1
|
Nikkhah D, Yassin A, Kodama H, Brady C. Letter to the Editor: A Response to "Ultra-Thin Anterolateral Thigh Free Flap: An Adipocutaneous Flap with the Most Superficial Elevation Plane". Plast Reconstr Surg 2024:00006534-990000000-02269. [PMID: 38439160 DOI: 10.1097/prs.0000000000011387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Affiliation(s)
- D Nikkhah
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
- University College London Division of Surgical Sciences, London, United Kingdom
| | - Ahmed Yassin
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
| | - Hiroki Kodama
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
| | - C Brady
- Department of Plastic Surgery, Royal Free Hospital, London, United Kingdom
| |
Collapse
|
2
|
Logel SN, Maru J, Whitehead J, Brady C, Walch A, Lasarev M, Rehm JL, Millington K. Higher Rates of Certain Autoimmune Diseases in Transgender and Gender Diverse Youth. Transgend Health 2023. [DOI: 10.1089/trgh.2022.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
|
3
|
Cook H, Brady C, Bray J, Nikkhah D. Letter to the Editor Regarding ‘Clinical application of an expanded reverse-island flap with two dorsal metacarpal arteries and dorsal metacarpal nerves in index- and middle-finger-degloving injury repair and amputation reconstruction’. J Plast Reconstr Aesthet Surg 2023; 80:25-27. [PMID: 36966655 DOI: 10.1016/j.bjps.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 02/13/2023] [Indexed: 03/08/2023]
Affiliation(s)
- H Cook
- Plastic Surgery Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
| | - C Brady
- Plastic Surgery Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK
| | - J Bray
- Plastic Surgery Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK
| | - D Nikkhah
- Plastic Surgery Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK; Department of Surgical Sciences, University College London, UK
| |
Collapse
|
4
|
Wheeler F, Duncan L, Brady C. 33. Variability in sex and phenotype: Impact of a familial pathogenic DHX37 variant leading to 46,XY gonadal dysgenesis. Cancer Genet 2022. [DOI: 10.1016/j.cancergen.2022.05.036] [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: 11/26/2022]
|
5
|
Teneback C, Prior C, McCuin T, Sender A, Weintraub Z, Brady C, Ludlow M, Steiert K, Antell M, Huguenin B, DeVoe S. 69: Implementation of a multifaceted mental health screening approach in an adult cystic fibrosis clinic. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
6
|
Wires C, Hoffman R, Talbert A, Brady C, O'Haire M, Croney C. 111 Ability to interpret and apply animal behavior and welfare terminology by adults within the horse industry. J Equine Vet Sci 2021. [DOI: 10.1016/j.jevs.2021.103574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
7
|
Lawson C, Ahmed SN, Brady C, Shoemaker AH. A Clinic-based Approach to Diagnosis and Management of Prediabetes in High-risk Children and Adolescents. J Endocr Soc 2020; 4:bvaa008. [PMID: 32215353 PMCID: PMC7085182 DOI: 10.1210/jendso/bvaa008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/28/2020] [Indexed: 12/02/2022] Open
Abstract
Background Type 2 diabetes (T2D) in youth is increasing in prevalence. Diabetes screening is recommended for at-risk youth but best-practice strategies for management of pediatric prediabetes are unknown. This study leverages a pediatric prediabetes clinic to assess identification of high-risk patients, the rate of clinic follow-up and progression to T2D in youth over time. Methods Retrospective chart review of children referred to a single center for evaluation of prediabetes over a 3-year period. Measurements included hemoglobin A1c (HbA1C) and oral glucose tolerance testing. Patients were classified as normal glucose tolerance (NGT), impaired glucose tolerance (IGT) or T2D based on 2019 American Diabetes Association criteria. Patients classified as IGT/T2D were prescribed metformin. Results Of the 254 patients included; 25.6% had IGT and 6.7% had T2D. The IGT/T2D groups were older and more obese than the NGT group. There was a moderate correlation between HbA1C and fasting glucose (r = 0.59, P < 0.001); HbA1C and 2-hour glucose (r = 0.63, P < 0.001). Over the 3-year study, 52 of 82 patients with IGT/T2D (63%) returned for follow-up. Four patients regained NGT; 3 of those had isolated impaired fasting glucose (100 to 102 mg/dL). Three patients (4.6%) progressed from IGT to T2D over an average of 13 ± 6.2 months. In those patients, body mass index had increased 1.7 ± 2.3 kg/m2 from baseline. Conclusions A pediatric prediabetes clinic may allow for identification of high-risk youth but lost to follow-up rates are high. Continued weight gain is a risk factor for progression to T2D and effective weight management programs are needed.
