O'Brien L, Shah K, Shah P, Richardson E, Brown V, Brown M, Brown J, Brown J, Brown A, Brown A, Brown M, Choudhury N, Jones S, Jones H, Jones L, Jones I, Jones G, Jones H, Jones D, Davies F, Davies E, Davies K, Davies G, Davies GA, Howard K, Porter J, Rowland J, Rowland A, Scott K, Singh S, Singh C, Thomas S, Thomas C, Lewis V, Lewis J, Lewis D, Harrison P, Francis C, Francis R, Hughes RA, Hughes J, Hughes AD, Thompson T, Kelly S, Smith D, Smith N, Smith A, Smith J, Smith L, Smith S, Evans T, Evans RI, Evans D, Evans R, Evans H, Evans J. Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study. Lancet Respir Med 2023; 11:1003-1019. [PMID: 37748493 PMCID: PMC7615263 DOI: 10.1016/s2213-2600(23)00262-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/16/2023] [Accepted: 06/30/2023] [Indexed: 09/27/2023]
Abstract
INTRODUCTION The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. METHODS In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. FINDINGS Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2-6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5-5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4-10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32-4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23-11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. INTERPRETATION After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification. FUNDING UK Research and Innovation and National Institute for Health Research.
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Youssef D, Richards S, Sheppard C, Hornberger L, Pietrosanu M, Bates A. Preteen with Prenatal Agenesis of the Ductus Venosus Presenting with a Portosystemic Shunt and Severe Delayed-Onset Pulmonary Arterial Hypertension: A Rare Case Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1353] [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: 04/05/2023] Open
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Youssef D, Richards S, Sheppard C, Gerdung C, Pietrosanu M, Bates A. An Infant Presenting with Severe Pulmonary Hypertension Following Nitric Oxide Treatment: A Case Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1354] [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: 04/05/2023] Open
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Bates A, Stowe RB, Travis EM, Cook LE, Dabney-Smith C, Lorigan GA. The role of native cysteine residues in the oligomerization of KCNQ1 channels. Biochem Biophys Res Commun 2023; 659:34-39. [PMID: 37031592 PMCID: PMC10170711 DOI: 10.1016/j.bbrc.2023.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023]
Abstract
KCNQ1, the major component of the slow-delayed rectifier potassium channel, is responsible for repolarization of cardiac action potential. Mutations in this channel can lead to a variety of diseases, most notably long QT syndrome. It is currently unknown how many of these mutations change channel function and structure on a molecular level. Since tetramerization is key to proper function and structure of the channel, it is likely that mutations modify the stability of KCNQ1 oligomers. Presently, the C-terminal domain of KCNQ1 has been noted as the driving force for oligomer formation. However, truncated versions of this protein lacking the C-terminal domain still tetramerize. Therefore, we explored the role of native cysteine residues in a truncated construct of human KCNQ1, amino acids 100-370, by blocking potential interactions of cysteines with a nitroxide based spin label. Mobility of the spin labels was investigated with continuous wave electron paramagnetic resonance (CW-EPR) spectroscopy. The oligomerization state was examined by gel electrophoresis. The data provide information on tetramerization of human KCNQ1 without the C-terminal domain. Specifically, how blocking the side chains of native cysteines residues reduces oligomerization. A better understanding of tetramer formation could provide improved understanding of the molecular etiology of long QT syndrome and other diseases related to KCNQ1.
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Affiliation(s)
- Alison Bates
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH, 45056, USA
| | - Rebecca B Stowe
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH, 45056, USA
| | - Elizabeth M Travis
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH, 45056, USA
| | - Lauryn E Cook
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH, 45056, USA
| | - Carole Dabney-Smith
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH, 45056, USA
| | - Gary A Lorigan
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH, 45056, USA.
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Bates A, Wei C, Szewczyk-Bieda M, Donnan P, Rauchhaus P, Gandy S, Ragupathy S, Singh P, Coll K, Serhan J, Wilson J, Nabi G. A multicentre parallel-group randomised trial assessing multiparametric MRI characterisation and image-guided biopsy of prostate in men suspected of having prostate cancer: MULTIPROS study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Youssef D, Handler S, Richards S, Sheppard C, Smith J, Tillman K, Pietrosanu M, Kirkpatrick E, Bates A. Multicenter review of a tadalafil suspension formulation in infants and children with pulmonary hypertension: a north american experience. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Pulmonary arterial hypertension (PAH) is a disease characterised by an increase in pulmonary vascular resistance and pulmonary artery pressure. Phosphodiesterase type 5 (PDE5) inhibitors, with sildenafil the earliest among them, are widely used in the management of pediatric PAH. There has more recently been a transition to once-daily tadalafil suspensions. Herein, we present a multicenter experience detailing safety, tolerability and haemodynamic data utilizing tadalafil suspension alone or in combination for the management of pediatric PAH.
Methods and materials
We performed a retrospective review of all infants and children at two North American paediatric PH centres between December 2013 and April 2022. We included all patients less than 9 years of age who were treated with a tadalafil suspension after an initial treatment with sildenafil. Demographic, clinical, imaging, and laboratory data were collected.
Results
Over the study period, 158 children were treated with tadalafil therapy: 41 (25.9%) had group 1 PAH, 81 (51.3%) had group 3 PH, and 33 (20.9%) had group 5 PH. The median initial dose of tadalafil was 1.0 mg/kg once daily with a median time to maximum dose of 1 day. The majority of patients required the suspension formulation due to an inability to take oral tablets or the need for nasogastric or nasojejunal feeding. We observed improvements in median echocardiographic parameters in the six months following initiation, namely, in RVFAC from 34.7% (Q1 = 31.0%, Q3 = 42.0%) to 37.0% (Q1 = 31.0%, Q3 = 44.0%) and in TAPSE from 1.0 (Q1 = 0.8, Q3 = 1.7) cm to 1.3 (Q1 = 1.0, Q3 = 1.7) cm. We observed median decreases in RVSp from 51.0 (Q1 = 35.0, Q3 = 69.0) mmHg to 37.0 (Q1 = 30.0, Q3 = 50.0) mmHg and in NT pro BNP levels from 439.0 (Q1 = 217.0, Q3 = 2051.0) ng/L to 313.0 (Q1 = 193.0, Q3 = 1110.0) ng/L. Tadalafil therapy was well tolerated over the six-month period: at baseline, only four patients (2.5%) reported gastrointestinal side effects, two (1.3%) reported adverse skin adverse effects (i.e., rash and flushing), and one (0.6%) reported adverse neurological effects. At six months, 150 patients (94.9%) reported no adverse effects.
Conclusion
Tadalafil, a long-acting PDE5 inhibitor, when administered in a suspension formulation, has a safe and tolerable adverse effect profile once patients are established on sildenafil therapy. Following 6 months of once daily tadalafil suspension, alone or in combination, showed a trend towards improvement in clinical parameters, echocardiographic measurements, and laboratory results for pediatric PAH. All patient adverse effects were managed with non pharmacological measures and there was good patient compliance.
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Affiliation(s)
- D Youssef
- Stollery Children's Hospital , Edmonton , Canada
| | - S Handler
- University of Wisconsin , Wisconsin , United States of America
| | - S Richards
- Stollery Children's Hospital , Edmonton , Canada
| | - C Sheppard
- Stollery Children's Hospital , Edmonton , Canada
| | - J Smith
- Stollery Children's Hospital , Edmonton , Canada
| | - K Tillman
- Stollery Children's Hospital , Edmonton , Canada
| | | | - E Kirkpatrick
- University of Wisconsin , Wisconsin , United States of America
| | - A Bates
- Stollery Children's Hospital , Edmonton , Canada
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Dixit G, Stowe RB, Bates A, Jaycox CK, Escobar JR, Harding BD, Drew DL, New CP, Sahu ID, Edelmann RE, Dabney-Smith C, Sanders CR, Lorigan GA. Purification and membrane interactions of human KCNQ1 100-370 potassium ion channel. Biochim Biophys Acta Biomembr 2022; 1864:184010. [PMID: 35870481 DOI: 10.1016/j.bbamem.2022.184010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
KCNQ1 (Kv7.1 or KvLQT1) is a voltage-gated potassium ion channel that is involved in the ventricular repolarization following an action potential in the heart. It forms a complex with KCNE1 in the heart and is the pore forming subunit of slow delayed rectifier potassium current (Iks). Mutations in KCNQ1, leading to a dysfunctional channel or loss of activity have been implicated in a cardiac disorder, long QT syndrome. In this study, we report the overexpression, purification, biochemical characterization of human KCNQ1100-370, and lipid bilayer dynamics upon interaction with KCNQ1100-370. The recombinant human KCNQ1 was expressed in Escherichia coli and purified into n-dodecylphosphocholine (DPC) micelles. The purified KCNQ1100-370 was biochemically characterized by SDS-PAGE electrophoresis, western blot and nano-LC-MS/MS to confirm the identity of the protein. Circular dichroism (CD) spectroscopy was utilized to confirm the secondary structure of purified protein in vesicles. Furthermore, 31P and 2H solid-state NMR spectroscopy in DPPC/POPC/POPG vesicles (MLVs) indicated a direct interaction between KCNQ100-370 and the phospholipid head groups. Finally, a visual inspection of KCNQ1100-370 incorporated into MLVs was confirmed by transmission electron microscopy (TEM). The findings of this study provide avenues for future structural studies of the human KCNQ1 ion channel to have an in depth understanding of its structure-function relationship.
