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Abstract
IMPORTANCE A new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021. OBJECTIVE To examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice. DESIGN, SETTING, AND PARTICIPANTS This cohort study of US patients with an ICD-10-CM code for post-COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity. Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post-COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post-COVID-19 diagnosis date was required. MAIN OUTCOMES AND MEASURES Presence of the ICD-10-CM U09.9 code. RESULTS There were 56 143 patients (7723 female patients [61.2%]; mean [SD] age, 47.6 [19.2] years) with a post-COVID-19 diagnosis code, with cases increasing in mid-December 2021 following the trajectory of the Omicron case wave by 3 to 4 weeks. The analysis cohort included 12 622 patients after the 3-month preindex CE criteria was applied. Among this cohort, the median (IQR) age was 49 (35-61) years; however, 1080 (8.6%) were pediatric patients. The U09.9 code was used most often in the outpatient setting, although 305 older adults (14.0%) were inpatients. Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance. Only 8879 patients (70.4%) had a documented acute COVID-19 diagnosis code (569 [52.7%] among children), and the median (IQR) time between acute COVID-19 and post-COVID-19 diagnosis codes was 56 (21-200) days. The most common concurrently coded conditions varied by age; children experienced COVID-19-like symptoms (eg, 207 [19.2%] had cough and 115 [10.6%] had breathing abnormalities), while 459 older adults aged 65 years or older (21.1%) experienced respiratory failure and 189 (8.7%) experienced viral pneumonia. CONCLUSIONS AND RELEVANCE This retrospective cohort study found patients with a post-COVID-19 ICD-10-CM diagnosis code following the acute phase of COVID-19 disease among patients of all ages in clinical practice in the US. The use of the U09.9 code encompassed a wide range of conditions. It will be important to monitor how the use of this code changes as the pandemic continues to evolve.
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Affiliation(s)
- Leah J. McGrath
- Real World Evidence Center of Excellence, Pfizer Inc, New York, New York
| | - Amie M. Scott
- Real World Evidence Center of Excellence, Pfizer Inc, New York, New York
| | | | - Richard Chambers
- Global Product Development Statistics, Pfizer Inc, Collegeville, Pennsylvania
| | - Michael Benigno
- Real World Evidence Center of Excellence, Pfizer Inc, New York, New York
| | - Deepa Malhotra
- Real World Evidence Center of Excellence, Pfizer Inc, New York, New York
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Lopci E, Hicks RJ, Dimitrakopoulou-Strauss A, Dercle L, Iravani A, Seban RD, Sachpekidis C, Humbert O, Gheysens O, Glaudemans AWJM, Weber W, Wahl RL, Scott AM, Pandit-Taskar N, Aide N. Joint EANM/SNMMI/ANZSNM practice guidelines/procedure standards on recommended use of [ 18F]FDG PET/CT imaging during immunomodulatory treatments in patients with solid tumors version 1.0. Eur J Nucl Med Mol Imaging 2022; 49:2323-2341. [PMID: 35376991 PMCID: PMC9165250 DOI: 10.1007/s00259-022-05780-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/22/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE The goal of this guideline/procedure standard is to assist nuclear medicine physicians, other nuclear medicine professionals, oncologists or other medical specialists for recommended use of [18F]FDG PET/CT in oncological patients undergoing immunotherapy, with special focus on response assessment in solid tumors. METHODS In a cooperative effort between the EANM, the SNMMI and the ANZSNM, clinical indications, recommended imaging procedures and reporting standards have been agreed upon and summarized in this joint guideline/procedure standard. CONCLUSIONS The field of immuno-oncology is rapidly evolving, and this guideline/procedure standard should not be seen as definitive, but rather as a guidance document standardizing the use and interpretation of [18F]FDG PET/CT during immunotherapy. Local variations to this guideline should be taken into consideration. PREAMBLE The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association founded in 1985 to facilitate worldwide communication among individuals pursuing clinical and academic excellence in nuclear medicine. The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote science, technology and practical application of nuclear medicine. The Australian and New Zealand Society of Nuclear Medicine (ANZSNM), founded in 1969, represents the major professional society fostering the technical and professional development of nuclear medicine practice across Australia and New Zealand. It promotes excellence in the nuclear medicine profession through education, research and a commitment to the highest professional standards. EANM, SNMMI and ANZSNM members are physicians, technologists, physicists and scientists specialized in the research and clinical practice of nuclear medicine. All three societies will periodically put forth new standards/guidelines for nuclear medicine practice to help advance the science of nuclear medicine and improve service to patients. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each standard/guideline, representing a policy statement by the EANM/SNMMI/ANZSNM, has undergone a thorough consensus process, entailing extensive review. These societies recognize that the safe and effective use of diagnostic nuclear medicine imaging requires particular training and skills, as described in each document. These standards/guidelines are educational tools designed to assist practitioners in providing appropriate and effective nuclear medicine care for patients. These guidelines are consensus documents based on current knowledge. They are not intended to be inflexible rules or requirements of practice, nor should they be used to establish a legal standard of care. For these reasons and those set forth below, the EANM, SNMMI and ANZSNM caution against the use of these standards/guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals considering the unique circumstances of each case. Thus, there is no implication that an action differing from what is laid out in the guidelines/procedure standards, standing alone, is below standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the standards/guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources or advances in knowledge or technology subsequent to publication of the guidelines/procedure standards. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation and treatment of disease. The variety and complexity of human conditions make it impossible for general guidelines to consistently allow for an accurate diagnosis to be reached or a particular treatment response to be predicted. Therefore, it should be recognized that adherence to these standards/ guidelines will not ensure a successful outcome. All that should be expected is that practitioners follow a reasonable course of action, based on their level of training, current knowledge, clinical practice guidelines, available resources and the needs/context of the patient being treated. The sole purpose of these guidelines is to assist practitioners in achieving this objective. The present guideline/procedure standard was developed collaboratively by the EANM, the SNMMI and the ANZSNM, with the support of international experts in the field. They summarize also the views of the Oncology and Theranostics and the Inflammation and Infection Committees of the EANM, as well as the procedure standards committee of the SNMMI, and reflect recommendations for which the EANM and SNMMI cannot be held responsible. The recommendations should be taken into the context of good practice of nuclear medicine and do not substitute for national and international legal or regulatory provisions.
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Affiliation(s)
- E Lopci
- Nuclear Medicine Unit, IRCCS - Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milano, Italy.
| | - R J Hicks
- The Department of Medicine, St Vincent's Medical School, the University of Melbourne, Melbourne, Australia
| | - A Dimitrakopoulou-Strauss
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210, Heidelberg, Germany
| | - L Dercle
- Department of Radiology, New York Presbyterian, Columbia University Irving Medical Center, New York, NY, USA
| | - A Iravani
- Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - R D Seban
- Department of Nuclear Medicine and Endocrine Oncology, Institut Curie, 92210, Saint-Cloud, France
- Laboratoire d'Imagerie Translationnelle en Oncologie, Inserm, Institut Curie, 91401, Orsay, France
| | - C Sachpekidis
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69210, Heidelberg, Germany
| | - O Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
- TIRO-UMR E 4320, Université Côte d'Azur, Nice, France
| | - O Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A W J M Glaudemans
- Nuclear Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W Weber
- Department of Nuclear Medicine, Klinikum Rechts Der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - R L Wahl
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Studley Rd, Heidelberg, Victoria, 3084, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, Australia
- Faculty of Medicine, University of Melbourne, Melbourne, Australia
- School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - N Pandit-Taskar
- Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY, 10021, USA
| | - N Aide
- Nuclear Medicine Department, University Hospital, Caen, France
- INSERM ANTICIPE, Normandie University, Caen, France
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Lindberg I, Geale K, Lilja M, Richardson C, Scott AM, Tian H. 15154 Incidence of psoriatic arthritis in patients with psoriasis: A population-based cohort study in Swedish routine clinical care. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.657] [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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Lee ST, Muralidharan V, Tebbutt N, Wong P, Fang C, Liu Z, Gan H, Sachinidis J, Pathmaraj K, Christophi C, Scott AM. Prevalence of hypoxia and correlation with glycolytic metabolism and angiogenic biomarkers in metastatic colorectal carcinoma. Eur J Nucl Med Mol Imaging 2020; 48:1585-1592. [PMID: 33125527 DOI: 10.1007/s00259-020-05074-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Hypoxia is associated with aggressive tumour behaviour and can influence response to systemic therapy and radiotherapy. The prevalence of hypoxia in metastatic colorectal cancer is poorly understood, and the relationship of hypoxia to patient outcomes has not been clearly established. The aims of the study were to evaluate hypoxia in metastatic colorectal cancer with [18F]Fluoromisonidazole ([18F]FMISO PET) and correlate these findings with glycolytic metabolism ([18F]FDG PET) and angiogenic blood biomarkers and patient outcomes. METHODS Patients with metastatic colorectal cancer received routine staging investigations and both [18F] FMISO PET and [18F] FDG PET scans. Correlative blood specimens were also obtained at the time of the [18F] FMISO PET scan. Patient follow-up was performed to establish progression-free survival. RESULTS A total of 40 patients were recruited into the trial. [18F]FMISO and [18F]FDG PET scans showed a significant correlation of SUVmax (p = 0.003). A significant correlation of progression-free survival and [18F] FMISO TNR (p = 0.02) and overall survival with [18F]FMISO TNR (p = 0.003) and [18F]FDG TGV (p = 0.02) was observed. Serum levels of osteopontin, but not VEGF, correlated with [18F] FMISO and [18F]FDG PET scan parameters. CONCLUSION [18F]FMISO PET uptake in metastatic colorectal cancer significantly correlates with glycolytic metabolism and is predictive of progression-free and overall survival. These findings have implications for the assessment and treatment of metastatic colorectal cancer patients with novel therapies which affect tumour angiogenesis and hypoxia.