Collapse
Affiliation(s)
- Chelsea Lawson
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - S Naseeruddin Ahmed
- Brody School of Medicine at East Carolina University, Greenville, North Carolina
| | - Cassandra Brady
- Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ashley H Shoemaker
- Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
8
|
Coleman K, Brady C, O’Reilly S, O’ Brien T. Exploring the Interface of Oncology and Palliative Care in Ireland. Ir Med J 2019; 112:969. [PMID: 31642643] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Aims To explore the integration and delivery of oncology led referrals to palliative care (PC) by examining physician attitudes and referral practices. Methods An online survey was circulated to oncologists and PC physicians in Ireland. Results The study (N = 100) comprised sixty-nine oncologists (69%) and thirty-one PC physicians (31%). Ninety-two(92%) believe patients with advanced cancer should receive concurrent treatment, however only 53% of oncologists(N = 37) routinely refer. Regarding end-of-life (EOL) care: 81% of oncologists (N = 55) are directly involved in its administration, despite 84% (N = 53) agreeing patients benefit when PC specialists coordinate EOL care. Conclusion The gulf between positive attitudes and limited implementation suggests the need for interdisciplinary changes to facilitate integration of PC in clinical practice in Ireland.
Collapse
Affiliation(s)
- K Coleman
- School of Medicine, University College Cork
| | - C Brady
- Department of Medical Oncology, Cork University Hospital
| | - S O’Reilly
- Department of Medical Oncology, Cork University Hospital
| | - T O’ Brien
- Marymount University Hospital and Hospice, Co Cork
| |
Collapse
|
9
|
Wires C, Talbert B, Croney C, O'Haire M, Hoffman R, Brady C. Interpretation and understanding of equine behavior terminology and learning theory in undergraduate students. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
10
|
McSorley L, Goggin C, Elhadi N, O’Dea P, Sui J, Kelly D, Brady C, O’Mahony D. Timing of treatment with concurrent chemoradiotherapy (CRT) and impact on progression free survival (PFS) in limited stage small cell lung cancer (LSSCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz071.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
11
|
Brady C, Pless Kaiser A, Davison E, Spiro A. COMBAT-RELATED TRAUMA RE-ENGAGEMENT IN AGING VIETNAM-ERA VETERANS: CORRELATES OF POSITIVE AND NEGATIVE OUTCOMES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Brady
- VA Boston Healthcare System, Boston, Massachusetts, United States
| | - A Pless Kaiser
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System
| | - E Davison
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System
| | - A Spiro
- Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System
| |
Collapse
|
12
|
Redel JM, DiFrancesco M, Vannest J, Altaye M, Beebe D, Khoury J, Dolan LM, Lee G, Brunner H, Holland S, Brady C, Shah AS. Brain gray matter volume differences in obese youth with type 2 diabetes: a pilot study. J Pediatr Endocrinol Metab 2018; 31:261-268. [PMID: 29373319 DOI: 10.1515/jpem-2017-0349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/22/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Adults with type 2 diabetes (T2D) have significantly lower gray matter volume (GMV) compared to healthy peers. Whether GMV differences exist in youth with T2D remains unclear. Thus, we compared global and regional GMV between obese youth with T2D with age, race and sex similar healthy controls. METHODS In a cross-sectional study, 20 obese youth with T2D underwent T1-weighted brain magnetic resonance imaging (MRI). Comparisons were made to 20 age, race and sex similar controls. Differences in global and regional GMV between groups were identified using voxel-based morphometry (VBM). RESULTS Youth with T2D had a significantly lower global GMV-to-intracranial volume ratio (0.51±0.02 in T2D vs. 0.53±0.02 in controls, p=0.02, Cohen's d=0.85). There were 14 regions where GMV was significantly lower in the T2D group, and nine of these were found in either the temporal or occipital lobes. There were six regions with increased GMV in T2D. All regional differences were significant at p<0.05 after adjusting for multiple comparisons. CONCLUSIONS Results from this pilot study show obese youth with T2D have significantly lower global GMV and regional GMV differences, when compared to their age, race and sex similar peers. Future work is needed to determine whether these brain findings are a direct result of adolescent-onset T2D.