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Affiliation(s)
- Gunjan Dixit
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA; Cell, Molecular and Structural Biology Program, Department of Chemistry & Biochemistry, Miami University, Oxford, OH 45056, USA
| | - Rebecca B Stowe
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA
| | - Alison Bates
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA
| | - Colleen K Jaycox
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA
| | - Jorge R Escobar
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA; Cell, Molecular and Structural Biology Program, Department of Chemistry & Biochemistry, Miami University, Oxford, OH 45056, USA
| | - Benjamin D Harding
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA
| | - Daniel L Drew
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA
| | - Christopher P New
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA; Cell, Molecular and Structural Biology Program, Department of Chemistry & Biochemistry, Miami University, Oxford, OH 45056, USA
| | - Indra D Sahu
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA
| | - Richard E Edelmann
- Center for Advanced Microscopy and Imaging, Miami University, Oxford, OH 45056, USA
| | - Carole Dabney-Smith
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA; Cell, Molecular and Structural Biology Program, Department of Chemistry & Biochemistry, Miami University, Oxford, OH 45056, USA
| | - Charles R Sanders
- Department of Biochemistry and Center for Structural Biology, Vanderbilt University, Nashville, TN 37240, USA
| | - Gary A Lorigan
- Department of Chemistry and Biochemistry, Miami University, 651 E. High Street, Oxford, OH 45056, USA; Cell, Molecular and Structural Biology Program, Department of Chemistry & Biochemistry, Miami University, Oxford, OH 45056, USA.
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Jagodinsky J, Jin W, Bates A, Clark P, Sriramaneni R, Havighurst T, Chakravarthy I, Nystuen E, Kim K, Sondel P, Morris Z. Intratumoral MPL Induces Th1 Polarization and Augments In Situ Vaccination Generated by Radiation and Checkpoint Blockade. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jones AM, Clode L, Fenton P, Bates A, Bhatnagar A. OA08.05 A Quality Improvement Project Determining if Dietitian Input with the UHS Lung Oncology Team Improved Patient Outcomes. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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Bates A, Paisey JR, Yue A, Banks P, Roberts PR, Ullah W. Establishing safe, effective ablation in the diseased human ventricle: an analysis of generator impedance and electrogram attenuation. Europace 2022. [DOI: 10.1093/europace/euac053.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Biosense Webster Inc
Background
Predictors of effective and safe lesion delivery in the human left ventricle have not been established. Generator impedance (GI) drop and electrogram (EGM) attenuation are indices which can be used as surrogates for ablation lesion parameters. Tissue pops are a complication of myocardial overheating preceded by a rise in GI and can have adverse consequences.
Purpose
To establish the relationships between Ablation Index (AI), Force Time Integral (FTI) and contact force with GI and EGM attenuation. To establish factors early in ablation that are predictive of a GI rise.
Methods
Patients undergoing ventricular tachycardia ablation were recruited. All ablations were performed with contact force sensing surround flow catheters. Electrograms were collected pre and post ablation, with GI, AI, FTI measured during. Ablations were divided into low (LVM, < 0.50mV), intermediate (IVM, 0.51 – 1.50mV) and normal voltage (NVM, > 1.50mV) based upon pre-ablation bipolar EGM amplitude. Ablations with a 5% rise in GI from maximal drop were noted and predictors of this explored.
Results
In 15 patients, 402 ablations were analysed. Filtered percentage GI drop correlated with AI and FTI, (p < 0.0005, Spearman’s ρ = 0.522 and 0.524) and reached a plateau at 763AI and 713gs, a filtered GI drop of 7.5% (Figure 1). Shallower curves occurred progressively from NVM to IVM to LVM, (p < 0.0005), (Figure 2)
The bipolar EGM significantly attenuated with ablation, (median attenuation 0.14mV, [29.3%], p <0.0005), but percentage attenuation did not correlate with AI or FTI.
Parameters associated with a GI rise during ablation were greater mean CF to maximum GI drop, (p = 0.002), greater initial percentage GI drop at 5 seconds, (p < 0.0005), power of 50W (p = 0.005), and perpendicular orientation, (p = 0.006). Percentage GI drop at 5 seconds was the best predictor of ablations with a GI rise, (AUCROC 0.773; 95% CI 0.708 – 0.838; optimal cut-off 2.44%). Mean contact force to maximum GI drop was a poor predictor of a GI rise (AUCROC 0.647; 95% CI 0.577 – 0.718, optimal cut-off 14.7g).
Conclusion
During left ventricular ablation, AI of 763 and FTI of 713gs should be targeted, with a lower impedance drop observed for more scarred myocardium. A GI drop of <2.5% at 5 seconds and contact force < 15g should be used to optimise ablation safety.
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Affiliation(s)
- A Bates
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - JR Paisey
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - A Yue
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - P Banks
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - PR Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - W Ullah
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
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13
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Bates A, Naseer MZ, Taylor M, Denham N, Yue A, Das M, Morris GM, Ullah W. UK multi-centre retrospective study of the learning curve and relative performance of the rhythmia high density mapping system for atrial ablation. Europace 2022. [DOI: 10.1093/europace/euac053.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): University Hospital Southampton
Background
Rhythmia HDx® is a novel ultra-high density electroanatomical mapping system using an innovative 64 electrode basket catheter. A learning curve is a recognised phenomenon for any new technology and was examined in this study.
Purpose
Comparison of performance, long-term success, and complications using Rhythmia for atrial ablation in the UK.
Methods
Retrospective data collection from three centres across the UK from the introduction of Rhythmia. Patients were matched with controls who had undergone ablation using the well-established Carto3 mapping system. Assessed were: fluoroscopy, radiofrequency ablation and procedure times; acute and long term success, and complications.
Results
253 study patients with 253 controls were included. Significant correlations existed between procedural efficiency metrics and centre experience for de novo atrial fibrillation (AF) ablation (procedure time, Spearman’s ρ = -0.624; ablation time, ρ = -0.795), and de novo atrial flutter (AFlut) ablation (ablation time, ρ = -0.566; fluoroscopy time, ρ = -0.520). No such correlations existed for redo AF, redo AFlut, de novo atrial tachycardia (AT), or redo AT cases. For de novo AF and AFlut, procedural efficiency metrics were significantly improved after 10 procedures in each centre, (procedure time [AF only, p = 0.001], ablation time [AF, p < 0.0005; AFlut p < 0.0005] and fluoroscopy time [AFlut only, p = 0.0022]), and became comparable to controls (Figures 1 and 2). Acute success and long-term success did not see significant improvement with experience but were comparable to the control group. There was no relationship between experience and complications, which were comparable to Carto3 (3.6% in both groups).
Conclusion
A short learning curve exists with the use of Rhythmia HDx for standardised procedures (de novo AF / AFlut). Procedural performance improves and becomes comparable to Carto3 following 10 cases at each centre. Clinical outcomes at 6 and 12 months, and complications are not affected by this learning curve and remain comparable with controls.
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Affiliation(s)
- A Bates
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - MZ Naseer
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Taylor
- Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom of Great Britain & Northern Ireland
| | - N Denham
- Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - A Yue
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - M Das
- Freeman Hospital, Newcastle-Upon-Tyne, United Kingdom of Great Britain & Northern Ireland
| | - GM Morris
- Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain & Northern Ireland
| | - W Ullah
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
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14
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Sharpless KE, Pappas II, Dobrow EM, Moccia M, Bates A, Pinette MG, Paul M. Severe hemorrhage due to acquired uterine arteriovenous malformation/fistula following first-trimester aspiration abortion: A case report. Case Rep Womens Health 2022; 34:e00410. [PMID: 35479418 PMCID: PMC9035398 DOI: 10.1016/j.crwh.2022.e00410] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022] Open
Abstract
Uterine arteriovenous malformation/arteriovenous fistula is a rare, but potentially life-threatening, cause of severe hemorrhage. A case of uterine arteriovenous malformation/fistula causing severe hemorrhage following a first-trimester aspiration abortion procedure in a patient with a history of prior cesarean sections is presented. In this case, the patient was promptly diagnosed and effectively treated with uterine artery embolization. Consideration of uterine arteriovenous malformation/fistula in the differential diagnosis of severe hemorrhage following first-trimester aspiration abortion, especially in women with risk factors, can lead to timely recognition and appropriate treatment. Uterine arteriovenous malformation/arteriovenous fistula is a vascular anomaly that can cause life-threatening hemorrhage. Acquired uterine arteriovenous malformation/arteriovenous fistula is a rare cause of hemorrhage following aspiration abortion. The diagnosis should be considered when hemorrhage fails to resolve with additional suction curettage and uterotonic administration. Uterine artery embolization is the treatment of choice for hemodynamically stable patients who want to preserve fertility.