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Affiliation(s)
- S T Lee
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia. .,Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia. .,School of Cancer Medicine, La Trobe University, Melbourne, Australia. .,Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia.
| | - V Muralidharan
- Department of Surgery, Austin Health, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia
| | - N Tebbutt
- Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia.,Department of Medical Oncology, Austin Health, Melbourne, Australia
| | - P Wong
- Department of Surgery, Austin Health, Melbourne, Australia
| | - C Fang
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
| | - Z Liu
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia
| | - H Gan
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia.,Department of Medical Oncology, Austin Health, Melbourne, Australia
| | - J Sachinidis
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - K Pathmaraj
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - C Christophi
- Department of Surgery, Austin Health, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia.,Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Austin Health, Melbourne, Australia.,School of Cancer Medicine, La Trobe University, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
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Huang HL, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Lan X, Herrmann K, Scott AM, Vinjamuri S, Dorbala S, Estrada E, Pellet O, Orellana P, El-Haj N, Giammarile F, Abdel-Wahab M, Bomanji J. Nuclear medicine services after COVID-19: gearing up back to normality. Eur J Nucl Med Mol Imaging 2020; 47:2048-2053. [PMID: 32367256 PMCID: PMC7197920 DOI: 10.1007/s00259-020-04848-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 01/08/2023]
Affiliation(s)
- H L Huang
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.,Department of Nuclear Medicine and Molecular Imaging, Division of Radiological Sciences, Singapore General Hospita, Bukit Merah, Singapore
| | | | - D Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - M Hacker
- Department of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University, Seoul, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Centre, Milan, Italy
| | - X Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - S Vinjamuri
- Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - S Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.
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Paez D, Gnanasegaran G, Fanti S, Bomanji J, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Herrmann K, Scott AM, Czernin J, El-Haj N, Estrada E, Pellet O, Orellana P, Giammarile F, Abdel-Wahab M. COVID-19 pandemic: guidance for nuclear medicine departments. Eur J Nucl Med Mol Imaging 2020; 47:1615-1619. [PMID: 32296886 PMCID: PMC7159284 DOI: 10.1007/s00259-020-04825-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- D Paez
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria.
| | | | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - J Bomanji
- Institute of Nuclear Medicine, University College London Hospital, London, UK
| | - M Hacker
- Division of Nuclear Medicine, Department of Nuclear Medicine Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University Medical School, Hwasun, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Hospital, Milan, Italy
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - J Czernin
- Ahmanson Translation Imaging Division, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, PO Box 100, 1400, Vienna, Austria
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Harrington RL, Hanna ML, Oehrlein EM, Camp R, Wheeler R, Cooblall C, Tesoro T, Scott AM, von Gizycki R, Nguyen F, Hareendran A, Patrick DL, Perfetto EM. Defining Patient Engagement in Research: Results of a Systematic Review and Analysis: Report of the ISPOR Patient-Centered Special Interest Group. Value Health 2020; 23:677-688. [PMID: 32540224 DOI: 10.1016/j.jval.2020.01.019] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [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: 02/07/2019] [Revised: 01/17/2020] [Accepted: 01/30/2020] [Indexed: 05/13/2023]
Abstract
OBJECTIVES Lack of clarity on the definition of "patient engagement" has been highlighted as a barrier to fully implementing patient engagement in research. This study identified themes within existing definitions related to patient engagement and proposes a consensus definition of "patient engagement in research." METHODS A systematic review was conducted to identify definitions of patient engagement and related terms in published literature (2006-2018). Definitions were extracted and qualitatively analyzed to identify themes and characteristics. A multistakeholder approach, including academia, industry, and patient representation, was taken at all stages. A proposed definition is offered based on a synthesis of the findings. RESULTS Of 1821 abstracts identified and screened for eligibility, 317 were selected for full-text review. Of these, 169 articles met inclusion criteria, from which 244 distinct definitions were extracted for analysis. The most frequently defined terms were: "patient-centered" (30.5%), "patient engagement" (15.5%), and "patient participation" (13.4%). The majority of definitions were specific to the healthcare delivery setting (70.5%); 11.9% were specific to research. Among the definitions of "patient engagement," the most common themes were "active process," "patient involvement," and "patient as participant." In the research setting, the top themes were "patient as partner," "patient involvement," and "active process"; these did not appear in the top 3 themes of nonresearch definitions. CONCLUSION Distinct themes are associated with the term "patient engagement" and with engagement in the "research" setting. Based on an analysis of existing literature and review by patient, industry, and academic stakeholders, we propose a scalable consensus definition of "patient engagement in research."
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Affiliation(s)
| | - Maya L Hanna
- Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT USA
| | | | - Rob Camp
- Community Advisory Board Programme, EURORDIS, Barcelona, Spain
| | | | - Clarissa Cooblall
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
| | - Theresa Tesoro
- Scientific & Health Policy Initiatives, ISPOR, Lawrenceville, NJ, USA
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Huang HL, Gnanasegaran G, Paez D, Fanti S, Hacker M, Sathekge M, Bom HS, Cerci JJ, Chiti A, Lan X, Herrmann K, Scott AM, Vinjamuri S, Dorbala S, Estrada E, Pellet O, Orellana P, El-Haj N, Giammarile F, Abdel-Wahab M, Bomanji J. Correction to: Nuclear medicine services after COVID-19: gearing up back to normality. Eur J Nucl Med Mol Imaging 2020; 47:2220. [PMID: 32462399 PMCID: PMC7252414 DOI: 10.1007/s00259-020-04884-x] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors P. Orellana and N. El-Haj were inadvertently deleted in the original paper.
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Affiliation(s)
- H L Huang
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK
- Department of Nuclear Medicine and Molecular Imaging, Division of Radiological Sciences, Singapore General Hospital, Bukit Merah, Singapore
| | | | - D Paez
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - S Fanti
- Department of Oncology, Division of Nuclear Medicine, University of Bologna, Bologna, Italy
| | - M Hacker
- Department of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - M Sathekge
- NuclearMedicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - H S Bom
- Department of Nuclear Medicine, Chonnam National University, Seoul, South Korea
| | - J J Cerci
- PET/CT Department at Quanta Diagnostics and Therapy, Curitiba, Brazil
| | - A Chiti
- Humanitas University and Humanitas Research Centre, Milan, Italy
| | - X Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - A M Scott
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Australia
| | - S Vinjamuri
- Royal Liverpool University Hospital, Liverpool, L7 8XP, UK
| | - S Dorbala
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - E Estrada
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - O Pellet
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - P Orellana
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - N El-Haj
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - F Giammarile
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - M Abdel-Wahab
- Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Jamshed Bomanji
- Institute of Nuclear Medicine, University College London Hospital, 5th Floor, 235 Euston Road, London, UK.
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Saunus JM, Lim M, Puttick S, Kalita-de Croft P, Houston ZH, Jones ML, Latter MJ, Campbell LC, Thomas P, Jeffree RL, Rose SE, Mahler SM, Thurecht KJ, Scott AM, Lakhani SR. Abstract P1-19-02: Innovation in diagnosis and treatment of brain metastases using multifunctional nanomedicines. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-19-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Systemic therapies have limited efficacy against brain metastases, largely because passive delivery of naked compounds via the bloodstream does not achieve sufficiently high or evenly dispersed intratumoural concentrations. Heterogeneous tissue architecture, abnormal perfusion, hypoxic zones and high interstitial fluid pressure are key factors limiting drug delivery, compounded by patchy blood-tumour-barrier permeability. Also, brain metastases are usually detected late, once patients become symptomatic. We are investigating whether engineered biopharmaceuticals might improve diagnostic sensitivity for earlier detection, as well as therapeutic efficacy and side-effect profiles of existing agents through active tumour targeting, delayed clearance and microenvironment-mediated activation. This study is proceeding with parallel preclinical and clinical tracks.
Preclinical aims: (1) Develop and characterise monoclonal antibody (mAb) fragments (scFvs) that target the brain metastasis markers HER2 and HER3; (2) Functionalise polyethylene glycol (PEG)-based nanocarriers with the scFvs, along with imaging agents to facilitate in vivoand ex vivoanalysis of tissue distribution; (3) Functionalise HER2/3-targeted carriers with doxorubicin via an acid-labile hydrazone bond for release in hypoxic environments, or the endosome compartment after internalization. Results to date. His-tagged HER2- and HER3-targeted scFvs based on ligand-binding sequences of clinically-approved mAbs were expressed and purified from Expi293 suspension cultures. Binding affinities are an order of magnitude stronger than parent mAbs (KD 2-8x10E-11M), determined using surface plasmon resonance analysis. The scFvs are cytostatic and moderately cytotoxic in vitro, with IC50s in order of 0.4-1.0μM. HER2 and HER3 scFvs exhibited dose-dependent, additive growth inhibition when used in combination, and induced internalisation of their receptor ligands within 4 hours in SKBr3 cells. Conclusions.The scFvs are strong carrier-tethering candidates in terms of both extracellular and intracellular payload release. Carrier synthesis is currently underway and preliminary in vivo data will be presented.
Clinical aims: (1) Develop and characterise 89Zirconium-labelled HER2-targeted PET tracers based on parent mAb and scFv; (2) Compare uptake and retention of the tracers in breast cancer patients with brain metastases; (3) Computationally relate tumour uptake to the administered dose, perfusion, tumour size and HER2 expression; (4) Determine the uptake range within and between patients, and the minimum size for reliable detection. Results to date. The mAb tracer has been synthesised, characterised and labelling processes scaled for clinical production. It is stable in physiologic conditions, retains HER2-binding activity and has a favourable biodistribution profile in NOD-SCID mice bearing BT474 xenografts. Conclusions. Australian regulatory approvals are in place and recruitment for the mAb imaging trial ("BoNSAI") has begun. Preliminary data will be presented.
Citation Format: Saunus JM, Lim M, Puttick S, Kalita-de Croft P, Houston ZH, Jones ML, Latter MJ, Campbell LC, Thomas P, Jeffree RL, Rose SE, Mahler SM, Thurecht KJ, Scott AM, Lakhani SR. Innovation in diagnosis and treatment of brain metastases using multifunctional nanomedicines [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-19-02.