Collapse
Affiliation(s)
- Jacob M Redel
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA, Phone: 513-636-4479, Fax: 513-803-1174
| | - Mark DiFrancesco
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer Vannest
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mekibib Altaye
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dean Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jane Khoury
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lawrence M Dolan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Gregory Lee
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Hermine Brunner
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Scott Holland
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Cassandra Brady
- Division of Endocrinology and Diabetes, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amy S Shah
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| |
Collapse
|
13
|
Brady C, Aulakh A, Elmiyeh B. Working Towards a National Tonsillectomy Database. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
14
|
Frank B, Brady C. BEST PRACTICES FOR IMPLEMENTING PERSONALIZED MUSIC WITH NURSING HOME RESIDENTS WITH DEMENTIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B. Frank
- B&F Consulting, Warren, Rhode Island
| | - C. Brady
- B&F Consulting, Warren, Rhode Island
| |
Collapse
|
15
|
Brady C, Allainguillaume J, Denman S, Arnold D. Rapid identification of bacteria associated with Acute Oak Decline by high-resolution melt analysis. Lett Appl Microbiol 2017; 63:89-95. [PMID: 27227694 DOI: 10.1111/lam.12593] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/06/2016] [Accepted: 05/23/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED Two Gram-negative Enterobacteriaceae, Gibbsiella quercinecans and Brenneria goodwinii, are frequently isolated from oak suffering from Acute Oak Decline. These two species are difficult to identify based on colony morphology, carbohydrate utilization or 16S rRNA gene sequence, and identification using gyrB gene sequencing is time-consuming and laborious. A rapid identification technique, based on high-resolution melt analysis of the atpD gene, was designed to efficiently process numerous isolates from an increasing number of affected woodlands and parks. Principal component analysis of the resulting melt curves from strains of G. quercinecans, B. goodwinii and their close phylogenetic relatives allowed differentiation into distinct clusters based on species or subspecies identity. SIGNIFICANCE AND IMPACT OF THE STUDY Acute Oak Decline is an increasing threat to Britain's native oak population. Two novel bacterial species both belonging to the family Enterobacteriaceae, Gibbsiella quercinecans and Brenneria goodwinii, are thought to play an important role in symptom development. Here, we describe a rapid identification technique using high-resolution melt analysis of the atpD gene able to assign isolates to either G. quercinecans or B. goodwinii in a single assay, greatly reducing the time taken to identify if either or both of these species are present in symptomatic oak.
Collapse
Affiliation(s)
- C Brady
- Faculty of Health and Applied Sciences, Centre for Research in Bioscience, University of the West of England, Bristol, UK
| | - J Allainguillaume
- Faculty of Health and Applied Sciences, Centre for Research in Bioscience, University of the West of England, Bristol, UK
| | - S Denman
- Forest Research, Centre for Ecosystems Society and Biosecurity, Farnham, UK
| | - D Arnold
- Faculty of Health and Applied Sciences, Centre for Research in Bioscience, University of the West of England, Bristol, UK
| |
Collapse
|
16
|
Sajdera K, Rice B, Brady C. Self-efficacy of 4-H horse and pony volunteers in equine science content. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2017.03.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Kelly D, Brady C, Sui J, Cronin E, O'Hare D, Waldron J, O'Mahony D, Power D, Bambury RM, O'Reilly S. Cancer Care Costs and Clinical Trials. Ir Med J 2017; 110:557. [PMID: 28665096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- D Kelly
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - C Brady
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - J Sui
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - E Cronin
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - D O'Hare
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - J Waldron
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - D O'Mahony
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - D Power
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - R M Bambury
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| | - S O'Reilly
- Department of Medical Oncology and Pharmacy, Cork University Hospital
| |
Collapse
|
18
|
Moss H, Brady C, Kelly B. A Fuller Picture: Evaluating an Art Therapy Programme in a Multi-disciplinary Mental Health Service. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Art therapy has a long history in mental health care but requires an enhanced evidence based in order to better identify its precise role in contemporary services. This paper describes an evaluation of an art therapy programme in an acute adult psychiatry admission unit in Ireland. A mixed method research design was used. Quantitative data were collected through a survey of 35 staff members and 11 service-users. Qualitative data included free-text comments collected in the survey and individual feedback from service-users. Both methods aimed to assess the role of art therapy as part of a multidisciplinary mental health service. Thematic content analysis was employed to analyse qualitative data. Staff demonstrated overwhelming support for art therapy as one element within multidisciplinary services available to patients in the acute psychiatry setting, qualitative feedback associated art therapy with improvements in quality of life and individual support, and emphasised its role as a nonverbal intervention, especially useful for those who find talking therapy difficult. Creative self-expression is valued by staff and service-users as part of the recovery process. Recommendations arising from the research include continuing the art therapy service, expanding it to include rehabilitation patients, provision of information and education sessions to staff and further research to identify other potential long-term effects. The low response of staff and small sample in this study, however, must be noted as limitations to these findings.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