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Affiliation(s)
- Kathryn E. Sharpless
- Maine Medical Center, 22 Bramhall St, Portland, ME 04102, USA
- Planned Parenthood of Northern New England, 443 Congress St., Portland, ME 04101, USA
- Corresponding author at: Department of Obstetrics and Gynecology, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102, USA.
| | - India I. Pappas
- Maine Medical Center, 22 Bramhall St, Portland, ME 04102, USA
| | - Ethan M. Dobrow
- Maine Medical Center, 22 Bramhall St, Portland, ME 04102, USA
- VA Maine Healthcare System, 1 VA Ctr., Augusta, ME 04330, USA
| | - Matthew Moccia
- Maine Medical Center, 22 Bramhall St, Portland, ME 04102, USA
| | - Alison Bates
- Planned Parenthood of Northern New England, 443 Congress St., Portland, ME 04101, USA
| | | | - Maureen Paul
- Planned Parenthood of Northern New England, 443 Congress St., Portland, ME 04101, USA
- Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, USA
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15
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Avdimiretz N, Conway J, Larson C, Guerra G, Jonker D, Bates A, Buccholz H, Carroll A. Novel Bridge to Recovery: Right Ventricular Assist Device for Primary Graft Dysfunction in Pediatric Lung Transplantation. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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16
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Bates A, Sahu ID, Dabney-Smith C, Lorigan GA. The expression, purification, and site-directed spin-labeling of KCNE4. Biophys J 2022. [DOI: 10.1016/j.bpj.2021.11.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Stowe R, Dixit G, Sahu ID, Bates A, Dabney-Smith C, Lorigan GA. Protein protein interactions of KCNQ1 and KCNE1 observed via SDSL EPR line shape analysis. Biophys J 2022. [DOI: 10.1016/j.bpj.2021.11.1548] [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: 11/30/2022] Open
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18
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Vasiliadou I, Mikhaeel G, Brady J, Poetter V, Benjamin R, Patten P, Cuadrado M, Evans R, Alexander E, Gillham C, Summers J, Ajithkumar T, Bates A, Kuhnl A, Sanderson R. Factors Affecting Outcome of Bridging Radiotherapy (RT) Before CAR-T for High Grade Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Brady J, Vasiliadou I, Potter V, Benjamin R, Patten P, Cuadrado M, Evans O, Alexander E, Gillham C, Summers J, Ajithkumar T, Bates A, Sanderson R, Kuhnl A, Mikhaeel N. PH-0329 Feasibility and outcome of bridging RT pre CAR-T in DLBCL in one centre with a wide referral network. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07302-3] [Citation(s) in RCA: 1] [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: 10/20/2022]
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20
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Lim S, Campbell N, Joseph‐Pietras D, Johnson M, Mundy C, Coleman H, Wynn T, Maynard B, Lown R, Bates A, Wetherall N, Muller D, Falconer J, Fox C, Collins G, O'Callaghan A, Willimott V, Ahearne M, Faust S, Johnson P, Goldblatt D, Davies A. SEROLOGICAL RESPONSES AFTER SARS‐COV‐2 VACCINATION FIRST DOSE IN PATIENTS WITH LYMPHOID MALIGNANCY: FIRST INTERIM ANALYSIS OF THE UK PROSECO STUDY. Hematol Oncol 2021. [PMCID: PMC8426672 DOI: 10.1002/hon.198_2880] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- S.H. Lim
- Centre for Cancer Immunology University of Southampton Southampton UK
- Cancer Research UK Centre University of Southampton UK
| | - N. Campbell
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - D. Joseph‐Pietras
- NIHR/Cancer Research UK Southampton Experimental Medicine Cancer Centre WISH Laboratory University Hospital Southampton UK
| | - M. Johnson
- Great Ormond Street Institute of Child Health University College London London UK
| | - C. Mundy
- Cancer Research UK Centre University of Southampton UK
| | - H. Coleman
- Cancer Research UK Centre University of Southampton UK
| | - T. Wynn
- NIHR/Cancer Research UK Southampton Experimental Medicine Cancer Centre WISH Laboratory University Hospital Southampton UK
| | - B. Maynard
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - R. Lown
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - A. Bates
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - N. Wetherall
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - D. Muller
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - J. Falconer
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - C. Fox
- Nottingham University Hospitals NHS Trust Nottingham UK
| | - G. Collins
- Oxford University Hospitals NHS Foundation Trust Oxford UK
| | | | - V. Willimott
- Norfolk and Norwich University Hospitals NHS Foundation Trust Norwich UK
| | - M. Ahearne
- University Hospitals of Leicester NHS Trust Leicester UK
| | - S.N. Faust
- University Hospital Southampton NHS Foundation Trust Southampton UK
| | - P.W. Johnson
- Centre for Cancer Immunology University of Southampton Southampton UK
- Cancer Research UK Centre University of Southampton UK
| | - D. Goldblatt
- Great Ormond Street Institute of Child Health University College London London UK
| | - A.J. Davies
- Centre for Cancer Immunology University of Southampton Southampton UK
- Cancer Research UK Centre University of Southampton UK
- NIHR/Cancer Research UK Southampton Experimental Medicine Cancer Centre WISH Laboratory University Hospital Southampton UK
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21
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Quaglino P, Prince H, Cowan R, Vermeer M, Papadavid L, Bagot M, Servitjie O, Berti E, Guenova E, Stadler R, Querfeld C, Busschots A, Hodak E, Patsatsi A, Sanches J, Maule M, Yoo J, Kevin M, Fava P, Ribero S, Zocchi L, Rubatto M, Fierro M, Wehkamp U, Marshalko M, Mitteldorf C, Akilov O, Ortiz-Romero P, Estrach T, Vakeva L, Enz P, Wobser M, Bayne M, Jonak C, Rubeta M, Forbes A, Bates A, Battistella M, Amel-Kashipaz R, Vydianath B, Combalia A, Georgiou E, Hauben E, Hong E, Jost M, Knobler R, Amitay-Laish I, Miyashiro D, Cury-Martins J, Martinez X, Muniesa C, Prag-Naveh H, Nikolaou V, Quint K, Ram-Wolff C, Rieger K, Stranzenbach R, Szepesi Á, Alberti-Violetti S, Felicity E, Cerroni L, Kempf W, Whittaker S, Willemze R, Kim Y, Scarisbrick J. Treatment of early-stage mycosis fungoides: results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study. Br J Dermatol 2021; 184:722-730. [PMID: 32479678 PMCID: PMC7704558 DOI: 10.1111/bjd.19252] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study is a prospective analysis of an international database. Here we examine front-line treatments and quality of life (QoL) in patients with newly diagnosed mycosis fungoides (MF). OBJECTIVES To identify (i) differences in first-line approaches according to tumour-nodes-metastasis-blood (TNMB) staging; (ii) parameters related to a first-line systemic approach and (iii) response rates and QoL measures. METHODS In total, 395 newly diagnosed patients with early-stage MF (stage IA-IIA) were recruited from 41 centres in 17 countries between 1 January 2015 and 31 December 2018 following central clinicopathological review. RESULTS The most common first-line therapy was skin-directed therapy (SDT) (322 cases, 81·5%), while a smaller percentage (44 cases, 11·1%) received systemic therapy. Expectant observation was used in 7·3%. In univariate analysis, the use of systemic therapy was significantly associated with higher clinical stage (IA, 6%; IB, 14%; IIA, 20%; IA-IB vs. IIA, P < 0·001), presence of plaques (T1a/T2a, 5%; T1b/T2b, 17%; P < 0·001), higher modified Severity Weighted Assessment Tool (> 10, 15%; ≤ 10, 7%; P = 0·01) and folliculotropic MF (FMF) (24% vs. 12%, P = 0·001). Multivariate analysis demonstrated significant associations with the presence of plaques (T1b/T2b vs. T1a/T2a, odds ratio 3·07) and FMF (odds ratio 2·83). The overall response rate (ORR) to first-line SDT was 73%, while the ORR to first-line systemic treatments was lower (57%) (P = 0·027). Health-related QoL improved significantly both in patients with responsive disease and in those with stable disease. CONCLUSIONS Disease characteristics such as presence of plaques and FMF influence physician treatment choices, and SDT was superior to systemic therapy even in patients with such disease characteristics. Consequently, future treatment guidelines for early-stage MF need to address these issues.