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Affiliation(s)
- JM Saunus
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - M Lim
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - S Puttick
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - P Kalita-de Croft
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - ZH Houston
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - ML Jones
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - MJ Latter
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - LC Campbell
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - P Thomas
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - RL Jeffree
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - SE Rose
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - SM Mahler
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - KJ Thurecht
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - AM Scott
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
| | - SR Lakhani
- Faculty of Medicine, The University of Queensland, Centre for Clinical Research, Herston, QLD, Australia; Australian Institute for Nanotechnology and Bioengineering, Centre for Advanced Imaging and ARC Centre of Excellence in Convergent BioNano Science and Technology, The University of Queensland, St. Lucia, QLD, Australia; Australian E-Health Research Centre, CSIRO Health & Biosecurity, Herston, QLD, Australia; Australian Institute for Bioengineering and Nanotechnology and ARC Training Centre for Biopharmaceutical Innovation, The University of Queensland, St. Lucia, QLD, Australia; The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Herston Imaging Research Facility (HIRF), The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Kenneth G. Jamieson Neurosurgical Unit, The Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Olivia Newton-John Cancer Research Institute and Austin Health, Heidelberg, VIC, Australia; Pathology Queensland, The Royal Brisbane and Women's Hospital
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Scott AM. Principal Red-Cell Antigens Responsible for Haemolytic Disease of the Newborn Foal: Naturally-Occurring Antibodies in Thoroughbreds. J R Soc Med 2018. [DOI: 10.1177/014107687807100807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- A M Scott
- Equine Research Station, Newmarket, Suffolk CB8 8AP
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Di Biase MA, Zalesky A, O'keefe G, Laskaris L, Baune BT, Weickert CS, Olver J, McGorry PD, Amminger GP, Nelson B, Scott AM, Hickie I, Banati R, Turkheimer F, Yaqub M, Everall IP, Pantelis C, Cropley V. PET imaging of putative microglial activation in individuals at ultra-high risk for psychosis, recently diagnosed and chronically ill with schizophrenia. Transl Psychiatry 2017; 7:e1225. [PMID: 28850113 PMCID: PMC5611755 DOI: 10.1038/tp.2017.193] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 06/23/2017] [Indexed: 01/22/2023] Open
Abstract
We examined putative microglial activation as a function of illness course in schizophrenia. Microglial activity was quantified using [11C](R)-(1-[2-chrorophynyl]-N-methyl-N-[1-methylpropyl]-3 isoquinoline carboxamide (11C-(R)-PK11195) positron emission tomography (PET) in: (i) 10 individuals at ultra-high risk (UHR) of psychosis; (ii) 18 patients recently diagnosed with schizophrenia; (iii) 15 patients chronically ill with schizophrenia; and, (iv) 27 age-matched healthy controls. Regional-binding potential (BPND) was calculated using the simplified reference-tissue model with four alternative reference inputs. The UHR, recent-onset and chronic patient groups were compared to age-matched healthy control groups to examine between-group BPND differences in 6 regions: dorsal frontal, orbital frontal, anterior cingulate, medial temporal, thalamus and insula. Correlation analysis tested for BPND associations with gray matter volume, peripheral cytokines and clinical variables. The null hypothesis of equality in BPND between patients (UHR, recent-onset and chronic) and respective healthy control groups (younger and older) was not rejected for any group comparison or region. Across all subjects, BPND was positively correlated to age in the thalamus (r=0.43, P=0.008, false discovery rate). No correlations with regional gray matter, peripheral cytokine levels or clinical symptoms were detected. We therefore found no evidence of microglial activation in groups of individuals at high risk, recently diagnosed or chronically ill with schizophrenia. While the possibility of 11C-(R)-PK11195-binding differences in certain patient subgroups remains, the patient cohorts in our study, who also displayed normal peripheral cytokine profiles, do not substantiate the assumption of microglial activation in schizophrenia as a regular and defining feature, as measured by 11C-(R)-PK11195 BPND.
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Affiliation(s)
- M A Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
| | - A Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
- Melbourne School of Engineering, The University of Melbourne, Parkville, VIC Australia
| | - G O'keefe
- Department of Molecular Imaging and Therapy, The University of Melbourne, Heidelberg, VIC Australia
- Department of Medicine, The University of Melbourne, and La Trobe University, Austin Hospital, Heidelberg, VIC, Australia
| | - L Laskaris
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
| | - B T Baune
- Discipline of Psychiatry, The University of Adelaide, Adelaide, SA, Australia
| | - C S Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
- Schizophrenia Research Institute, Randwick, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - J Olver
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
- Department of Molecular Imaging and Therapy, The University of Melbourne, Heidelberg, VIC Australia
- Department of Medicine, The University of Melbourne, and La Trobe University, Austin Hospital, Heidelberg, VIC, Australia
| | - P D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - G P Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - B Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - A M Scott
- Department of Molecular Imaging and Therapy, The University of Melbourne, Heidelberg, VIC Australia
- Department of Medicine, The University of Melbourne, and La Trobe University, Austin Hospital, Heidelberg, VIC, Australia
| | - I Hickie
- Brain & Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - R Banati
- Medical Radiation Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - F Turkheimer
- Department of Neuroimaging, King’s College London, London, UK
| | - M Yaqub
- VU University Medical Center, Amsterdam, The Netherlands
| | - I P Everall
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
- North Western Mental Health, Melbourne Health, Parkville, VIC, Australia
- Florey Institute for Neurosciences and Mental Health, Parkville, VIC, Australia
- Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia
- Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
- North Western Mental Health, Melbourne Health, Parkville, VIC, Australia
- Florey Institute for Neurosciences and Mental Health, Parkville, VIC, Australia
- Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton South, VIC, Australia
- Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - V Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC Australia
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Ko H, Hunter KE, Scott AM, Ayson M, Willson ML. A systematic review of performance-enhancing pharmacologicals and biotechnologies in the Army. J ROY ARMY MED CORPS 2017; 164:197-206. [PMID: 28835510 DOI: 10.1136/jramc-2016-000752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/20/2017] [Accepted: 04/30/2017] [Indexed: 11/04/2022]
Abstract
INTRODUCTION In 2015, the Australian Army commissioned a systematic review to assess the evidence on effectiveness and safety of pharmacological and biotechnological products for cognitive enhancement specifically in Army personnel. METHODS Searches for studies examining biotechnological and pharmacological products in Army populations were conducted in December 2015. Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL and PsycINFO were searched without date or language restrictions. WHO's International Clinical Trials Registry Platform and ClinicalTrials.gov were searched to identify ongoing trials. Studies meeting inclusion criteria were evaluated for risk of bias using Cochrane's Risk of Bias tool. Due to heterogeneity of findings, meta-analysis could not be conducted. Findings were synthesised narratively and by vote-counting method. RESULTS Sixteen pharmacological enhancement products were evaluated in 22 randomised controlled trials (RCTs), involving 1284 personnel. Only three of the studies were published since 2010. The interventions evaluated were varied, including supplements (eg, carbohydrate), stimulants (eg, caffeine) and hormones (eg, melatonin). Generally, caffeine provided an improvement in performance compared with placebo on 5/7 reported cognitive outcomes, followed by levothyroxine (four cognitive outcomes) and prazosin (three cognitive outcomes). Performance results were mixed (finding an improvement and no effect in comparison to placebo) for caffeine and melatonin on two outcomes. No evidence was found pertaining to biotechnological products. Studies rarely reported safety outcomes (eg, adverse events and addiction). CONCLUSION Findings from this review need to be interpreted with considerable caution. Future studies should include outcomes such as acute and long-term adverse events, and should evaluate cognitive performance using cognitive tests that are specific to the Army population.
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Affiliation(s)
- Henry Ko
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - K E Hunter
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - A M Scott
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Queensland, Australia
| | - M Ayson
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - M L Willson
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
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Van Scoy LJ, Scott AM, Reading JM, Chuang CH, Chinchilli VM, Levi BH, Green MJ. From Theory to Practice: Measuring end-of-life communication quality using multiple goals theory. Patient Educ Couns 2017; 100:909-918. [PMID: 28011081 DOI: 10.1016/j.pec.2016.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 02/05/2016] [Revised: 11/17/2016] [Accepted: 12/14/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To describe how multiple goals theory can be used as a reliable and valid measure (i.e., coding scheme) of the quality of conversations about end-of-life issues. METHODS We analyzed conversations from 17 conversations in which 68 participants (mean age=51years) played a game that prompted discussion in response to open-ended questions about end-of-life issues. Conversations (mean duration=91min) were audio-recorded and transcribed. Communication quality was assessed by three coders who assigned numeric scores rating how well individuals accomplished task, relational, and identity goals in the conversation. RESULTS The coding measure, which results in a quantifiable outcome, yielded strong reliability (intra-class correlation range=0.73-0.89 and Cronbach's alpha range=0.69-0.89 for each of the coded domains) and validity (using multilevel nonlinear modeling, we detected significant variability in scores between games for each of the coded domains, all p-values <0.02). CONCLUSIONS Our coding scheme provides a theory-based measure of end-of-life conversation quality that is superior to other methods of measuring communication quality. PRACTICE IMPLICATIONS Our description of the coding method enables researches to adapt and apply this measure to communication interventions in other clinical contexts.
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Affiliation(s)
- L J Van Scoy
- Department of Medicine and Humanities, Penn State Milton S. Hershey Medical Center, United States.
| | - A M Scott
- Department of Communication, University of Kentucky, United States
| | - J M Reading
- Department of Medicine, Penn State Milton S. Hershey Medical Center, United States
| | - C H Chuang
- Department of Medicine and Public Health Sciences, Penn State Milton S. Hershey Medical Center, United States
| | - V M Chinchilli
- Department of Public Health Sciences and Statistics, Penn State Milton S. Hershey Medical Center, United States
| | - B H Levi
- Department of Humanities and Pediatrics, Penn State Milton S. Hershey Medical Center, United States
| | - M J Green
- Department of Medicine and Humanities, Penn State Milton S. Hershey Medical Center, United States
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Wei CH, Scott AM, Price AN, Miller HC, Klassen AF, Jhanwar SM, Mehrara BJ, Disa JJ, McCarthy C, Matros E, Cordeiro PG, Sacchini V, Pusic AL. Psychosocial and Sexual Well-Being Following Nipple-Sparing Mastectomy and Reconstruction. Breast J 2016; 22:10-7. [PMID: 26782950 DOI: 10.1111/tbj.12542] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Nipple-sparing mastectomy (NSM) is considered an oncologically safe option for select patients. As many patients are candidates for nipple-sparing or skin-sparing mastectomy (SSM), reliable patient-reported outcome data are crucial for decision-making. The objective of this study was to determine whether patient satisfaction and/or health-related quality of life (HRQOL) were improved by preservation of the nipple with NSM compared to SSM and nipple reconstruction. Subjects were identified from a prospectively maintained database of patients who completed the BREAST-Q following mastectomy and breast reconstruction between March and October 2011 at Memorial Sloan Kettering Cancer Center. Fifty-two patients underwent NSM followed by immediate expander-implant reconstruction. A comparison group consisted of 202 patients who underwent SSM followed by immediate expander-implant reconstruction and later nipple reconstruction. HRQOL and satisfaction domains as measured by BREAST-Q scores were compared in multivariate linear regression analyzes that controlled for potential confounding factors. NSM patients reported significantly higher scores in the psychosocial (p = 0.01) and sexual well-being (p = 0.02) domains compared to SSM patients. There was no significant difference in the BREAST-Q physical well-being, satisfaction with breast, or satisfaction with outcome domains between the NSM and SSM groups. NSM is associated with higher psychosocial and sexual well-being compared to SSM and nipple reconstruction. Preoperative discussion of such HRQOL outcomes with patients may facilitate informed decision-making and realistic postoperative expectations.