19
|
Healy C, Brady C, Sze Yin Sui J, McSorley L, Barry J, Relihan N, Corrigan M, O’Connor T, O’Mahony T, O’Reilly S. An Irish regional cancer centre experience of impact of incidental pulmonary nodules detected during treatment for early stage breast cancer. Breast 2017. [DOI: 10.1016/s0960-9776(17)30273-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
20
|
Lynch H, Leonard FC, Walia K, Lawlor PG, Duffy G, Fanning S, Markey BK, Brady C, Gardiner GE, Argüello H. Investigation of in-feed organic acids as a low cost strategy to combat Salmonella in grower pigs. Prev Vet Med 2017; 139:50-57. [PMID: 28364832 DOI: 10.1016/j.prevetmed.2017.02.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/29/2017] [Accepted: 02/17/2017] [Indexed: 12/21/2022]
Abstract
Salmonella carriage in pigs is a significant food safety issue. Dietary supplementation with organic acids has previously been shown to reduce shedding and transmission of Salmonella. Therefore, this study aimed to examine the effect of three commercially available organic acid-based products on Salmonella levels in grower pigs, using a model of experimental infection that closely mimics natural exposure to the organism. Seven week old trial pigs (n=40) with a mean weight of 14.7kg were placed in one of four pens with 10 pigs/pen. Pens had previously been contaminated with Salmonella Typhimurium 4,[5],12;i;- via seeder pigs. Trial pigs received one of four diets for 28days: 1, control diet; 2, sodium butyrate supplemented diet; 3, benzoic acid supplemented diet and 4, formic-citric acid supplemented diet. A further 10 pigs were placed in a Salmonella-free pen receiving the control diet. Pigs were weighed and blood sampled on days 0 and 28. Faeces was collected on day 0, 2, 3, 5, 7, 14, 21 and 28 and examined for Salmonella. On day 28, 5 pigs/group were euthanised and ileocaecal lymph nodes (ILN) and caecal contents sampled for culture. The remaining 5 pigs/pen were then fed the control diet and faeces were collected on days 35 and 42. On day 42 pigs were euthanised and ILN and caecal contents tested for Salmonella levels. The trial was repeated once. Within the first two days of exposure to the contaminated environment, 96% (77/80) of pigs became infected. Most pigs shed Salmonella at levels of between 100-103 CFU/g faeces for at least 7days post-exposure. A significant reduction in Salmonella faecal concentration was observed after supplementation with sodium butyrate (p=0.001) and a formic citric acid blend (p<0.0001). Average daily weight gain (ADWG) was significantly increased in all groups fed the supplemented feed when compared to the positive control group. The use of sodium butyrate or a blend of formic and citric acid in feed could be considered a cost-effective control measure to reduce Salmonella faecal shedding and improve ADWG in Salmonella infected herds.
Collapse
Affiliation(s)
- H Lynch
- National Food Research Centre, Teagasc, Ashtown, Dublin, Ireland; UCD Veterinary Sciences Centre, University College Dublin, Dublin, Ireland.
| | - F C Leonard
- UCD Veterinary Sciences Centre, University College Dublin, Dublin, Ireland
| | - K Walia
- National Food Research Centre, Teagasc, Ashtown, Dublin, Ireland; Department of Science, Waterford Institute of Technology, Waterford, Ireland
| | - P G Lawlor
- Pig Development Department, Teagasc, Moorepark, Fermoy, Co. Cork, Ireland
| | - G Duffy
- National Food Research Centre, Teagasc, Ashtown, Dublin, Ireland
| | - S Fanning
- UCD Veterinary Sciences Centre, University College Dublin, Dublin, Ireland
| | - B K Markey
- UCD Veterinary Sciences Centre, University College Dublin, Dublin, Ireland
| | - C Brady
- Department of Agriculture, Food and the Marine, Central Veterinary Research Laboratory, Backweston, Ireland
| | - G E Gardiner
- Department of Science, Waterford Institute of Technology, Waterford, Ireland
| | - H Argüello
- National Food Research Centre, Teagasc, Ashtown, Dublin, Ireland
| |
Collapse
|
21
|
Kelly D, Mc Sorley L, O'Shea E, Mc Carthy E, Bowe S, Brady C, Sui J, Dawod MA, O'Brien O, Graham D, McCarthy J, Burke L, Power D, O'Reilly S, Bambury RM, Mahony DO. A regional analysis of epidermal growth factor receptor (EGFR) mutated lung cancer for HSE South. Ir J Med Sci 2017; 186:855-857. [PMID: 28185061 DOI: 10.1007/s11845-017-1579-y] [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: 01/07/2017] [Accepted: 02/05/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND EGFR mutated lung cancer represents a subgroup with distinct clinical presentations, prognosis, and management requirements. We investigated the survival, prognostic factors, and real-world treatment of NSCLC patients with EGFR mutation in clinical practice. METHODS A retrospective review of all specimens sent for EGFR analysis from December 2009 to September 2015 was performed. Patient demographics, specimen type, EGFR mutation status/type, stage at diagnosis, treatment, response rate, and survival data were recorded. RESULTS 27/334 (8%) patient specimens sent for EGFR testing tested positive for a sensitising EGFR mutation. The median age was 65 years (40-85 years). Exon 19 deletion represented the most commonly detected alteration, accounting for 39% (n = 11). First-line treatment for those with Exon 18, 19, or 21 alterations (n = 24) was with an EGFR tyrosine kinase inhibitor (TKI) in 79% (n = 19). Objective response rate among these patients was 74% and median duration of response was 13 months (range 7-35 months). CONCLUSION The incidence of EGFR mutation in our cohort of NSCLC is 9% which is consistent with mutation incidence reported in other countries. The rate of EGFR mutation in our population is slightly below that reported internationally, but treatment outcomes are consistent with published data. Real-world patient data have important contributions to make with regard to quality measurement, incorporating patient experience into guidelines and identifying safety signals.