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Affiliation(s)
- P. Quaglino
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - H.M. Prince
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
| | - R. Cowan
- Christie Hospital, Manchester UK
| | - M. Vermeer
- Leiden University Medical Centre, The Netherlands
| | | | - M. Bagot
- Hospital St Louis, Paris, France
| | - O. Servitjie
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - R. Stadler
- University Medical Centre, Johannes Wesling, Minden, Germany
| | - C. Querfeld
- City of Hope National Medical Center and Beckman Research Institute, Duarte, California, US
| | | | - E. Hodak
- Rabin Medical Center, Tel Aviv University, Israel
| | - A. Patsatsi
- Aristotle University of Thessaloniki, in Papageorgiou General Hospital, Greece
| | - J. Sanches
- University of Sao Paulo Medical School, Brazil, South America
| | - M. Maule
- Cancer Epidemiology Unit, Department Medical Sciences, University of Turin, Italy
| | - J. Yoo
- University Hospitals Birmingham, UK
| | - M. Kevin
- University Hospitals Birmingham, UK
| | - P. Fava
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - S. Ribero
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - L. Zocchi
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - M. Rubatto
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - M.T. Fierro
- Dermatologic Clinic, University of Turin Medical School, Torino, Italy
| | - U. Wehkamp
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - C. Mitteldorf
- HELIOS Klinikum Hildesheim GmbH, University Medical Center Göttingen, Germany
| | - O. Akilov
- University of Pittsburgh School of Medicine, Pennsylvania, USA
| | | | - T. Estrach
- Hospital Clinico, University of Barcelona, Spain
| | - L. Vakeva
- Helsinki University Central Hospital, Finland
| | - P.A. Enz
- Hospital Italiano De Buenos Aires, Argentina, South America
| | - M. Wobser
- University Hospital Wuerzburg, Germany
| | | | - C. Jonak
- Dept of Dermatology, Medical University of Vienna, Austria
| | - M. Rubeta
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford UK
| | | | - A. Bates
- University Hospital Southampton, Southampton, UK
| | | | | | | | - A. Combalia
- Hospital Clinico, University of Barcelona, Spain
| | - E. Georgiou
- Aristotle University of Thessaloniki, in Papageorgiou General Hospital, Greece
| | - E. Hauben
- Belgium University Hospitals Leuven, Leuven, Belgium
| | | | - M. Jost
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R. Knobler
- Dept of Dermatology, Medical University of Vienna, Austria
| | | | - D. Miyashiro
- University of Sao Paulo Medical School, Brazil, South America
| | - J. Cury-Martins
- University of Sao Paulo Medical School, Brazil, South America
| | - X. Martinez
- City of Hope National Medical Center and Beckman Research Institute, Duarte, California, US
| | - C. Muniesa
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | | | - K. Quint
- Leiden University Medical Centre, The Netherlands
| | | | | | - R. Stranzenbach
- University Medical Centre, Johannes Wesling, Minden, Germany
| | - Á. Szepesi
- Semmelweis University, Budapest, Hungary
| | | | | | - L. Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | - W. Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zurich, Switzerland
| | - S. Whittaker
- Kings College London, Guys and St Thomas NHS Foundation Trust, London
| | - R. Willemze
- Leiden University Medical Centre, The Netherlands
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22
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Matthews L, Bates A, Wootton SA, Levett D. The use of bioelectrical impedance analysis to predict post-operative complications in adult patients having surgery for cancer: A systematic review. Clin Nutr 2021; 40:2914-2922. [PMID: 33962360 DOI: 10.1016/j.clnu.2021.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Patients undergoing surgery for cancer are at particular risk of post-operative complications. The pre-operative period is an opportunity to identify and mitigate risk factors and improve outcome. Bioelectrical impedance analysis (BIA) may offer an additional means of identifying patients at risk of post-operative morbidity. AIMS The aim of this systematic review was to assess the use of measures and estimates of body composition determined by BIA as markers of peri-operative risk in adult patients undergoing elective surgery for cancer. METHODS This review was performed in accordance with the PRISMA guidelines. The electronic databases of MEDLINE, EMBASE, CINAHL, CENTRAL and the Web of Science were searched from inception. Studies of adult participants having elective surgery for cancer were included if participants underwent BIA in the peri-operative period and were assessed for post-operative complications. RESULTS 2578 studies were identified, of which 12 were eligible for inclusion. In total the studies report data from 1508 subjects. Five studies examined phase angle or standardized phase angle, six examined derived measures and one examined both. Eight of the 12 demonstrated an association between phase angle and/or body composition and an increased risk of post-operative complications. CONCLUSIONS Bioelectrical impedance analysis in the peri-operative period may be useful in predicting the risk of complications following elective cancer surgery. Phase angle more consistently demonstrates an association than derived estimates. Further high quality studies are needed and should report the raw impedance values, standardized phase angle and the equations used to derive body composition.
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Affiliation(s)
- L Matthews
- Department of Perioperative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK; University of Southampton, Southampton, UK.
| | - A Bates
- National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S A Wootton
- University of Southampton, Southampton, UK; National Institute for Health Research Cancer and Nutrition Collaboration, UK
| | - D Levett
- Department of Perioperative Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK; University of Southampton, Southampton, UK
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23
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Hodak E, Sherman S, Papadavid E, Bagot M, Querfeld C, Quaglino P, Prince HM, Ortiz-Romero PL, Stadler R, Knobler R, Guenova E, Estrach T, Patsatsi A, Leshem YA, Prague-Naveh H, Berti E, Alberti-Violetti S, Cowan R, Jonak C, Nikolaou V, Mitteldorf C, Akilov O, Geskin L, Matin R, Beylot-Barry M, Vakeva L, Sanches JA, Servitje O, Weatherhead S, Wobser M, Yoo J, Bayne M, Bates A, Dunnill G, Marschalko M, Buschots AM, Wehkamp U, Evison F, Hong E, Amitay-Laish I, Stranzenbach R, Vermeer M, Willemze R, Kempf W, Cerroni L, Whittaker S, Kim YH, Scarisbrick JJ. Should we be imaging lymph nodes at initial diagnosis of early-stage mycosis fungoides? Results from the PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) international study. Br J Dermatol 2021; 184:524-531. [PMID: 32574377 DOI: 10.1111/bjd.19303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Early-stage mycosis fungoides (MF) includes involvement of dermatopathic lymph nodes (LNs) or early lymphomatous LNs. There is a lack of unanimity among current guidelines regarding the indications for initial staging imaging in early-stage presentation of MF in the absence of enlarged palpable LNs. OBJECTIVES To investigate how often imaging is performed in patients with early-stage presentation of MF, to assess the yield of LN imaging, and to determine what disease characteristics promoted imaging. METHODS A review of clinicopathologically confirmed newly diagnosed patients with cutaneous patch/plaque (T1/T2) MF from PROspective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) data. RESULTS PROCLIPI enrolled 375 patients with stage T1/T2 MF: 304 with classical MF and 71 with folliculotropic MF. Imaging was performed in 169 patients (45%): 83 with computed tomography, 18 with positron emission tomography-computed tomography and 68 with ultrasound. Only nine of these (5%) had palpable enlarged (≥ 15 mm) LNs, with an over-representation of plaques, irrespectively of the 10% body surface area cutoff that distinguishes T1 from T2. Folliculotropic MF was not more frequently imaged than classical MF. Radiologically enlarged LNs (≥ 15 mm) were detected in 30 patients (18%); only seven had clinical lymphadenopathy. On multivariate analysis, plaque presentation was the sole parameter significantly associated with radiologically enlarged LNs. Imaging of only clinically enlarged LNs upstaged 4% of patients (seven of 169) to at least IIA, whereas nonselective imaging upstaged another 14% (24 of 169). LN biopsy, performed in eight of 30 patients, identified N3 (extensive lymphomatous involvement) in two and N1 (dermatopathic changes) in six. CONCLUSIONS Physical examination was a poor determinant of LN enlargement or involvement. Presence of plaques was associated with a significant increase in identification of enlarged or involved LNs in patients with early-stage presentation of MF, which may be important when deciding who to image. Imaging increases the detection rate of stage IIA MF, and identifies rare cases of extensive lymphomatous nodes, upstaging them to advanced-stage IVA2.