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Affiliation(s)
- Cindy H Wei
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amie M Scott
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alison N Price
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Helen Catherine Miller
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anne F Klassen
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sabrina M Jhanwar
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Babak J Mehrara
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph J Disa
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Colleen McCarthy
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Evan Matros
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peter G Cordeiro
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Virgilio Sacchini
- Breast Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrea L Pusic
- Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Lee EH, Klassen AF, Lawson JL, Scott AM, Pusic AL. Patient experiences and outcomes following facial skin cancer surgery: A qualitative study. Australas J Dermatol 2016; 57:e100-4. [PMID: 25833383 PMCID: PMC5461874 DOI: 10.1111/ajd.12323] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [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: 12/01/2014] [Accepted: 02/05/2015] [Indexed: 11/29/2022]
Abstract
Early melanoma and non-melanoma skin cancer of the facial area are primarily treated with surgery. Little is known about the outcomes of treatment for facial skin cancer patients. The objective of the study was to identify concerns about aesthetics, procedures and health from the patients' perspective after facial skin surgery. Semi-structured in-depth interviews were conducted with 15 participants. Line-by-line coding was used to establish categories and develop themes. We identified five major themes on the impact of skin cancer surgery: appearance-related concerns; psychological (e.g., fear of new cancers or recurrence); social (e.g. impact on social activities and interaction); physical (e.g. pain and swelling) concerns and satisfaction with the experience of care (e.g., satisfaction with surgeon). The priority of participants was the removal of the facial skin cancer, as this reduced their overall worry. The aesthetic outcome was secondary but important, as it had important implications on the participants' social and psychological functioning. The participants' experience with the care provided by the surgeon and staff also contributed to their satisfaction with their treatment. This conceptual framework provides the basis for the development of a new patient-reported outcome instrument.
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Affiliation(s)
- Erica H. Lee
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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16
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Schwitzer JA, Albino FP, Mathis RK, Scott AM, Gamble L, Baker SB. Assessing Demographic Differences in Patient-Perceived Improvement in Facial Appearance and Quality of Life Following Rhinoplasty. Aesthet Surg J 2015; 35:784-93. [PMID: 26063837 DOI: 10.1093/asj/sjv066] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 03/26/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As rhinoplasty patient demographics evolve, surgeons must consider the impact of demographics on patient satisfaction. OBJECTIVES The objective of this study was to identify independent demographic predictors of differences in satisfaction with appearance and quality of life following rhinoplasty utilizing the FACE-Q patient-reported outcome instrument. METHODS Patients presenting for rhinoplasty completed the following FACE-Q scales: Satisfaction with Facial Appearance, Satisfaction with Nose, Social Function, and Psychological Well-being. Higher FACE-Q scores indicate greater satisfaction with appearance or superior quality of life. Pre- and post-treatment scores were compared in the context of patient demographics. RESULTS The scales were completed by 59 patients. Women demonstrated statistically significant improvements in Satisfaction with Facial Appearance and quality of life while men only experienced significant improvement in Satisfaction with Facial appearance. Caucasians demonstrated statistically significant improvement in Satisfaction with Facial Appearance and quality of life while non-Caucasians did not. Patients younger than 35 years old were more likely to experience enhanced Satisfaction with Facial Appearance and quality of life compared with patients older than 35 years old. Patients with income ≥$100,000 were more likely to experience significant increases in Satisfaction with Facial Appearance and quality of life than patients with incomes <$100,000. CONCLUSIONS In an objective study using a validated patient-reported outcome instrument, the authors were able to quantify differences in the clinically meaningful change in perception of appearance and quality of life that rhinoplasty patients gain based on demographic variables. The authors also demonstrated that these variables are potential predictors of differences in satisfaction.
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Affiliation(s)
- Jonathan A Schwitzer
- Mr Schwitzer is a Research Fellow and Ms Scott is a Research Coordinator, Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Drs. Albino and Mathis are Residents, Ms. Gamble is an Executive Assistant, and Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC and Medical Director, Inova Children's Hospital Craniofacial Program, Falls Church, VA
| | - Frank P Albino
- Mr Schwitzer is a Research Fellow and Ms Scott is a Research Coordinator, Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Drs. Albino and Mathis are Residents, Ms. Gamble is an Executive Assistant, and Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC and Medical Director, Inova Children's Hospital Craniofacial Program, Falls Church, VA
| | - Ryan K Mathis
- Mr Schwitzer is a Research Fellow and Ms Scott is a Research Coordinator, Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Drs. Albino and Mathis are Residents, Ms. Gamble is an Executive Assistant, and Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC and Medical Director, Inova Children's Hospital Craniofacial Program, Falls Church, VA
| | - Amie M Scott
- Mr Schwitzer is a Research Fellow and Ms Scott is a Research Coordinator, Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Drs. Albino and Mathis are Residents, Ms. Gamble is an Executive Assistant, and Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC and Medical Director, Inova Children's Hospital Craniofacial Program, Falls Church, VA
| | - Laurie Gamble
- Mr Schwitzer is a Research Fellow and Ms Scott is a Research Coordinator, Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Drs. Albino and Mathis are Residents, Ms. Gamble is an Executive Assistant, and Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC and Medical Director, Inova Children's Hospital Craniofacial Program, Falls Church, VA
| | - Stephen B Baker
- Mr Schwitzer is a Research Fellow and Ms Scott is a Research Coordinator, Department of Plastic and Reconstructive Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York. Drs. Albino and Mathis are Residents, Ms. Gamble is an Executive Assistant, and Dr Baker is a Professor and Program Director, Department of Plastic Surgery, Medstar Georgetown University Hospital, Washington, DC and Medical Director, Inova Children's Hospital Craniofacial Program, Falls Church, VA
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17
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Klassen AF, Cano SJ, Schwitzer JA, Scott AM, Pusic AL. FACE-Q scales for health-related quality of life, early life impact, satisfaction with outcomes, and decision to have treatment: development and validation. Plast Reconstr Surg 2015; 135:375-386. [PMID: 25626785 DOI: 10.1097/prs.0000000000000895] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND An ever-growing range of facial cosmetic products and treatments are available, but little clinical research is being performed to determine treatment outcomes from the patient's perspective. The FACE-Q is a patient-reported outcome instrument composed of more than 40 independently functioning scales and checklists. The aim of this article is to describe the development and psychometric evaluation of five new FACE-Q scales. METHODS FACE-Q scales were developed according to international guidelines for patient-reported outcome instrument development. The following FACE-Q scales and a single symptom checklist (Recovery Early Symptoms) were evaluated in this study: Psychological Wellbeing, Social Function, Satisfaction with Decision to Have Treatment, Satisfaction with Outcome of Treatment, and Early Life Impact of Treatment. Modern and traditional psychometric methods were used to examine reliability, validity, and responsiveness. RESULTS The sample included 702 participants from three studies. The FACE-Q scales were found to be reliable, valid, and responsive to clinical change. These findings were supported by Rasch measurement theory (e.g., overall chi-square values, p ≥ 0.06; Person Separation Index ≥0.81), traditional psychometric (e.g., Cronbach alpha values ≥0.90) and responsiveness (i.e., significant improvement following face lift and lip treatment) analysis. CONCLUSIONS The FACE-Q measures concepts and symptoms important to facial aesthetic patients. The five scales and single symptom checklist described here can be used to measure what patients think about cosmetic treatments in a scientifically sound manner. As the cosmetics industry continues to expand, the patient perspective of treatment outcomes should be measured and reported. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, III.
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Affiliation(s)
- Anne F Klassen
- Hamilton, Ontario, Canada; Plymouth, United Kingdom; and New York, N.Y. From McMaster University; Plymouth University Peninsula Schools of Medicine and Dentistry; and Memorial Sloan Kettering Cancer Center
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18
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Scott AM, Lawson JL, Mazza MC, Rubin LR. The Role Of Prior Breast Cancer Diagnosis In Articulating Expectations For Reconstructed Breast Appearance. Value Health 2014; 17:A660. [PMID: 27202402 DOI: 10.1016/j.jval.2014.08.2421] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A M Scott
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - M C Mazza
- The New School for Social Research, New York, NY, USA
| | - L R Rubin
- The New School for Social Research, New York, NY, USA
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19
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Scott AM, Jhanwar SM, Pusic A, McCarthy CM. Shared Decision-Making in Women with Early Stage Breast Cancer and Implications for Long-Term Health-Related Quality of Life. Value Health 2014; 17:A651. [PMID: 27202348 DOI: 10.1016/j.jval.2014.08.2370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A M Scott
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S M Jhanwar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Pusic
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - C M McCarthy
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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20
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Jones DC, Bennett CR, Smith MA, Scott AM. High-power beam transport through a hollow-core photonic bandgap fiber. Opt Lett 2014; 39:3122-3125. [PMID: 24875992 DOI: 10.1364/ol.39.003122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We investigate the use of a seven-cell hollow-core photonic bandgap fiber for transport of CW laser radiation from a single-mode, narrow-linewidth, high-power fiber laser amplifier. Over 90% of the amplifier output was coupled successfully and transmitted through the fiber in a near-Gaussian mode, with negligible backreflection into the source. 100 W of power was successfully transmitted continuously without damage and 160 W of power was transmitted briefly before the onset of thermal lensing in the coupling optics.