Collapse
Affiliation(s)
- D Kelly
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland.
| | - L Mc Sorley
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - E O'Shea
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - E Mc Carthy
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - S Bowe
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - C Brady
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - J Sui
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - M A Dawod
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - O O'Brien
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - D Graham
- Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - J McCarthy
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - L Burke
- Department of Pathology, Cork University Hospital, Cork, Ireland
| | - D Power
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - S O'Reilly
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - R M Bambury
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| | - D O Mahony
- Department of Medical Oncology, Cork University Hospital, Mercy University Hospital Cork, University Hospital Kerry, Tralee, County Kerry, Ireland
| |
Collapse
|
22
|
Mullally WJ, O'Súilleabháin CB, Brady C, O'Reilly S. Vinorelbine induced perforation of a metastatic gastric lesion. Ir J Med Sci 2016; 186:571-575. [PMID: 28039597 PMCID: PMC5550518 DOI: 10.1007/s11845-016-1536-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022]
Abstract
Background Breast carcinoma metastasis to the gastrointestinal tract is rare and more frequently associated with lobular than ductal carcinoma (Borst and Ingold, Surg 114(4):637–641 [1]). The purpose of this article is to present a case based review of a unique gastrointestinal metastasis and literature review. Methods A 46 year old lady with metastatic invasive ductal breast cancer was admitted to A&E with sudden onset of epigastric and left shoulder pain. She completed the first cycle of capecitabine/vinorelbine 1 week previously. Clinical examination revealed a tender epigastrium with rigidity in the upper abdomen. Free air under the diaphragm and a positive Rigler’s sign was radiologically identified. A laparoscopy demonstrated a fibrinous exudate in the left upper quadrant consistent with a walled off lesser curvature gastric perforation. A subsequent oesophagogastroduodenoscopy (OGD) demonstrated a healed gastric ulcer of benign appearance; however the pathology confirmed metastatic breast carcinoma. Results Literature review confirmed no previously reported cases of vinorelbine induced gastric perforation. Four cases of metastatic breast cancer with gastric metastasis presenting with perforation were identified; three of these cases (Fra et al., Presse Med 25(26):1215 (1996) [2], Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91–92 (2004) [3], Ghosn et al., Bull Cancer 78(11):1071–1073 (1991) [4]), were in the French medical literature, including one male patient (Fra et al., Presse Med 25(26):1215 (1996) [2]) and at least one ductal breast carcinoma (Solis-Caxaj et al., Gastroenterol Clin Biol 28(1):91–92 (2004) [3]). The fourth case (van Geel et al., Ned Tijdschr Geneeskd 144(37):1761–1763 (2000) [5]), was in the Dutch medical literature and a lobular breast carcinoma. Conclusion This case represents a rare complication of breast cancer chemotherapy, the subsequent significant benefit the patient received from treatment is consistent with the chemosensitivity to therapy that also resulted in gastric perforation. Five years after gastric perforation she resumed palliative chemotherapy after progression on sequential hormonal therapies.
Collapse
Affiliation(s)
- W J Mullally
- Department of Medical Oncology, Cork University Hospital, Wilton Rd, Cork, Ireland. .,, Kells, Bishopstown Avenue West, Model Farm Rd, Cork, Ireland.
| | - C B O'Súilleabháin
- Hepatobiliary Pancreas Unit, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - C Brady
- Department of Medical Oncology, Cork University Hospital, Wilton Rd, Cork, Ireland
| | - S O'Reilly
- Department of Medical Oncology, Cork University Hospital, Wilton Rd, Cork, Ireland
| |
Collapse
|
23
|
Hou L, Vierra-Green C, Lazaro A, Brady C, Haagenson M, Spellman S, Hurley CK. Limited HLA sequence variation outside of antigen recognition domain exons of 360 10 of 10 matched unrelated hematopoietic stem cell transplant donor-recipient pairs. HLA 2016; 89:39-46. [PMID: 27976839 DOI: 10.1111/tan.12942] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 08/26/2016] [Revised: 10/24/2016] [Accepted: 11/17/2016] [Indexed: 12/27/2022]
Abstract
Traditional DNA-based typing focuses primarily on interrogating the exons of human leukocyte antigen (HLA) genes that form the antigen recognition domain (ARD). The relevance of mismatching donor and recipient for HLA variation outside the ARD on hematopoietic stem cell transplantation (HSCT) outcomes is unknown. This study was designed to evaluate the frequency of variation outside the ARD in 10 of 10 (HLA-A, -B, -C, -DRB1, -DQB1) matched unrelated donor transplant pairs (n = 360). Next-generation DNA sequencing was used to characterize both HLA exons and introns for HLA-A, -B, -C alleles; exons 2, 3 and the intervening intron for HLA-DRB1 and exons only for HLA-DQA1 and -DQB1. Over 97% of alleles at each locus were matched for their nucleotide sequence outside of the ARD exons. Of the 4320 allele comparisons overall, only 17 allele pairs were mismatched for non-ARD exons, 41 for noncoding regions and 9 for ARD exons. The observed variation between donor and recipient usually involved a single nucleotide difference (88% of mismatches); 88% of the non-ARD exon variants impacted the amino acid sequence. The impact of amino acid sequence variation caused by substitutions in exons outside ARD regions in D-R pairs will be difficult to assess in HSCT outcome studies because these mismatches do not occur very frequently.