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Affiliation(s)
- E Hodak
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Sherman
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Papadavid
- Athens University Medical School, Athens, Greece
| | - M Bagot
- Hospital St Louis, Paris, France
| | - C Querfeld
- City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| | - P Quaglino
- Dermatologic Clinic, University of Turin Medical School, Turin, Italy
| | - H M Prince
- Sir Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - P L Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Medical School, University Complutense, Madrid, Spain
| | - R Stadler
- Johannes Wesling University Medical Centre, Minden, Germany
| | - R Knobler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - E Guenova
- University Hospital Zurich, Zurich, Switzerland
| | - T Estrach
- Hospital Clinico, University of Barcelona, Barcelona, Spain
| | - A Patsatsi
- Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Y A Leshem
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Prague-Naveh
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Berti
- University of Milan, Milan, Italy
| | | | - R Cowan
- Christie Hospital, Manchester, UK
| | - C Jonak
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - V Nikolaou
- Athens University Medical School, Athens, Greece
| | - C Mitteldorf
- HELIOS Klinikum Hildesheim GmbH, University Medical Centre Göttingen, Göttingen, Germany
| | - O Akilov
- University of Pittsburgh School of Medicine, Pennsylvania, PA, USA
| | - L Geskin
- University of Columbia, New York, NY, USA
| | - R Matin
- Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - L Vakeva
- Helsinki University Central Hospital, Helsinki, Finland
| | - J A Sanches
- University of São Paulo Medical School, São Paulo, SP, Brazil
| | - O Servitje
- Hospital Universatari de Bellvitge, Barcelona, Spain
| | | | - M Wobser
- University Hospital Wuerzburg, Wuerzburg, Germany
| | - J Yoo
- University Hospital Birmingham, Birmingham, UK
| | | | - A Bates
- University Hospital Southampton, Southampton, UK
| | - G Dunnill
- University Hospital Bristol, Bristol, UK
| | | | | | - U Wehkamp
- University Hospital Kiel, Kiel, Germany
| | - F Evison
- University Hospital Birmingham, Birmingham, UK
| | - E Hong
- Stanford University Medical Center, Stanford, CA, USA
| | - I Amitay-Laish
- Division of Dermatology, Rabin Medical Center - Beilinson Hospital, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Stranzenbach
- Johannes Wesling University Medical Centre, Minden, Germany
| | - M Vermeer
- Leiden University Medical Centre, Leiden, the Netherlands
| | - R Willemze
- Leiden University Medical Centre, Leiden, the Netherlands
| | - W Kempf
- Kempf and PFlatz, Histologische Diagnostik, Zurich, Switzerland
| | - L Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | | | - Y H Kim
- Stanford University Medical Center, Stanford, CA, USA
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Terrell CR, Nickodem K, Bates A, Kersten C, Mernitz H. Game-based activities targeting visual literacy skills to increase understanding of biomolecule structure and function concepts in undergraduate biochemistry. Biochem Mol Biol Educ 2021; 49:94-107. [PMID: 33202110 DOI: 10.1002/bmb.21398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/23/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
Introductory biochemistry courses are often challenging for students because they require the integration of chemistry, biology, physics, math, and physiology knowledge and frameworks to understand and apply a large body of knowledge. This can be complicated by students' persistent misconceptions of fundamental concepts and lack of fluency with the extensive visual and symbolic literacy used in biochemistry. Card sorting tasks and game-based activities have been used to reveal insights into how students are assimilating, organizing, and structuring disciplinary knowledge, and how they are progressing along a continuum from disciplinary novice to expert. In this study, game-based activities and card sorting tasks were used to promote and evaluate students' understanding of fundamental structure-function relationships in biochemistry. Our results suggest that while many markers of expertise increased for both the control and intervention groups over the course of the semester, students involved in the intervention activities tended to move further towards expert-like sorting. This indicates that intentional visual literacy game-based activities have the ability to build underdeveloped skills in undergraduate students.
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Affiliation(s)
- Cassidy R Terrell
- Center for Learning Innovation, University of Minnesota, Rochester, Minnesota, USA
| | - Kyle Nickodem
- Department of Educational Psychology, Quantitative Methods in Education, University of Minnesota, Twin Cities, Minneapolis, Minnesota, USA
| | - Alison Bates
- Center for Learning Innovation, University of Minnesota, Rochester, Minnesota, USA
| | - Cassandra Kersten
- Center for Learning Innovation, University of Minnesota, Rochester, Minnesota, USA
| | - Heather Mernitz
- Department of Physical Science, Alverno College, Milwaukee, Wisconsin, USA
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25
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Soleimani M, Kollmannsberger C, Bates A, Leung B, Ho C. Patient-reported psychosocial distress in adolescents and young adults with germ cell tumours. Support Care Cancer 2020; 29:2105-2110. [PMID: 32865672 DOI: 10.1007/s00520-020-05723-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Germ cell tumours are the most common cancer of male adolescents and young adults (AYA, age 18-39). Men in this age group have been healthy much of their lives, and a diagnosis of cancer can cause significant psychosocial distress. We therefore sought to examine the psychosocial needs of patients with germ cell tumour and determine whether needs vary based on age (AYA vs non-AYA). We hypothesized that AYA experience more anxiety and distress in emotional, practical and physical domains. METHODS We evaluated the responses of all patients referred to British Columbia (BC) Cancer who completed a pre-consultation health assessment form. This is a validated screening questionnaire for distress, subclinical/clinical symptoms of depression and anxiety and includes the Canadian Problem Checklist domains of emotional, informational, practical, spiritual, social/family and physical concerns. RESULTS Data were collected for 349 patients (2011-2015). Patient population was predominantly AYA (n = 227) with median age 33 (range 18-83). The top 3 AYA concerns were financial, work/school, frustration and anger. AYA patients more commonly scored positive for symptoms of subclinical/clinical anxiety than non-AYA (39.4% vs. 27.9%, p = 0.028). Those AYA patients with subclinical/clinical anxiety symptoms experienced more fears and worries, concerns regarding work/school, lack of understanding of their disease, finances and frustration and anger. CONCLUSIONS The results of this study indicate that AYA with testicular cancer have unique needs and experience more self-reported anxiety symptoms with emotional, informational and practical concerns. This is valuable information to stakeholders for allocation of resources to address cancer survivorship amongst these patients.
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Affiliation(s)
- M Soleimani
- Division of Medical Oncology, BC Cancer, Vancouver, Canada
| | | | - A Bates
- Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - B Leung
- Division of Medical Oncology, BC Cancer, Vancouver, Canada
| | - Cheryl Ho
- Division of Medical Oncology, BC Cancer, Vancouver, Canada.
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Abstract
A video abstract is available at https://youtu.be/LYJPmWunnKE
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Affiliation(s)
- A Bates
- Anaesthesia and Critical Care Research Area, National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, and Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M A West
- Anaesthesia and Critical Care Research Area, National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, and Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Jack
- Anaesthesia and Critical Care Research Area, National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, and Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Bates A, Lumsden T, Ayres J, Schoots I, Willemse P, Yuan C, Van Den Bergh R, Grummet J, Van Der Poel H, Rouvière O, Lam T, Cornford P, Mottet N. EAU PCa Guideline Panel: Systematic review of focal ablative therapy for localised prostate cancer compared with standard therapies. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33809-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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McDougall S, Aberdein D, Bates A, Burke CR. Prevalence of endometritis diagnosed by vaginal discharge scoring or uterine cytology in dairy cows and herds. J Dairy Sci 2020; 103:6511-6521. [PMID: 32359992 DOI: 10.3168/jds.2019-18048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/21/2020] [Indexed: 11/19/2022]
Abstract
Endometritis, diagnosed either by assessing the proportion of nucleated cells that are neutrophils (PMN%) following cytology of the endometrium or by assessing the degree of purulent material within the vagina (purulent vaginal discharge or PVD score), is prevalent among dairy cows. However, limited data exist as to the degree of variation among herds in the prevalence of endometritis diagnosed by these 2 methods. Thus, we undertook a study involving uterine cytological and vaginal sampling at a median of 41 d in milk of 1,807 cows from 100 seasonally breeding dairy herds in New Zealand. The optimal cut-point for PMN% was determined by receiver operator characteristic (ROC) curve analysis using conception to first artificial insemination (AI) as the outcome variable. The prevalence of disease was then calculated at the cow and herd levels, and an estimate of the effect of clustering of cow within a herd was calculated. Reproductive outcomes were collated and associations between endometritis and reproductive outcomes assessed using multivariable models. The optimal PMN% cut-point was ≥2%. The correlation of results for cows within a herd (the intraclass correlation) was 0.03, which was significant; hence, subsequent modeling accounted for this clustering. The cow-level prevalence of PMN% ≥2% was 27.0% [95% confidence interval (CI): 25.0 to 29.1%], whereas the mean within-herd prevalence of PMN% ≥2% was 27.1% (95% CI: 24.7 to 29.6%; range: 5.0 to 63.6%), and the prevalence among herds varied significantly. An elevated PMN% (≥2%) was significantly associated with a reduction in the proportion of cows conceiving to first AI (45.8 vs. 54.5%), a reduced proportion of cows submitted for AI in the first 3 wk of the seasonal breeding program (83.7 vs. 89.3%), and a lower proportion pregnant in the first 3 (44.4 vs. 55.4%) and 6 wk (67.5 vs. 76.4%) of the breeding program relative to cows with a low PMN% (i.e., <2%). A total of 24.6% of cows had a PVD score ≥2. The herd mean prevalence of PVD score ≥2 was 25.1% (95% CI: 22.5 to 27.7%; range: 5.0 to 65.0%) and varied significantly among herds. The level of agreement (kappa) between the PVD score and PMN% was low (16.8%) and nonsignificant. The effects of PVD score and PMN% on reproductive outcomes were independent. The within-herd median prevalence of endometritis based on combining both diagnostic tests and using a Bayesian latent class model was 22.9% (Bayesian 95% CI: 10.4 to 40.1%). We conclude that more than one-fifth of dairy cows have endometritis diagnosed either by PMN% or PVD in seasonal breeding herds when assessed at an average of 41 DIM, which was, on average, 30 d before the start of the seasonal breeding program. There is large and unexplained variation in prevalence of endometritis among herds. The 2 diagnostic methods were both associated with reproductive outcomes but have low levels of agreement between them and their effects appear to be independent.