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Panchapakesan V, Klassen AF, Cano SJ, Scott AM, Pusic AL. Development and psychometric evaluation of the FACE-Q Aging Appraisal Scale and Patient-Perceived Age Visual Analog Scale. Aesthet Surg J 2013; 33:1099-109. [PMID: 24243890 DOI: 10.1177/1090820x13510170] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The primary outcome measures for patients who undergo aesthetic facial procedures are quality of life and satisfaction with appearance. The FACE-Q, a new patient-reported outcome (PRO) instrument composed of independently functioning scales, is designed to measure a broad range of important outcomes in patients who undergo cosmetic surgical and/or nonsurgical facial procedures. OBJECTIVES The authors describe the development and psychometric evaluation of the FACE-Q Aging Appraisal Scale and the FACE-Q Patient-Perceived Age Visual Analog Scale (VAS). METHODS International guidelines for creating PRO instruments were strictly observed throughout development of the FACE-Q scales. Qualitative methods were used to identify the concepts most important to patients who received aesthetic facial procedures. These were turned into "items"-and the resultant FACE-Q Aging Appraisal Scale was field tested, along with the Patient-Perceived Age VAS, in 288 patients who underwent cosmetic surgical and/or nonsurgical facial procedures. RESULTS Rasch measurement theory and traditional psychometric methods confirmed the reliability and validity of the scales. CONCLUSIONS The FACE-Q Aging Appraisal Scale and Patient-Perceived Age VAS are psychometrically sound, condition-specific PRO instruments with excellent reliability and validity. They enable accurate outcome assessments in patients who undergo aesthetic facial procedures.
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Affiliation(s)
- Vivek Panchapakesan
- Dr Panchapakesan is an attending surgeon in the Department of Plastic and Reconstructive Surgery at William Osler Health System, Toronto, Canada, and an MSc Candidate at McMaster University, Hamilton, Ontario, Canada
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22
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Pusic AL, Klassen AF, Scott AM, Cano SJ. Development and psychometric evaluation of the FACE-Q satisfaction with appearance scale: a new patient-reported outcome instrument for facial aesthetics patients. Clin Plast Surg 2013; 40:249-60. [PMID: 23506765 DOI: 10.1016/j.cps.2012.12.001] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Satisfaction with appearance and improved quality of life are key outcomes for patients undergoing facial aesthetic procedures. The FACE-Q is a new patient-reported outcome (PRO) instrument encompassing a suite of independently functioning scales designed to measure a range of important outcomes for facial aesthetics patients. FACE-Q scales were developed with strict adherence to international guidelines for PRO instrument development. This article describes the development and psychometric evaluation of the core FACE-Q scale, the Satisfaction with Facial Appearance scale. Both modern and traditional psychometric methods were used to confirm that this new 10-item scale is a reliable, valid, and responsive measure.
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Affiliation(s)
- Andrea L Pusic
- Memorial Sloan-Kettering Cancer Center, Room MRI-1007, 1275 York Avenue, New York, NY 10065, USA.
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23
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Abstract
The BREAST-Q(©) is a multiscale, multimodule, patient-reported outcome instrument (PRO) measuring health-related quality of life and patient satisfaction in women who undergo breast surgery. This PRO instrument is the flagship of our team's research, which has spanned almost a decade. This article provides detail about the BREAST-Q(©). The BREAST-Q(©) represents a significant advance in measuring the impact and effectiveness of breast surgery from the patients' perspective. In addition, our overall approach may provide a useful template for the development of future PRO instruments.
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Affiliation(s)
- Stefan J Cano
- Clinical Neurology Research Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Tamar Science Park, Plymouth PL6 8BX, UK
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24
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Koslow S, Pharmer LA, Scott AM, Stempel M, Morrow M, Pusic AL, King TA. Long-Term Patient-Reported Satisfaction after Contralateral Prophylactic Mastectomy and Implant Reconstruction. Ann Surg Oncol 2013; 20:3422-9. [DOI: 10.1245/s10434-013-3026-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Indexed: 11/18/2022]
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25
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Albornoz CR, Pusic AL, Reavey P, Scott AM, Klassen AF, Cano SJ, Cordeiro PG, Matros E. Measuring health-related quality of life outcomes in head and neck reconstruction. Clin Plast Surg 2012; 40:341-9. [PMID: 23506775 DOI: 10.1016/j.cps.2012.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A qualitative study was undertaken to understand the impact of omitted health concepts in existing patient-reported outcome (PRO) instruments for health-related quality of life (HR-QOL) evaluation following head and neck (H&N) cancer reconstruction. Twenty-six patients were interviewed. Patients described a broad range of symptoms. Oral competence, rhinorrhea, facial sensation, smile, vision and eye discharge are missing from existing PRO instruments. Altered appearance was a major stressor; both function and appearance changes had a negative psychosocial impact leading to social isolation and embarrassment. This framework is the foundation for development of a more complete PRO instrument, the FACE-Q Oncology.
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Affiliation(s)
- Claudia R Albornoz
- Plastic and Reconstructive Surgical Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, MRI 1007, New York, NY 10065, USA
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26
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Scott AM, Gorb L, Mobley EA, Hill FC, Leszczynski J. Predictions of Gibbs free energies for the adsorption of polyaromatic and nitroaromatic environmental contaminants on carbonaceous materials: efficient computational approach. Langmuir 2012; 28:13307-13317. [PMID: 22909085 DOI: 10.1021/la3027286] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The adsorption of benzene, polycyclic aromatic hydrocarbons (PAHs), and nitroaromatic compounds (NACs) on the carbonaceous surfaces from the gas phase and water solution was investigated. Several different levels of theory were applied, including DFT-, MP2-, and CCSD(T)-based methods, to find an approach that is computationally inexpensive and can provide accurate thermodynamic parameters for studied adsorption phenomena. The methods and techniques used (including cluster and periodic approximations) were evaluated on the basis of comparison with available experimental data. The optimized structures of calculated complexes are obtained, and the interaction energies and Gibbs free energies are predicted. Good agreement was revealed for the theoretical and experimental adsorption energies of benzene and PAHs adsorbed on the carbon surfaces. The adsorption of benzene, PAHs, and NACs on carbon is suggested to be effective from the gas phase for all studied compounds and for PAHs and NACs also from water solution at room temperature.
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Affiliation(s)
- A M Scott
- U.S. Army Engineer Research and Development Center, 3909 Halls Ferry Road, Vicksburg, Mississippi 39180, USA
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27
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Murphy R, Green S, Ritter G, Cohen L, Ryan D, Woods W, Rubira M, Cebon J, Davis ID, Sjolander A, Kypridis A, Kalnins H, McNamara M, Moloney MB, Ackland J, Cartwright G, Rood J, Dumsday G, Healey K, Maher D, Maraskovsky E, Chen YT, Hoffman EW, Old LJ, Scott AM. Recombinant NY‐ESO‐1 Cancer Antigen: Production and Purification under cGMP Conditions. Prep Biochem Biotechnol 2010; 35:119-34. [PMID: 15881594 DOI: 10.1081/pb-200054732] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The cancer-testis antigen, NY-ESO-1, has been engineered into a bacterial expression plasmid which incorporates a His6-tag. The plasmid was transfected into E. coli strain BL21 and Master and Working cell banks generated from this expression system. Three 15-litre fermentations were performed under cGMP (code of Good Manufacturing Practice) conditions and the crude NY-ESO-1 tagged protein isolated as solubilised inclusion bodies. A three-step cGMP chromatography process (immobilised metal affinity, anion exchange, and hydrophobic interaction) was utilised to purify the protein. The purified NY-ESO-1 is being used in early stage human cancer vaccine trials in Australia and the U.S.A.
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Affiliation(s)
- R Murphy
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Austin Hospital, Heidelberg, Australia.
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Tveiten H, Frantzen M, Scott AM, Scott AP. Synthesis of 17,20beta,21-trihydroxypregn-4-en-3-one by ovaries of reproductively mature Atlantic cod Gadus morhua. J Fish Biol 2010; 77:33-53. [PMID: 20646137 DOI: 10.1111/j.1095-8649.2010.02655.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Atlantic cod Gadus morhua ovaries were incubated in vitro with tritiated 17-hydroxypregn-4-ene-3,20-dione (17-P) to determine whether 17,20beta-dihydroxypregn-4-en-3-one (17,20beta-P) or 17,20beta, 21-trihydroxypregn-4-en-3-one (17,20beta,21-P), or both, were more likely to be the steroid responsible for inducing oocyte final maturation (i.e. resumption of meiosis). Only 17,20beta,21-P was produced, in addition to 11-deoxycortisol (17,21-P), which is intermediate between 17-P and 17,20beta,21-P. Also, the 5beta-reduced forms of 17-P, 17,21-P and 17,20beta,21-P were all found. Some sulphation of 21-hydroxylated steroids was demonstrated. The ability of female G. morhua to make 17,20beta,21-P but not 17,20beta-P was confirmed by radioimmunoassay of plasma samples from spawning fish. Although small amounts of 17,20beta-P immunoreactivity were detected in a few plasma samples, this was shown, by thin-layer chromatography, to be mostly due to cross-reaction with other unidentified compounds. The evidence strongly suggests that 17,20beta,21-P is more likely than 17,20beta-P to be the maturation-inducing steroid in G. morhua.
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Affiliation(s)
- H Tveiten
- Nofima Marin, Tromsø, Postboks 6122, 9291 Tromsø, Norway.