Collapse
Affiliation(s)
- L Hou
- Department of Pediatrics, Georgetown University, Washington, DC, USA
| | - C Vierra-Green
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - A Lazaro
- Department of Pediatrics, Georgetown University, Washington, DC, USA
| | - C Brady
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - M Haagenson
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - S Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, MN, USA
| | - C K Hurley
- Department of Pediatrics, Georgetown University, Washington, DC, USA.,Department of Oncology, Georgetown University, Washington, DC, USA
| |
Collapse
|
24
|
Chen YB, Wang T, Hemmer MT, Brady C, Couriel DR, Alousi A, Pidala J, Urbano-Ispizua A, Choi SW, Nishihori T, Teshima T, Inamoto Y, Wirk B, Marks DI, Abdel-Azim H, Lehmann L, Yu L, Bitan M, Cairo MS, Qayed M, Salit R, Gale RP, Martino R, Jaglowski S, Bajel A, Savani B, Frangoul H, Lewis ID, Storek J, Askar M, Kharfan-Dabaja MA, Aljurf M, Ringden O, Reshef R, Olsson RF, Hashmi S, Seo S, Spitzer TR, MacMillan ML, Lazaryan A, Spellman SR, Arora M, Cutler CS. GvHD after umbilical cord blood transplantation for acute leukemia: an analysis of risk factors and effect on outcomes. Bone Marrow Transplant 2016; 52:400-408. [PMID: 27941764 PMCID: PMC5332289 DOI: 10.1038/bmt.2016.265] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/12/2016] [Accepted: 08/28/2016] [Indexed: 11/15/2022]
Abstract
Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1,404 UCBT patients [single (< 18 years) = 810, double (≥ 18 years) = 594] with acute leukemia to define the incidence of acute and chronic graft-vs.-host disease (GVHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grades II–IV aGVHD was 39% (95% CI, 36–43%), grades III–IV aGVHD was 18% (95% CI, 15–20%), and 1-year cGVHD was 27% (95% CI, 24–30%). After double UCBT, 100-day incidence of grades II–IV aGVHD was 45% (95% CI, 41%–49%), grades III–IV aGVHD was 22% (95% CI, 19–26%), and 1-year cGVHD was 26% (95% CI, 22–29%). For single UCBT, multivariate analysis showed that absence of anti-thymocyte globulin (ATG) was associated with aGVHD, whereas prior aGVHD was associated with cGVHD. For double UCBT, absence of ATG and myeloablative conditioning were associated with aGVHD, while prior aGVHD predicted for cGVHD. Grades III–IV aGVHD led to worse survival whereas cGVHD had no significant effect on disease-free or overall survival. GVHD is prevalent after UCBT with severe aGVHD leading to higher mortality. Future research in UCBT should prioritize prevention of GVHD.
Collapse
Affiliation(s)
- Y-B Chen
- Massachusetts General Hospital, Boston, MA, USA
| | - T Wang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M T Hemmer
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - C Brady
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - D R Couriel
- Utah Blood and Marrow Transplant Program, Adults, Salt Lake City, UT, USA
| | - A Alousi
- Division of Cancer Medicine, Department of Stem Cell Transplantation, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Pidala
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - A Urbano-Ispizua
- Department of Hematology, Hospital Clinic, University of Barcelona, IDIBAPS and Institute of Research Josep Carreras, Barcelona, Spain
| | - S W Choi
- The University of Michigan, Ann Arbor, MI, USA
| | - T Nishihori
- Department of Blood and Marrow Transplantation, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - T Teshima
- Kyushu University Hospital, Fukuoka, Japan
| | - Y Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - B Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - D I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK
| | - H Abdel-Azim
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - L Lehmann
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, MA, USA
| | - L Yu
- Division of Hematology/Oncology and HSCT, The Center for Cancer and Blood Disorders, Children's Hospital/Louisiana State University Medical Center, New Orleans, LA, USA
| | - M Bitan
- Department of Pediatric Hematology/Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - M S Cairo
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - M Qayed
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, Australia
| | - R Salit
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - R P Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | - R Martino
- Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - S Jaglowski
- Division of Hematology, The Ohio State University Medical Center, Columbus, OH, USA
| | - A Bajel
- Royal Melbourne Hospital City Campus, Melbourne, Victoria, Australia
| | - B Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - H Frangoul
- Division of Hematology-Oncology, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - I D Lewis
- Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - J Storek
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Askar
- Baylor University Medical Center, Dallas, TX, USA
| | - M A Kharfan-Dabaja
- Department of Blood and Marrow Transplantation, H Lee Mofitt Cancer Center and Research Institute, Tampa, FL, USA