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Affiliation(s)
- S McDougall
- Cognosco, Anexa, Morrinsville 3300, New Zealand.
| | - D Aberdein
- School of Veterinary Science, Massey University, Palmerston North 4442, New Zealand
| | - A Bates
- Vetlife, Temuka 7920, New Zealand
| | - C R Burke
- DairyNZ Ltd., Hamilton 3240, New Zealand
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Molloy K, Jonak C, Sherida F, Woei‐A‐Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. A study of quality of life in people with mycosis fungoides and Sézary syndrome. Br J Dermatol 2020. [DOI: 10.1111/bjd.18827] [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: 11/30/2022]
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Molloy K, Jonak C, Sherida F, Woei‐A‐Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. 样肉芽肿和 Sézary 综合征患者生活质量研究. Br J Dermatol 2020. [DOI: 10.1111/bjd.18840] [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: 11/30/2022]
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Docimo S, Bates A, Alteri M, Talamini M, Pryor A, Spaniolas K. Evaluation of the use of component separation in elderly patients: results of a large cohort study with 30-day follow-up. Hernia 2020; 24:503-507. [PMID: 31894430 DOI: 10.1007/s10029-019-02069-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 10/11/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND The incidence of massive ventral hernias among the elderly will increase as the population ages. Advanced age is often viewed as a contraindication to elective hernia repair. A relationship between age and complications of component separation procedures for ventral hernias is not well established. This study evaluated the effect of age on the peri-operative safety of AWR. METHODS The 2005-2013 ACS-NSQIP participant use data were reviewed to compare surgical site infection (SSI), overall morbidity, and serious morbidity in non-emergent component separation procedures among all age groups. All patients were stratified into four age quartiles and evaluated. Baseline characteristics included age, body mass index (BMI) and ASA 3 or 4 criteria. Statistical analysis was performed using SPSS. Odds ratios (OR) and 95% confidence intervals were reported as appropriate. RESULTS 4485 patients were identified. Majority of the cases were clean (76.8%). Patients were divided into the following quartiles based on age. The older quartile had a mean age of 72.7 ± 4.87 years. There were baseline differences in BMI and chronic comorbidity severity (measured by incidence of ASA score of 3 or 4) between the age groups, with the oldest group having lower BMI but higher rate of ASA 3 or 4 (p < 0.0001 for both). The rate of postoperative SSI was significantly different between age quartile groups (ranging from 16.3% from the youngest group to 9.4% for the oldest group, p < 0.0001). After adjusting for other baseline differences, advanced age was independently associated with lower SSI rate (OR 0.55, 95% CI 0.41-0.73). There was no significant difference in overall morbidity (p = 0.277) and serious morbidity (p = 0.131) between groups. CONCLUSION AWR is being performed with safety across all age groups. In selected patients of advanced age, AWR can be performed with similar safety profile and low SSI rate.
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Affiliation(s)
- S Docimo
- Department of Surgery, Division of Bariatric, Foregut, and Advanced GI surgery, Stony Brook Medicine, HST T19 R053, Stony Brook, NY, 11794-8191, USA.
| | - A Bates
- Department of Surgery, Division of Bariatric, Foregut, and Advanced GI surgery, Stony Brook Medicine, HST T19 R053, Stony Brook, NY, 11794-8191, USA
| | - M Alteri
- Department of Surgery, Division of Bariatric, Foregut, and Advanced GI surgery, Stony Brook Medicine, HST T19 R053, Stony Brook, NY, 11794-8191, USA
| | - M Talamini
- Department of Surgery, Division of Bariatric, Foregut, and Advanced GI surgery, Stony Brook Medicine, HST T19 R053, Stony Brook, NY, 11794-8191, USA
| | - A Pryor
- Department of Surgery, Division of Bariatric, Foregut, and Advanced GI surgery, Stony Brook Medicine, HST T19 R053, Stony Brook, NY, 11794-8191, USA
| | - K Spaniolas
- Department of Surgery, Division of Bariatric, Foregut, and Advanced GI surgery, Stony Brook Medicine, HST T19 R053, Stony Brook, NY, 11794-8191, USA
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Sahu SS, Dey S, Nabinger SC, Jiang G, Bates A, Tanaka H, Liu Y, Kota J. The Role and Therapeutic Potential of miRNAs in Colorectal Liver Metastasis. Sci Rep 2019; 9:15803. [PMID: 31676795 PMCID: PMC6825151 DOI: 10.1038/s41598-019-52225-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/12/2019] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is the fourth leading cause of cancer-related deaths worldwide. Liver metastasis is the major cause of CRC patient mortality, occurring in 60% patients with no effective therapies. Although studies have indicated the role of miRNAs in CRC, an in-depth miRNA expression analysis is essential to identify clinically relevant miRNAs and understand their potential in targeting liver metastasis. Here we analyzed miRNA expressions in 405 patient tumors from publicly available colorectal cancer genome sequencing project database. Our analyses showed miR-132, miR-378f, miR-605 and miR-1976 to be the most significantly downregulated miRNAs in primary and CRC liver metastatic tissues, and CRC cell lines. Observations in CRC cell lines indicated that ectopic expressions of miR-378f, -605 and -1976 suppress CRC cell proliferation, anchorage independent growth, metastatic potential, and enhance apoptosis. Consistently, CRC patients with higher miR-378f and miR-1976 levels exhibited better survival. Together, our data suggests an anti-tumorigenic role of these miRNAs in CRC and warrant future in vivo evaluation of the molecules for developing biomarkers or novel therapeutic strategies.
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Affiliation(s)
- Smiti S Sahu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shatovisha Dey
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sarah C Nabinger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Guanglong Jiang
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of BioHealth Informatics, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Alison Bates
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hiromi Tanaka
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Janaiah Kota
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA. .,The Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA.
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Smrke A, Leung B, Bates A, Srikanthan A, Ho C. Psychosocial distress of adolescent and young adults with cancer at diagnosis: A case-matched retrospective cohort of 2045 patients in British Columbia. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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34
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Burr A, Bayouth J, Bates A, Murphy T, Niewold N, Wang A, Francis D, Yadav P, Morris Z, Iyer G, Baschnagel A. Correlation of Serum Inflammatory Cytokine Levels and Pulmonary Toxicity Following Lung Irradiation. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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35
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Scarisbrick JJ, Quaglino P, Prince HM, Papadavid E, Hodak E, Bagot M, Servitje O, Berti E, Ortiz-Romero P, Stadler R, Patsatsi A, Knobler R, Guenova E, Child F, Whittaker S, Nikolaou V, Tomasini C, Amitay I, Prag Naveh H, Ram-Wolff C, Battistella M, Alberti-Violetti S, Stranzenbach R, Gargallo V, Muniesa C, Koletsa T, Jonak C, Porkert S, Mitteldorf C, Estrach T, Combalia A, Marschalko M, Csomor J, Szepesi A, Cozzio A, Dummer R, Pimpinelli N, Grandi V, Beylot-Barry M, Pham-Ledard A, Wobser M, Geissinger E, Wehkamp U, Weichenthal M, Cowan R, Parry E, Harris J, Wachsmuth R, Turner D, Bates A, Healy E, Trautinger F, Latzka J, Yoo J, Vydianath B, Amel-Kashipaz R, Marinos L, Oikonomidi A, Stratigos A, Vignon-Pennamen MD, Battistella M, Climent F, Gonzalez-Barca E, Georgiou E, Senetta R, Zinzani P, Vakeva L, Ranki A, Busschots AM, Hauben E, Bervoets A, Woei-A-Jin FJSH, Matin R, Collins G, Weatherhead S, Frew J, Bayne M, Dunnill G, McKay P, Arumainathan A, Azurdia R, Benstead K, Twigger R, Rieger K, Brown R, Sanches JA, Miyashiro D, Akilov O, McCann S, Sahi H, Damasco FM, Querfeld C, Folkes A, Bur C, Klemke CD, Enz P, Pujol R, Quint K, Geskin L, Hong E, Evison F, Vermeer M, Cerroni L, Kempf W, Kim Y, Willemze R. The PROCLIPI international registry of early-stage mycosis fungoides identifies substantial diagnostic delay in most patients. Br J Dermatol 2019; 181:350-357. [PMID: 30267549 DOI: 10.1111/bjd.17258] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Survival in mycosis fungoides (MF) is varied and may be poor. The PROCLIPI (PROspective Cutaneous Lymphoma International Prognostic Index) study is a web-based data collection system for early-stage MF with legal data-sharing agreements permitting international collaboration in a rare cancer with complex pathology. Clinicopathological data must be 100% complete and in-built intelligence in the database system ensures accurate staging. OBJECTIVES To develop a prognostic index for MF. METHODS Predefined datasets for clinical, haematological, radiological, immunohistochemical, genotypic, treatment and quality of life are collected at first diagnosis of MF and annually to test against survival. Biobanked tissue samples are recorded within a Federated Biobank for translational studies. RESULTS In total, 430 patients were enrolled from 29 centres in 15 countries spanning five continents. Altogether, 348 were confirmed as having early-stage MF at central review. The majority had classical MF (81·6%) with a CD4 phenotype (88·2%). Folliculotropic MF was diagnosed in 17·8%. Most presented with stage I (IA: 49·4%; IB: 42·8%), but 7·8% presented with enlarged lymph nodes (stage IIA). A diagnostic delay between first symptom development and initial diagnosis was frequent [85·6%; median delay 36 months (interquartile range 12-90)]. This highlights the difficulties in accurate diagnosis, which includes lack of a singular diagnostic test for MF. CONCLUSIONS This confirmed early-stage MF cohort is being followed-up to identify prognostic factors, which may allow better management and improve survival by identifying patients at risk of disease progression. This study design is a useful model for collaboration in other rare diseases, especially where pathological diagnosis can be complex.