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McCarthy CM, VanLaeken N, Lennox P, Scott AM, Pusic AL. The efficacy of Artecoll injections for the augmentation of nipple projection in breast reconstruction. Eplasty 2010; 10:e7. [PMID: 20360871 PMCID: PMC2848402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Various techniques have been used in an attempt to achieve long-term nipple projection following nipple-areolar reconstruction. A common setback, however, is the diminution of projection overtime; this phenomenon is particularly evident following implant-based breast reconstruction. Artecoll may be suitable for injection into the nipple complex to maintain permanent, 3-dimensional projection. Artecoll is an injectable substance that is biocompatible and immunologically inert and resists degradation in vivo. The purpose of this study was thus to prospectively evaluate the efficacy of Artecoll (polymethylmethacrylate microspheres suspended in 3.5% denatured bovine collagen with 0.3% lidocaine) in obtaining and maintaining nipple projection following postmastectomy, nipple-areolar reconstruction. METHODS A prospective, clinical trial was performed. Consecutive patients deemed to have inadequate nipple projection at least 6 months following "C-V flap" or "modified-skate flap" reconstruction were identified. Only women who had postmastectomy reconstruction with tissue expanders and implants were considered eligible for participation. Artecoll was injected under the nipple at 2 time points: baseline and 3 months. Calipers were used to measure nipple projection preinjection and postinjection at baseline, 3, 6, and 9 months. RESULTS Thirty-three nipples were injected in 23 patients. There were no adverse events. Prior to injection, mean nipple projection was 1.33 +/- 1.0 mm. The mean increase in projection over the 9-month study period was both clinically and statistically significant (1.60 +/- 1.24 mm; P <.001). A history of prior irradiation was a significant negative predictor of final nipple projection (P = .012). CONCLUSION Artecoll injection is both feasible and effective in increasing and maintaining nipple projection in the setting of implant-based breast reconstruction.
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Affiliation(s)
- Colleen M. McCarthy
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York,Correspondence:
| | - Nancy VanLaeken
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Lennox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amie M. Scott
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York
| | - Andrea L. Pusic
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York
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Abstract
A new method for separating the isozymes of horse serum esterase is described. The improved resolution has enabled us to detect several previously undescribed phenotypes. This method has also been used to detect two different apparently 'silent' alleles.
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Scott AM. Horse blood typing comparison test 1973. Anim Blood Groups Biochem Genet 2009; 5:195-6. [PMID: 4451299 DOI: 10.1111/j.1365-2052.1974.tb01333.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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32
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Abstract
Four minor haplotypes that produce abnormal haemoglobin phenotypes in horses have been characterized. Two of them, AIIb and V, are copy number variants with, respectively, one and three alpha genes instead of the normal complement of two. The AIIa and C haplotypes, on the other hand, each have two alpha genes but, as a result of probable gene conversions, they now encode identical, though haplotype specific, globins. Two out of 60 unrelated and phenotypically normal horses studied had an unusual triplicated rearrangement in the embryonic zeta-gene locus. Each of these variants appears to have been produced by aberrant recombination events.
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Affiliation(s)
- A T Bowling
- MRC Molecular Haematology Unit, Nuffield Department of Clinical Medicine, University of Oxford, UK
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Gill S, Cosolo W, Herbertson RA, Berlangieri SU, Scott AM. Medullary carcinoma of the thyroid in a patient with colon cancer and a rising carcinoembryonic antigen level. Intern Med J 2009; 39:264-5. [PMID: 19220550 DOI: 10.1111/j.1445-5994.2009.01904.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Gill
- Ludwig Institute for Cancer Research, Melbourne Centre for Clinical Sciences, Austin Health, Melbourne, Victoria, Australia
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Chatterton BE, Ho Shon I, Baldey A, Lenzo N, Patrikeos A, Kelley B, Wong D, Ramshaw JE, Scott AM. Positron emission tomography changes management and prognostic stratification in patients with oesophageal cancer: results of a multicentre prospective study. Eur J Nucl Med Mol Imaging 2008; 36:354-61. [PMID: 18931839 DOI: 10.1007/s00259-008-0959-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 09/03/2008] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aims of this study were (1) to determine the incremental information provided by (18)F-FDG positron emission tomography (PET) in staging patients with oesophageal cancer, and (2) to determine the impact of PET staging on post-PET clinical management of oesophageal cancer, and on prognosis. METHODS In a multicentre, single-arm open study, patients with proved oesophageal cancer without definite distant metastases and regarded as suitable for potentially curative treatment were examined by PET. Clinicians were requested to supply a management plan before and another plan after being supplied with the PET scan results. Patients were followed for at least 1 year for outcome analysis. RESULTS A total of 129 patients (104 men, mean age 67 y) were recruited. PET detected additional sites of disease in 53 patients (41%). Significant changes in management (high or medium impact) were observed in 38% of patients, primarily as a result of identifying additional sites of disease and/or confirming previously equivocal regional and distant metastases. Progression-free survival was significantly shorter in patients found to have additional lesions on PET (p < 0.05), but was not related to SUV(max). CONCLUSION These findings demonstrate the significant impact of PET on the clinical management of patients with newly diagnosed oesophageal carcinoma, and on prognostic stratification of these patients.
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Affiliation(s)
- B E Chatterton
- Department of Nuclear Medicine and PET, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
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Lee ST, Tan T, Poon AMT, Toh HB, Gill S, Berlangieri SU, Kraft E, Byrne AJ, Pathmaraj K, O'Keefe GJ, Tebbutt N, Scott AM. Role of low-dose, noncontrast computed tomography from integrated positron emission tomography/computed tomography in evaluating incidental 2-deoxy-2-[F-18]fluoro-D-glucose-avid colon lesions. Mol Imaging Biol 2007; 10:48-53. [PMID: 17994266 DOI: 10.1007/s11307-007-0117-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Accepted: 10/03/2007] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the contribution of concurrent low-dose, noncontrast CT in the assessment of the malignant potential of incidental focal 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-avid colonic lesions on positron emission tomography/computed tomography (PET/CT). PROCEDURES Routine FDG-PET/CT scans were reviewed for identification of focal FDG-avid colon lesions, and the CT component was independently reviewed for an anatomical lesion and malignant potential based on CT criteria. Clinical, endoscopic, and histopathology follow-up was obtained. RESULTS A total of 85/2,916 (3%) oncology FDG-PET/CT scans had incidental focal colon lesions. Clinical and/or endoscopic follow-up was available in 83/85 (98%) patients. Focal, corresponding CT lesions were found in 44/83 (53%) patients, but features of malignancy were not assessable. Of the 44 patients with a final diagnosis, 32/44 (73%) were FDG-PET/CT true positives; 5/44 (11%) were false positives; and 7/44 (16%) had inconclusive FDG-PET/CT findings. CONCLUSIONS Concurrent low-dose, noncontrast CT improves localization, but does not provide independent information on the malignant potential of incidental focal colonic activity on FDG-PET/CT.
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Affiliation(s)
- S T Lee
- Centre for PET, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
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Abstract
The therapeutic options and subsequent survival of colorectal cancer (CRC) patients has increased substantially over recent years. While surgical excision of the primary cancer results in cure of approximately 50% of patients, recurrence and metastatic disease still remains a significant cause of death. Although resection of liver or lung metastases can result in cure, relapse rates remain high, indicating that patient selection needs improvement. Positron emission tomography (PET) technology has a great deal to offer with respect to CRC management, particularly in the setting of patient selection for metastasectomy and in the evaluation of possible recurrent disease, however it has not yet become a routine part of the management of all CRC patients. This review article aims to discuss the current and future implications of PET technology in the optimal management of CRC patients throughout their care pathway.
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Affiliation(s)
- R A Herbertson
- Ludwig Institute for Cancer Research, Melbourne Centre for Clinical Sciences, Harold Stokes Building, Austin Hospital, Heidelberg, Victoria, Australia.
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Lee ST, Berlangieri SU, Poon AMT, Mitchell P, Pathmaraj K, Tabone K, Byrne AJ, O'Keefe GJ, Knight SR, Clarke CP, Scott AM. Prevalence of occult metastatic disease in patients undergoing 18F-FDG PET for primary diagnosis or staging of lung carcinoma and solitary pulmonary nodules. Intern Med J 2007; 37:753-9. [PMID: 17517082 DOI: 10.1111/j.1445-5994.2007.01383.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Accurate staging of lung cancer is essential in determining the most appropriate management plan, as detection of occult metastasis can significantly alter management. AIMS The aims of this study are to determine the prevalence of occult metastasis in patients undergoing 2-(18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET) for evaluation of suspected/proven lung carcinoma and correlate pre-PET TNM stage with prevalence of metastasis. METHODS FDG-PET, which identified patients with metastasis on institutional database, was re-evaluated by a nuclear medicine physician blinded to clinical information. The confidence level of metastasis was scored on a 5-point scale, with a score of >/=4 considered positive. RESULTS There were 67 of 645 (10%) patients identified with suspected occult metastasis on FDG-PET. Twelve patients scoring </=3 were excluded. Prevalence of occult metastasis was 10/156 (6%) in solitary pulmonary nodules (SPN); 22/319 (7%) and 23/170 (14%) in proven and suspected lung cancer, respectively. Positive predictive value of FDG-PET for metastasis was 8/10 (80%) in solitary pulmonary nodules, 14/20 (70%) and 17/21 (81%) in proven and suspected lung cancer, respectively. (18)F-FDG-avid lesions classified as false positives were patients with cholelithiasis, rib fractures and those with equivocal/negative bone scans or computed tomography on follow up. There was a higher incidence of true positive occult metastasis in patients in all stages of disease, particularly stage III disease. CONCLUSION (18)F-FDG PET is predictive for occult metastatic disease in patients with solitary pulmonary nodules and proven or suspected lung cancer and is more likely to be present in all stages, particularly in stage III. PET findings should be actively pursued with correlative investigation to identify benign pathology in patients who remain candidates for curative treatment.
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Affiliation(s)
- S T Lee
- Centre for Positron Emission Tomography, and Department of Medicine, University of Melbourne, and Ludwig Institute for Cancer Research, Austin Health, Melbourne, Victoria, Australia.
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38
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Jones DC, Stacey CD, Scott AM. Phase stabilization of a large-mode-area ytterbium-doped fiber amplifier. Opt Lett 2007; 32:466-8. [PMID: 17392889 DOI: 10.1364/ol.32.000466] [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] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Measurements are reported on the open and closed-loop phase stability of a large-mode-area ytterbium-doped fiber amplifier. Phase fluctuations are characterized by a high-frequency low-amplitude jitter superimposed on a slow power-dependent drift. The amplifier may be phase locked to a precision of lambda/20 by using a low-bandwidth feedback loop.
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Affiliation(s)
- D C Jones
- QinetiQ, St. Andrews Road, Malvern, Worcestershire, UK.