| | - M Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
| | - O Ringden
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - R Reshef
- Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - R F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - S Hashmi
- Mayo Clinic Rochester, Rochester, MN, USA
| | - S Seo
- National Cancer Research Center, East Hospital, Kashiwa, Chiba, Japan
| | - T R Spitzer
- Massachusetts General Hospital, Boston, MA, USA
| | - M L MacMillan
- University of Minnesota Medical Center, Fairview, Minneapolis, MN, USA
| | - A Lazaryan
- University of Minnesota Medical Center, Fairview, Minneapolis, MN, USA
| | - S R Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - M Arora
- Division of Hematology, Oncology, Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - C S Cutler
- Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| |
Collapse
|
25
|
Lingren T, Thaker V, Brady C, Namjou B, Kennebeck S, Bickel J, Patibandla N, Ni Y, Van Driest SL, Chen L, Roach A, Cobb B, Kirby J, Denny J, Bailey-Davis L, Williams MS, Marsolo K, Solti I, Holm IA, Harley J, Kohane IS, Savova G, Crimmins N. Developing an Algorithm to Detect Early Childhood Obesity in Two Tertiary Pediatric Medical Centers. Appl Clin Inform 2016; 7:693-706. [PMID: 27452794 DOI: 10.4338/aci-2016-01-ra-0015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/15/2016] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The objective of this study is to develop an algorithm to accurately identify children with severe early onset childhood obesity (ages 1-5.99 years) using structured and unstructured data from the electronic health record (EHR). INTRODUCTION Childhood obesity increases risk factors for cardiovascular morbidity and vascular disease. Accurate definition of a high precision phenotype through a standardize tool is critical to the success of large-scale genomic studies and validating rare monogenic variants causing severe early onset obesity. DATA AND METHODS Rule based and machine learning based algorithms were developed using structured and unstructured data from two EHR databases from Boston Children's Hospital (BCH) and Cincinnati Children's Hospital and Medical Center (CCHMC). Exclusion criteria including medications or comorbid diagnoses were defined. Machine learning algorithms were developed using cross-site training and testing in addition to experimenting with natural language processing features. RESULTS Precision was emphasized for a high fidelity cohort. The rule-based algorithm performed the best overall, 0.895 (CCHMC) and 0.770 (BCH). The best feature set for machine learning employed Unified Medical Language System (UMLS) concept unique identifiers (CUIs), ICD-9 codes, and RxNorm codes. CONCLUSIONS Detecting severe early childhood obesity is essential for the intervention potential in children at the highest long-term risk of developing comorbidities related to obesity and excluding patients with underlying pathological and non-syndromic causes of obesity assists in developing a high-precision cohort for genetic study. Further such phenotyping efforts inform future practical application in health care environments utilizing clinical decision support.
Collapse
Affiliation(s)
- Todd Lingren
- Todd Lingren, Cincinnati Children's Hospital Medical Center, Biomedical Informatics, 3333 Burnet Avenue, MLC 7024 Cincinnati, OH 45229-3039, Phone: 513-803-9032, Fax: 513-636-2056,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Freed B, Semaan E, Benefield B, Spottiswoode B, Brady C, Allen B, Shah S, Carr J, Markl M, Collins J. Right Ventricular T1 Mapping: A Feasibility Study. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
27
|
Brady C, Palladino AA, Gutmark-Little I. A novel case of compound heterozygous congenital hyperinsulinism without high insulin levels. Int J Pediatr Endocrinol 2015; 2015:16. [PMID: 26180531 PMCID: PMC4502541 DOI: 10.1186/s13633-015-0012-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/01/2015] [Indexed: 11/24/2022]
Abstract
Background Congenital hyperinsulinism leads to unregulated insulin secretion and hypoglycemia. Diagnosis can be difficult and genetic testing may be warranted. Case This patient initially presented at 11 months with seizure activity secondary to severe hypoglycemia. Her diagnostic evaluation included genetic studies, which confirmed congenital hyperinsulinism. A novel combination of mutations in the ABCC8 gene leading to diffuse, diazoxide-unresponsive congenital hyperinsulinism was identified. Mutation analysis of ABCC8 showed three variants (R1215W – paternal, pathogenic; W739C – maternal, variant of unknown significance; R1393L – maternal, variant of unknown significance). Her clinical course continues to be complicated by severe, refractory hypoglycemia at age 3 years. Conclusion We describe a novel compound heterozygous mutation leading to diffuse, diazoxide-unresponsive congenital hyperinsulinism. This case illustrates challenges associated with diagnosing and managing congenital hyperinsulinism and the importance of genetic testing.