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Affiliation(s)
- J J Scarisbrick
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - P Quaglino
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H M Prince
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Papadavid
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hodak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Bagot
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Servitje
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Berti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - P Ortiz-Romero
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Stadler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Patsatsi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Knobler
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Guenova
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Child
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - S Whittaker
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
- Member of the UK Cutaneous Lymphoma Group
| | - V Nikolaou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Tomasini
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - I Amitay
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Prag Naveh
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Ram-Wolff
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Alberti-Violetti
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Stranzenbach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - V Gargallo
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Muniesa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Koletsa
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Jonak
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S Porkert
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - C Mitteldorf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - T Estrach
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Combalia
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Marschalko
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Csomor
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Szepesi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Cozzio
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Dummer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - N Pimpinelli
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - V Grandi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Beylot-Barry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Pham-Ledard
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Wobser
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Geissinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - U Wehkamp
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - M Weichenthal
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Cowan
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - E Parry
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - J Harris
- Member of the UK Cutaneous Lymphoma Group
| | - R Wachsmuth
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the UK Cutaneous Lymphoma Group
| | - D Turner
- Member of the UK Cutaneous Lymphoma Group
| | - A Bates
- Member of the UK Cutaneous Lymphoma Group
| | - E Healy
- Member of the UK Cutaneous Lymphoma Group
| | - F Trautinger
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J Latzka
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - J Yoo
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - B Vydianath
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - R Amel-Kashipaz
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - L Marinos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Oikonomidi
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Stratigos
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M-D Vignon-Pennamen
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - M Battistella
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F Climent
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Gonzalez-Barca
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Georgiou
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Senetta
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Zinzani
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Vakeva
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Ranki
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A-M Busschots
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - E Hauben
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - A Bervoets
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - F J S H Woei-A-Jin
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - R Matin
- Member of the UK Cutaneous Lymphoma Group
| | - G Collins
- Member of the UK Cutaneous Lymphoma Group
| | | | - J Frew
- Member of the UK Cutaneous Lymphoma Group
| | - M Bayne
- Member of the UK Cutaneous Lymphoma Group
| | - G Dunnill
- Member of the UK Cutaneous Lymphoma Group
| | - P McKay
- Member of the UK Cutaneous Lymphoma Group
| | | | - R Azurdia
- Member of the UK Cutaneous Lymphoma Group
| | - K Benstead
- Member of the UK Cutaneous Lymphoma Group
| | - R Twigger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Rieger
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Brown
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - J A Sanches
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - D Miyashiro
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - O Akilov
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - S McCann
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - H Sahi
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F M Damasco
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Querfeld
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - A Folkes
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C Bur
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - C-D Klemke
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - P Enz
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Pujol
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - K Quint
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - L Geskin
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - E Hong
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - F Evison
- European Co-ordinating PROCLIPI Centre for PROCLIPI, University Hospitals Birmingham, Birmingham, U.K
| | - M Vermeer
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - L Cerroni
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - W Kempf
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
| | - Y Kim
- Member of the Cutaneous Lymphoma International Consortium (CLIC)
| | - R Willemze
- Member of the European Organisation of Research and Treatment of Cancer (EORTC), Cutaneous Lymphoma Task Force
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Molloy K, Jonak C, Woei‐A‐Jin F, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot‐Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Sanches J, McKay P, Klemke D, Peng C, Howles A, Yoo J, Evison F, Scarisbrick J. Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (
PROCLIPI
) study. Br J Dermatol 2019; 182:770-779. [DOI: 10.1111/bjd.18089] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2019] [Indexed: 01/01/2023]
Affiliation(s)
- K. Molloy
- University Hospitals Birmingham Birmingham U.K
| | - C. Jonak
- Medical University of Vienna Vienna Austria
| | | | | | | | | | | | - R. Knobler
- Medical University of Vienna Vienna Austria
| | - S. Porkert
- Medical University of Vienna Vienna Austria
| | | | - R. Cowan
- Christie Hospital Manchester U.K
| | | | - M. Beylot‐Barry
- Centre Hospitalier Universitaire Hospital de Bordeaux Bordeaux France
| | - E. Berti
- Department of Dermatology Fondazione Ca’ Granda IRCCS OMP Milan Italy
| | | | - T. Estrach
- Hospital Clinico University of Barcelona Barcelona Spain
| | | | - O. Akilov
- University of Pittsburgh School of Medicine Pittsburgh PA U.S.A
| | - L. Vakeva
- Helsinki University Central Hospital Helsinki Finland
| | - M. Prince
- Peter MacCallum Cancer Centre Melbourne Australia
| | - A. Bates
- University Hospital Southampton Southampton U.K
| | | | | | | | | | - O. Servitje
- Hospital Universatari de Bellvitge Barcelona Spain
| | | | | | - M. Wobser
- University Hospital Würzburg Würzburg Germany
| | - J.A. Sanches
- University of São Paulo Medical School São Paulo Brazil
| | - P. McKay
- Beatson West of Scotland Cancer Centre Glasgow U.K
| | - D. Klemke
- Stadtisches Klinikum Karlsruhe Karlsruhe Germany
| | - C. Peng
- University Hospitals Birmingham Birmingham U.K
| | - A. Howles
- University Hospitals Birmingham Birmingham U.K
| | - J. Yoo
- University Hospitals Birmingham Birmingham U.K
| | - F. Evison
- University Hospitals Birmingham Birmingham U.K
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37
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West MA, Astin R, Moyses HE, Cave J, White D, Levett DZH, Bates A, Brown G, Grocott MPW, Jack S. Exercise prehabilitation may lead to augmented tumor regression following neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Acta Oncol 2019; 58:588-595. [PMID: 30724668 DOI: 10.1080/0284186x.2019.1566775] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose: We evaluate the effect of an exercised prehabilitation programme on tumour response in rectal cancer patients following neoadjuvant chemoradiotherapy (NACRT). Patients and Methods: Rectal cancer patients with (MRI-defined) threatened resection margins who completed standardized NACRT were prospectively studied in a post hoc, explorative analysis of two previously reported clinical trials. MRI was performed at Weeks 9 and 14 post-NACRT, with surgery at Week 15. Patients undertook a 6-week preoperative exercise-training programme. Oxygen uptake (VO2) at anaerobic threshold (AT) wasmeasured at baseline (pre-NACRT), after completion of NACRT and at week 6 (post-NACRT). Tumour related outcome variables: MRI tumour regression grading (ymrTRG) at Week 9 and 14; histopathological T-stage (ypT); and tumour regression grading (ypTRG)) were compared. Results: 35 patients (26 males) were recruited. 26 patients undertook tailored exercise-training with 9 unmatched controls. NACRT resulted in a fall in VO2 at AT -2.0 ml/kg-1/min-1(-1.3,-2.6), p < 0.001. Exercise was shown to reverse this effect. VO2 at AT increased between groups, (post-NACRT vs. week 6) by +1.9 ml/kg-1/min-1(0.6, 3.2), p = 0.007. A significantly greater ypTRG in the exercise group at the time of surgery was found (p = 0.02). Conclusion: Following completion of NACRT, exercise resulted in significant improvements in fitness and augmented pathological tumour regression.