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Abstract
Fluorine-18 fluorothymidine (F-18 FLT) is a radioisotope based on the nucleic acid thymidine and has emerged as an important tracer that mirrors cellular proliferation in positron emission tomography (PET) studies. Early studies in human tumors have been promising. However, imaging of renal tumors using F-18 FLT PET studies has not previously been described. In this report, a difficult case of renal transitional cell carcinoma in a longstanding cyst was clearly delineated using F-18 FLT. Importantly, the study was able to guide clinicians toward appropriate surgical management. The use of such tracers may herald a new era in renal tumor imaging.
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Affiliation(s)
- Nathan Lawrentschuk
- Department of Surgery, Urology and Medicine, University of Melbourne, Melbourne, Australia.
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40
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Yücel M, Brewer WJ, Harrison BJ, Fornito A, O'Keefe GJ, Olver J, Scott AM, Egan GF, Velakoulis D, McGorry PD, Pantelis C. Anterior cingulate activation in antipsychotic-naïve first-episode schizophrenia. Acta Psychiatr Scand 2007; 115:155-8. [PMID: 17244179 DOI: 10.1111/j.1600-0447.2006.00902.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED Anterior cingulate (ACC) hypo-activity is commonly observed in chronically ill schizophrenia patients. However, it is unclear whether this is secondary to persistent illness and/or medication. METHOD We examined eight antipsychotic-naïve first-episode patients and matched healthy controls undergoing PET scanning while performing the Stroop task. RESULTS Group-averaged and single-subject analyses showed ACC activation in both controls and patients, albeit in different sub-regions (paracingulate and cingulate respectively). A direct comparison revealed relative under-activity of the left paracingulate cortex in patients. CONCLUSION These findings suggest that the more pervasive hypo-activation observed in chronic patients may be secondary to persistent illness and/or medication.
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Affiliation(s)
- M Yücel
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Carlton South, VIC 3053, Australia.
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Abstract
Innate immunity is the primary host defense against invading microorganisms. Pathogen recognition, mediated through an elaborate 'microbial sensing' system comprising the Toll-like and Nod-like receptor families results in the activation of caspase-1, which is a prerequisite for pathogen clearance. Tight regulation of caspase-1 is necessary to control the magnitude of the innate immune response and protect the organism from possible damaging effects such as sepsis. Recent findings from population studies and animal models of infectious diseases and sepsis have uncovered a role for full-length caspase-12 in blocking the inflammatory response initiated by caspase-1, thus predisposing the organism to severe sepsis and sepsis-related lethality. In this review, we re-examine the relationship among the Group I caspases, their known substrates and their proposed role in apoptosis. We further discuss their function in inflammation and bacterial clearance, with an emphasis on their regulatory mechanisms during the innate immune response.
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Affiliation(s)
- A M Scott
- Department of Biochemistry, McGill University, Montreal, Canada H3G 1Y6
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42
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Cebon J, Findlay M, Hargreaves C, Stockler M, Thompson P, Boyer M, Roberts S, Poon A, Scott AM, Kalff V, Garas G, Dowling A, Crawford D, Ring J, Basser R, Strickland A, Macdonald G, Green M, Nowak A, Dickman B, Dhillon H, Gebski V. Somatostatin receptor expression, tumour response, and quality of life in patients with advanced hepatocellular carcinoma treated with long-acting octreotide. Br J Cancer 2006; 95:853-61. [PMID: 16953241 PMCID: PMC2360532 DOI: 10.1038/sj.bjc.6603325] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Octreotide may extend survival in hepatocellular carcinoma (HCC). Forty-one per cent of HCCs have high-affinity somatostatin receptors. We aimed to determine the feasibility, safety, and activity of long-acting octreotide in advanced HCC; to identify the best method for assessing somatostatin receptor expression; to relate receptor expression to clinical outcomes; and to evaluate toxicity. Sixty-three patients with advanced HCC received intramuscular long-acting octreotide 20 mg monthly until progression or toxicity. Median age was 67 years (range 28–81 years), male 81%, Child–Pugh A 83%, and B 17%. The aetiologies of chronic liver disease were alcohol (22%), viral hepatitis (44%), and haemochromatosis (6%). Prior treatments for HCC included surgery (8%), chemotherapy (2%), local ablation (11%), and chemoembolisation (6%). One patient had an objective partial tumour response (2%, 95% CI 0–9%). Serum alpha-fetoprotein levels decreased more than 50% in four (6%). Median survival was 8 months. Thirty four of 61 patients (56%) had receptor expression detected by scintigraphy; no clear relationship with clinical outcomes was identified. There were few grade 3 or 4 toxicities: hyperglycaemia (8%), hypoglycaemia (2%), diarrhoea (5%), and anorexia (2%). Patients reported improvements in some symptoms, but no major changes in quality of life were detected. Long-acting octreotide is safe in advanced HCC. We found little evidence of anticancer activity. A definitive randomised trial would identify whether patients benefit from this treatment in other ways.
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Affiliation(s)
- J Cebon
- AGITG Trial Coordinating Centre, NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, NSW 1450, Australia.
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43
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Ellis AG, Doherty MM, Walker F, Weinstock J, Nerrie M, Vitali A, Murphy R, Johns TG, Scott AM, Levitzki A, McLachlan G, Webster LK, Burgess AW, Nice EC. Preclinical analysis of the analinoquinazoline AG1478, a specific small molecule inhibitor of EGF receptor tyrosine kinase. Biochem Pharmacol 2006; 71:1422-34. [PMID: 16522318 DOI: 10.1016/j.bcp.2006.01.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2005] [Revised: 01/30/2006] [Accepted: 01/30/2006] [Indexed: 10/24/2022]
Abstract
The tyrphostin 4-(3-chloroanilino)-6,7-dimethoxyquinazoline (AG1478) is a potent and specific inhibitor of EGFR tyrosine kinase whose favourable preclinical profile supports progression towards clinical trials. Microphysiometric evaluation revealed a short (<24 min) effective inhibition of cellular receptor response to EGF challenge in BaF/ERX cells indicating a need to maintain sustained levels of inhibitor. Initial pharmacokinetic evaluation in mice of novel AG1478 formulations in a beta-cyclodextrin (Captisol) showed monoexponential elimination from plasma (half-life 30 min) following subcutaneous administration. A two-fold dose escalation gave a 2.4-fold increase in the total AUC. Bolus i.v. and 6 h continuous infusion were investigated in rats to mimic a more clinically relevant administration regimen. Drug elimination following bolus i.v. administration was biphasic (terminal elimination half-life 30-48 min). The linear relationship between dose and AUC(0-->infinity) (r2=0.979) enabled the prediction of infusion rates and doses for sustained delivery using continuous 6 h infusions, where steady state was reached in 120 min. Plasma levels of AG1478>10 microM were achieved over the duration of the infusion. At the lowest dose, plasma drug levels after the cessation of infusion declined with a half-life of approximately 43 min. EGFR activity, measured both by autophosphorylation and downstream signalling, was inhibited in a dose-dependent manner by injection of AG1478 in mice bearing xenografts of the human glioblastoma cell line U87MG.delta2-7, which expresses a constitutively active variant of the EGF receptor. Taken together, these experiments provide essential data to assess the anti-tumour efficacy of AG1478 and will assist in the rational design of dose regimens for clinical studies.
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Affiliation(s)
- A G Ellis
- Pharmacology and Developmental Therapeutics Unit, Trescowthick Research Laboratories, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia
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Cooper LJ, Wang P, Williams RB, Sahu JK, Clarkson WA, Scott AM, Jones D. High-power Yb-doped multicore ribbon fiber laser. Opt Lett 2005; 30:2906-8. [PMID: 16279465 DOI: 10.1364/ol.30.002906] [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] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A highly elongated double-clad ribbon fiber that comprises a pure-silica inner cladding with transverse dimensions of approximately 1.4 mm by 0.23 mm with a linear array of ten ytterbium-doped cores has been fabricated and operated in a simple laser configuration pumped by two diode stacks. The fiber laser yielded 320 W of output power at a center wavelength of 1045 nm in a combined beam with beam propagation factors of approximately 2 (perpendicular to the array) and approximately 150 (parallel to the array) for 576 W of launched pump power. The slope efficiency with respect to absorbed pump power was 62%. The prospects for further power scaling and improved beam quality and efficiency are discussed.
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Affiliation(s)
- L J Cooper
- Optoelectronics Research Centre, University of Southampton, Southampton SO17 1BJ, UK
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45
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Panousis C, Rayzman VM, Johns TG, Renner C, Liu Z, Cartwright G, Lee FT, Wang D, Gan H, Cao D, Kypridis A, Smyth FE, Brechbiel MW, Burgess AW, Old LJ, Scott AM. Engineering and characterisation of chimeric monoclonal antibody 806 (ch806) for targeted immunotherapy of tumours expressing de2-7 EGFR or amplified EGFR. Br J Cancer 2005; 92:1069-77. [PMID: 15770208 PMCID: PMC2361945 DOI: 10.1038/sj.bjc.6602470] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We report the generation of a chimeric monoclonal antibody (ch806) with specificity for an epitope on the epidermal growth factor receptor (EGFR) that is different from that targeted by all other anti-EGFR therapies. Ch806 antibody is reactive to both de2-7 and overexpressed wild-type (wt) EGFR but not native EGFR expressed in normal tissues at physiological levels. Ch806 was stably expressed in CHO (DHFR −/−) cells and purified for subsequent characterisation and validated for use in preliminary immunotherapy investigations. Ch806 retained the antigen binding specificity and affinity of the murine parental antibody. Furthermore, ch806 displayed enhanced antibody-dependent cellular cytotoxicity against target cells expressing the 806 antigen in the presence of human effector cells. Ch806 was successfully radiolabelled with both iodine-125 and indium-111 without loss of antigen binding affinity or specificity. The radioimmunoconjugates were stable in the presence of human serum at 37°C for up to 9 days and displayed a terminal half-life (T1/2β) of approximately 78 h in nude mice. Biodistribution studies undertaken in BALB/c nude mice bearing de2-7 EGFR-expressing or amplified EGFR-expressing xenografts revealed that 125I-labelled ch806 failed to display any significant tumour retention. However, specific and prolonged tumour localisation of' 111In-labelled ch806 was demonstrated with uptake of 31%ID g−1 and a tumour to blood ratio of 5 : 1 observed at 7 days postinjection. In vivo therapy studies with ch806 demonstrated significant antitumour effects on established de2-7 EGFR xenografts in BALB/c nude mice compared to control, and both murine 806 and the anti-EGFR 528 antibodies. These results support a potential therapeutic role of ch806 in the treatment of suitable EGFR-expressing tumours, and warrants further investigation of the potential of ch806 as a therapeutic agent.
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Affiliation(s)
- C Panousis
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - V M Rayzman
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - T G Johns
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - C Renner
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - Z Liu
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - G Cartwright
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - F-T Lee
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - D Wang
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - H Gan
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - D Cao
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - A Kypridis
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - F E Smyth
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - M W Brechbiel
- Radioimmune & Inorganic Chemistry Section, Radiation Oncology Branch, National Cancer Institute. Bethesda, MD 20892, USA
| | - A W Burgess
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
| | - L J Old
- Ludwig Institute for Cancer Research, Memorial Sloan Kettering Cancer Centre, New York, NY 10021, USA
| | - A M Scott
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia
- Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, Level 1, Harold Stokes Building, Austin Hospital, 145-163 Studley Road, Heidelberg 3084. Victoria, Australia. E-mail:
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Johns Putra L, Putra LJ, Lawrentschuk N, Ballok Z, Hannah A, Poon A, Tauro A, Davis ID, Hicks RJ, Bolton DM, Scott AM. 18F-fluorodeoxyglucose positron emission tomography in evaluation of germ cell tumor after chemotherapy. Urology 2004; 64:1202-7. [PMID: 15596197 DOI: 10.1016/j.urology.2004.07.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Accepted: 07/22/2004] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in the assessment of germ cell tumors after chemotherapy. METHODS We reviewed patients' records for the histologic findings and clinical outcome. 18F-FDG PET results were correlated with tissue histologic features where available; and if not available, the correlation was with the clinical outcome. RESULTS A total of 45 PET studies were performed on 38 patients (age range 19 to 64 years, median 31). All patients had received chemotherapy. In the nonseminomatous germ cell tumor (NSGCT) group, of the 31 patients with one scan, 18 PET scans were reported as positive, with only 2 not having active disease. Of the 12 negative scans, 6 showed teratoma, 1 tumor, and 5 did not show active disease. The equivocal scan revealed thyroid adenoma. In the seminoma group, the PET scans correlated well with the clinical and histologic outcomes. Four patients underwent salvage chemotherapy, and in this subgroup, the PET findings also correlated with the outcome. CONCLUSIONS (18)F-FDG PET is a promising tool as an adjunct to current imaging techniques in detecting residual viable germ cell tumor after chemotherapy. In NSGCT, a positive PET scan was accurate in 16 of 18 patients, although negative PET studies did not exclude the presence of disease, mainly because of the presence of teratoma. In seminoma, a negative 18F-FDG PET study correlated with a favorable clinical outcome. PET was also predictive of the response to salvage chemotherapy and was highly specific for active tumor in both NSGCT and seminoma.
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Affiliation(s)
- L Johns Putra
- Department of Surgery, University of Melbourne, Melbourne, Australia
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Issa W, Tochon-Danguy HJ, Lambert J, Sachinidis JI, Ackermann U, Liu Z, Scott AM. Synthesis and evaluation of a thymidine analog for positron emission tomography study of tumor DNA proliferation in vivo. Nucl Med Biol 2004; 31:839-49. [PMID: 15464385 DOI: 10.1016/j.nucmedbio.2004.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Revised: 07/17/2003] [Accepted: 03/02/2004] [Indexed: 11/26/2022]
Abstract
This study describes the synthesis, radiolabelling and biological evaluation of 5-(2,4-difluoro-5-[18F]fluoromethyl-phenyl)-2-hydroxymethyl-tetrahydrofuran-3-ol, 13. Radiolabelling was achieved by reaction of the tosylate 3 with K[18F] in the presence of Kryptofix 222. Good stability in saline and serum solutions at physiological temperatures in vitro was observed. A cell incorporation study of 13 using SW1222 tumor cells showed a linear uptake, unfortunately, in vivo studies indicated that 13 was undergoing defluorination. Rapid defluorination of the radiotracer was confirmed by an in vitro stability study in blood plasma. Finally, a comparison between the DNA uptake of 13 and tritiated thymidine was performed in vitro to asses the potential utility of more stable analogs. These studies showed that 13 and its analogs are unsuitable as potential tracers to image DNA proliferation and highlighted the difficulty in predicting the in vivo stability of novel radiotracers.
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Affiliation(s)
- W Issa
- Centre for PET, Austin Health Studley Rd, Melbourne 3084, VIC Australia
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Abstract
BACKGROUND The detection of lymphoma by computed tomography (CT) scanning is known to be improved by positron emission tomography (PET) and/or gallium scanning, although the direct comparative accuracy of these imaging modalities remains a subject of ongoing review. AIMS The aim of the present study was to compare PET scanning with conventional imaging (CT and/or gallium scanning) in patients with lymphoma. METHODS A retrospective study of 38 patients (25 men; 13 women; median age 39.5 years; range 18.0-81.0 years) who had had PET scans (24 scans at initial staging and 46 scans at restaging, including suspected disease relapse) was carried out. Thirty-one concurrent gallium scans had been performed. Disease was validated with clinical follow up or biopsy. RESULTS The sensitivities of PET and CT at initial staging were 96 and 71%, respectively. PET identified additional sites of disease compared with CT in 29% of patients. Of the 15 patients who had had all three imaging modalities, the sensitivities of PET, CT and gallium were 93, 67 and 87%, respectively. At treatment completion, the positive predictive values of PET, CT and gallium scans for relapse given a residual mass were 100, 33 and 0%, respectively (P = 0.006 for PET and CT comparison). The negative predictive values of PET, CT and gallium were 76, 0 and 70%, respectively (P-value not significant). In suspected disease relapse, PET results changed management in 50% of patients. CONCLUSION Compared with CT and gallium scans, PET has superior accuracy in staging and restaging, and its greatest value lies in its positive predictive value for relapse in patients with residual masses.
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Affiliation(s)
- S S Foo
- Department of Medical Oncology, Ludwig Institute for Cancer Research, University of Melbourne, Austin Hospital, Melbourne, Victoria, Australia.
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Kloft C, Graefe EU, Tanswell P, Scott AM, Hofheinz R, Amelsberg A, Karlsson MO. Population pharmacokinetics of sibrotuzumab, a novel therapeutic monoclonal antibody, in cancer patients. Invest New Drugs 2004; 22:39-52. [PMID: 14707493 DOI: 10.1023/b:drug.0000006173.72210.1c] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Population pharmacokinetics of sibrotuzumab, a humanized monoclonal antibody directed against fibroblast activation protein, were determined after multiple intravenous infusions of dosages ranging from 5 mg/m(2) to an absolute dose of 100 mg, in patients with advanced or metastatic carcinoma. In total, 1844 serum concentrations from 60 patients in three Phase I and II clinical studies were analyzed. The structural model incorporated two disposition compartments and two parallel elimination pathways from the central compartment, one linear and one nonlinear. Finally estimated pharmacokinetic parameters (%RSE) were: linear clearance CLL 22.1 ml/h (9.6), central distribution volume V1 4.13l (3.7), peripheral volume V2 3.19l (8.8), inter-compartmental clearance Q 37.6 ml/h (9.6); for the nonlinear clearance Vmax was 0.0338 mg/h (25) and Km 0.219 microg/ml (57). At serum concentrations between approximately 20 ng/ml and 7 microg/ml, the effect of the nonlinear clearance on pharmacokinetics was marked. Only at >7 microg/ml did CLL dominate overall clearance. Interindividual variability was 57% for CLL, 20% for V1 and V2, and 29% for Vmax and was larger than the inter-occasional variability of 13%. Of the many investigated patient covariates, only body weight was found to contribute to the population model. It significantly affected CLL, V1, V2 and Vmax resulting in marked differences in the model-predicted concentration-time profiles after multiple dosing in patients with low and high body weights. In conclusion, a robust population pharmacokinetic model was developed and evaluated for sibrotuzumab, which identified a possible need to consider body weight when designing dosage regimen for future clinical cancer trials.
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Affiliation(s)
- C Kloft
- Freie Universitaet Berlin, Germany.
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Markus R, Donnan GA, Kazui S, Read S, Hirano T, Scott AM, O'Keefe GJ, Tochon-Danguy HJ, Sachinidis JI, Reutens DC. Statistical parametric mapping of hypoxic tissue identified by [(18)F]fluoromisonidazole and positron emission tomography following acute ischemic stroke. Neuroimage 2002; 16:425-33. [PMID: 12030827 DOI: 10.1006/nimg.2002.1056] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Positron emission tomography (PET) and the ligand [(18)F]fluoromisonidazole ((18)F-FMISO) have been used to image hypoxic tissue in the brain following acute stroke. Existing region of interest (ROI)-based methods of analysis are time consuming and operator-dependent. We describe and validate a method of statistical parametric mapping to identify regions of increased (18)F-FMISO uptake. The (18)F-FMISO PET images were transformed into a standardized coordinate space and intensity normalized. Then t statistic maps were created using a pooled estimate of variance. Statistical inference was based on the theory of Gaussian Random Fields. We examined the homogeneity of variance in normal subjects and the influence of normalization by mean whole brain activity versus mean activity in the contralateral hemisphere. Validity of the distributional assumptions inherent in parametric analysis was tested by comparison with a non-parametric method. The results of parametric analysis were also compared with those obtained with the existing ROI-based method. Variance in uptake at each voxel in normal subjects was homogeneous and not affected by mean voxel activity or distance from the centre of the image. The method of normalization influenced results significantly. Normalization by whole brain mean activity resulted in a smaller volume of tissue being classified as hypoxic compared to normalisation by mean activity in the contralateral hemisphere. The ROI-based method was subject to interobserver variability with a coefficient of variability of 16%. The volumes of hypoxic tissue identified by parametric and nonparametric methods were highly correlated (r = 0.99). These findings suggest that using a pooled variance and contralateral hemisphere normalisation, statistical parametric mapping can be used to objectively identify regions of increased (18)F-FMISO uptake following acute stroke in individual subjects.
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Affiliation(s)
- R Markus
- Department of Medicine, The University of Melbourne, Australia
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