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Affiliation(s)
- M. A. West
- Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R. Astin
- Department of Medicine, Institute for Sport, Exercise and Health, University College London, London, UK
| | - H. E. Moyses
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - J. Cave
- Department of Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - D. White
- Department of Radiology, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - D. Z. H. Levett
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A. Bates
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - G. Brown
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, UK
| | - M. P. W. Grocott
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S. Jack
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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38
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Bates A. Trials with small QALY benefits can be badly misinterpreted. BJOG 2019; 126:1051. [PMID: 30955234 DOI: 10.1111/1471-0528.15750] [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: 11/25/2022]
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39
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Noble D, Harrison K, Hoole A, Wilson M, Thomas S, Bates A, Shelley L, Burnet N, Jena R. PO-0984 Univariate toxicity associations are stronger with delivered than planned dose in HNC patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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40
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Wehkamp U, Whittaker S, Servitje O, Berti E, Querfeld C, Bagot M, Stadler R, Stranzenbach R, Marschalko M, Busschots AM, Jost M, Sanches J, Ortiz-Romero P, Estrach T, Vakeva L, Jonak C, Akilov O, Hodak E, Mitteldorf C, Bates A, Beylot-Barry M, Cowan R, Pujol R, Matin R, Papadavid E, Quaglino P, Vermeer M, Kempf W, Kim Y, Scarisbrick J. T-cell receptor rearrangements in the skin and blood of patients in the PROCLIPI study: detection of clonal rearrangements in the skin (and blood) correlates with the B-class of MF and SS patients. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30580-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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41
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Molloy K, Jonak C, Sherida F, Woei-A-Ji H, Guenova E, Busschots A, Bervoets A, Hauben E, Knobler R, Porkert S, Fassnacht C, Cowan R, Papadavid E, Beylot-Barry M, Berti E, Alberti Violetti S, Estrach T, Matin R, Akilov O, Vakeva L, Prince M, Bates A, Bayne M, Wachsmuch R, Wehkamp U, Marschalko M, Servitje O, Turner D, Weatherhead S, Wobser M, Antonio Sanches J, McKay P, Klemke D, Howles A, Yoo J, Evison F, Scarisbrick J. An overall response in skin is associated with improved HRQoL in patients with MF/SS enrolled in the PROCLIPI study. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30617-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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42
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Leung B, Wu J, Laskin J, Rennie H, Bates A, Ho C. MA14.05 Social Isolation Increases Psychological Distress in Patients With NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.433] [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: 10/28/2022]
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43
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Ho C, Leung B, Rennie H, Laskin J, Wu J, Bates A. Patient reported stressors in the practical domain of a cancer diagnosis: The impact of socioeconomic status and geographic location. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy297.025] [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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44
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Bates A, Terrell CR. Visualizing Biochemistry: The Implementation of Biomolecular Visualization and Structure‐Function Conceptual Game‐based Card Sorting Activities. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.663.25] [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: 11/11/2022]
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45
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Kodali M, Hattiangady B, Shetty G, Bates A, Shuai B, Shetty A. Curcumin treatment leads to better cognitive and mood function in a model of Gulf War Illness with enhanced neurogenesis, and alleviation of inflammation and mitochondrial dysfunction in the hippocampus. Brain Behav Immun 2018; 69:499-514. [PMID: 29454881 PMCID: PMC7023905 DOI: 10.1016/j.bbi.2018.01.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/11/2018] [Accepted: 01/15/2018] [Indexed: 01/10/2023] Open
Abstract
Diminished cognitive and mood function are among the most conspicuous symptoms of Gulf War Illness (GWI). Our previous studies in a rat model of GWI have demonstrated that persistent cognitive and mood impairments are associated with substantially declined neurogenesis, chronic low-grade inflammation, increased oxidative stress and mitochondrial dysfunction in the hippocampus. We tested the efficacy of curcumin (CUR) to maintain better cognitive and mood function in a rat model of GWI because of its neurogenic, antiinflammatory, antioxidant, and memory and mood enhancing properties. Male rats were exposed daily to low doses of GWI-related chemicals, pyridostigmine bromide, N,N-diethyl-m-toluamide (DEET) and permethrin, and 5-minutes of restraint stress for 28 days. Animals were next randomly assigned to two groups, which received daily CUR or vehicle treatment for 30 days. Animals also received 5'-bromodeoxyuridine during the last seven days of treatment for analysis of neurogenesis. Behavioral studies through object location, novel object recognition and novelty suppressed feeding tests performed sixty days after treatment revealed better cognitive and mood function in CUR treated GWI rats. These rats also displayed enhanced neurogenesis and diminished inflammation typified by reduced astrocyte hypertrophy and activated microglia in the hippocampus. Additional studies showed that CUR treatment to GWI rats enhanced the expression of antioxidant genes and normalized the expression of multiple genes related to mitochondrial respiration. Thus, CUR therapy is efficacious for maintaining better memory and mood function in a model of GWI. Enhanced neurogenesis, restrained inflammation and oxidative stress with normalized mitochondrial respiration may underlie better memory and mood function mediated by CUR treatment.
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Affiliation(s)
- M. Kodali
- Olin E. Teague Veterans’ Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA,Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, Temple and College Station, TX, USA,Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA
| | - B. Hattiangady
- Olin E. Teague Veterans’ Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA,Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, Temple and College Station, TX, USA,Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA
| | - G.A. Shetty
- Olin E. Teague Veterans’ Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA,Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, Temple and College Station, TX, USA,Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA
| | - A. Bates
- Olin E. Teague Veterans’ Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA,Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, Temple and College Station, TX, USA,Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA
| | - B. Shuai
- Olin E. Teague Veterans’ Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA,Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, Temple and College Station, TX, USA,Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA
| | - A.K. Shetty
- Olin E. Teague Veterans’ Medical Center, Central Texas Veterans Health Care System, Temple, TX, USA,Institute for Regenerative Medicine, Texas A&M Health Science Center College of Medicine, Temple and College Station, TX, USA,Department of Molecular and Cellular Medicine, Texas A&M Health Science Center College of Medicine, College Station, TX, USA,Corresponding author at: Institute for Regenerative Medicine, Texas A&M Health Science Center, College of Medicine, 1114 TAMU, 206 Olsen Boulevard, College Station, TX 77843, USA. (A.K. Shetty)
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46
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Abstract
Chronic subdural haematoma (CSDH) is predominantly a disease of the elderly. Most of the existing data come from studies done several decades ago. We examined the incidence, risk factors, clinical presentation, management and outcome in elderly patients with CSDH by retrospective study of the period 1996–1999 in the three district hospitals of North Wales. 40 cases of CSDH were identified in patients > 65 years, the incidence in this population being 8.2/100000. Falls (57%) and antithrombotic therapy (33%) were the most frequent risk factors. The most common presenting features were altered mental state (52%) and focal neurological deficit (50%). 24 patients (60%) underwent surgical intervention with 4 deaths (17%). In the non-operated group mortality was 7/16 (44%). Most of the deaths in this series were due either to CSDH or to the complications of frailty and poor mobility. Surgery itself was generally successful.
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Affiliation(s)
| | - Vedamurthy Adhiyaman
- Department of Geriatric Medicine, Glan Clwyd District General Hospital, Rhyl, Denbighshire LL18 5UJ
| | - M W Greenway
- Department of Geriatric Medicine, Glan Clwyd District General Hospital, Rhyl, Denbighshire LL18 5UJ
| | - Bhimal K Bhowmick
- Department of Geriatric Medicine, Glan Clwyd District General Hospital, Rhyl, Denbighshire LL18 5UJ
| | - A Bates
- Ysbyty Gwynedd, Bangor, Gwynedd LL57 2PW, UK
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47
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Leung B, Naik H, Laskin J, Wu J, Mackenzie R, Bates A, Ho C. MA 04.02 Assessing the Psychosocial Needs of Newly Diagnosed NSCLC Patients: Identifying the Population Most At-Risk. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.470] [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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48
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Bayman N, Appel W, Ashcroft L, Baldwin D, Bates A, Darlison L, Edwards J, Ezhil V, Gilligan D, Hatton M, Mansy T, Peake M, Pemberton L, Rintoul R, Ryder D, Taylor P, Faivre-Finn C. OA 02.03 Prophylactic Irradiation of Tracts (PIT) in Patients with Pleural Mesothelioma: Results of a Multicenter Phase III Trial. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sacco KA, Bates A, Brigham TJ, Imam JS, Burton MC. Clinical outcomes following inpatient penicillin allergy testing: A systematic review and meta-analysis. Allergy 2017; 72:1288-1296. [PMID: 28370003 DOI: 10.1111/all.13168] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [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: 03/24/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND A documented penicillin allergy is associated with increased morbidity including length of hospital stay and an increased incidence of resistant infections attributed to use of broader-spectrum antibiotics. The aim of the systematic review was to identify whether inpatient penicillin allergy testing affected clinical outcomes during hospitalization. METHODS We performed an electronic search of Ovid MEDLINE/PubMed, Embase, Web of Science, Scopus, and the Cochrane Library over the past 20 years. Inpatients having a documented penicillin allergy that underwent penicillin allergy testing were included. RESULTS Twenty-four studies met eligibility criteria. Study sample size was between 24 and 252 patients in exclusively inpatient cohorts. Penicillin skin testing (PST) with or without oral amoxicillin challenge was the main intervention described (18 studies). The population-weighted mean for a negative PST was 95.1% [CI 93.8-96.1]. Inpatient penicillin allergy testing led to a change in antibiotic selection that was greater in the intensive care unit (77.97% [CI 72.0-83.1] vs 54.73% [CI 51.2-58.2], P<.01). An increased prescription of penicillin (range 9.9%-49%) and cephalosporin (range 10.7%-48%) antibiotics was reported. Vancomycin and fluoroquinolone use was decreased. Inpatient penicillin allergy testing was associated with decreased healthcare cost in four studies. CONCLUSIONS Inpatient penicillin allergy testing is safe and effective in ruling out penicillin allergy. The rate of negative tests is comparable to outpatient and perioperative data. Patients with a documented penicillin allergy who require penicillin should be tested during hospitalization given its benefit for individual patient outcomes and antibiotic stewardship.
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Affiliation(s)
- K. A. Sacco
- Department of Internal Medicine; Mayo Clinic; Jacksonville FL USA
| | - A. Bates
- Department of Internal Medicine; Mayo Clinic; Jacksonville FL USA
| | - T. J. Brigham
- Winn-Dixie Foundation Medical Library; Mayo Clinic; Jacksonville FL USA
| | - J. S. Imam
- Department of Internal Medicine; Mayo Clinic; Jacksonville FL USA
| | - M. C. Burton
- Department of Internal Medicine; Mayo Clinic; Jacksonville FL USA
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Conway J, Bates A, Freed D, MacArthur R, Buchholz H. Bivalirudin Experience in a Heterogenous VAD Population. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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