Collapse
Affiliation(s)
- Cassandra Brady
- Cincinnati Children's Hospital Medical Center, Division of Endocrinology, 3333 Burnet Ave, MLC 7012, Cincinnati, OH 45229 USA
| | - Andrew A Palladino
- Children's Hospital of Philadelphia, Division of Endocrinology, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 USA
| | - Iris Gutmark-Little
- Cincinnati Children's Hospital Medical Center, Division of Endocrinology, 3333 Burnet Ave, MLC 7012, Cincinnati, OH 45229 USA
| |
Collapse
|
28
|
Brady C, Bambury RM, O'Reilly S. Empathy and the wounded healer: a mixed-method study of patients and doctors views on empathy. Ir Med J 2015; 108:125-126. [PMID: 26016309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Empathy is increasingly being recognized as a crucial component for an effective doctor-patient relationship. Using a mixed method approach, we surveyed 125 patients and 361 medical practitioners (doctors and medical students) views of the doctor-patient relationship. We qualitatively assessed patients' views of what constituted a good doctor and qualitatively measured empathy using a validated scale in medical practitioners. Patients desire a doctor that is both clinically proficient 66 (55%) and caring 32 (27%). Doctors who have a personal experience of illness have a statistically higher empathy score. These doctors may be well placed to help develop and foster empathy in our profession.
Collapse
|
29
|
Hicks CAE, Barker EN, Brady C, Stokes CR, Helps CR, Tasker S. Non-ribosomal phylogenetic exploration of Mollicute species: new insights into haemoplasma taxonomy. Infect Genet Evol 2014; 23:99-105. [PMID: 24518692 PMCID: PMC3988868 DOI: 10.1016/j.meegid.2014.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/01/2014] [Indexed: 11/29/2022]
Abstract
The first gapA and dnaK phylogenetic analysis of Mollicute species. Analysis includes a wide range of haemoplasmas species. Analysis supports that haemoplasmas reside within a single clade. Evidence of phylogenetic distance between the haemoplasmas and Mycoplasma species.
Nine species of uncultivable haemoplasmas and several Mycoplasma species were examined by partial sequencing of two protein-encoding housekeeping genes. Partial glyceraldehyde-3-phosphate dehydrogenase (gapA) and heat shock protein 70 (dnaK) gene sequences were determined for these Mollicute species; in total nine gapA sequences and ten dnaK sequences were obtained. Phylogenetic analyses of these sequences, along with those of a broad selection of Mollicute species downloaded from GenBank, for the individual genes, and for the gapA and dnaK concatenated data set, revealed a clear separation of the haemoplasmas from other species within the Mycoplasma genus; indeed the haemoplasmas resided within a single clade which was phylogenetically detached from the pneumoniae group of Mycoplasmas. This is the first report to examine the use of gapA and dnaK, as well as a concatenated data set, for phylogenetic analysis of the haemoplasmas and other Mollicute species. These results demonstrate a distinct phylogenetic separation between the haemoplasmas and Mycoplasmas that corresponds with the biological differences observed in these species, indicating that further evaluation of the haemoplasmas’ relationship with the Mycoplasma genus is required to determine whether reclassification of the haemoplasmas is necessary.
Collapse
Affiliation(s)
- C A E Hicks
- School of Veterinary Sciences, University of Bristol, Langford BS40 5DU, United Kingdom.
| | - E N Barker
- School of Veterinary Sciences, University of Bristol, Langford BS40 5DU, United Kingdom
| | - C Brady
- Department of Applied Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol BS16 1QY, United Kingdom
| | - C R Stokes
- School of Veterinary Sciences, University of Bristol, Langford BS40 5DU, United Kingdom
| | - C R Helps
- School of Veterinary Sciences, University of Bristol, Langford BS40 5DU, United Kingdom
| | - S Tasker
- School of Veterinary Sciences, University of Bristol, Langford BS40 5DU, United Kingdom
| |
Collapse
|
30
|
Martin S, Lamb HK, Brady C, Lefkove B, Bonner MY, Thompson P, Lovat PE, Arbiser JL, Hawkins AR, Redfern CPF. Inducing apoptosis of cancer cells using small-molecule plant compounds that bind to GRP78. Br J Cancer 2013; 109:433-43. [PMID: 23807168 PMCID: PMC3721410 DOI: 10.1038/bjc.2013.325] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 05/30/2013] [Accepted: 06/04/2013] [Indexed: 02/07/2023] Open
Abstract
Background: Glucose regulated protein 78 (GRP78) functions as a sensor of endoplasmic reticulum (ER) stress. The aim of this study was to test the hypothesis that molecules that bind to GRP78 induce the unfolded protein response (UPR) and enhance cell death in combination with ER stress inducers. Methods: Differential scanning calorimetry (DSC), measurement of cell death by flow cytometry and the induction of ER stress markers using western blotting. Results: Epigallocatechin gallate (EGCG), a flavonoid component of Green Tea Camellia sinensis, and honokiol (HNK), a Magnolia grandiflora derivative, bind to unfolded conformations of the GRP78 ATPase domain. Epigallocatechin gallate and HNK induced death in six neuroectodermal tumour cell lines tested. Levels of death to HNK were twice that for EGCG; half-maximal effective doses were similar but EGCG sensitivity varied more widely between cell types. Honokiol induced ER stress and UPR as predicted from its ability to interact with GRP78, but EGCG was less effective. With respect to cell death, HNK had synergistic effects on melanoma and glioblastoma cells with the ER stress inducers fenretinide or bortezomib, but only additive (fenretinide) or inhibitory (bortezomib) effects on neuroblastoma cells. Conclusion: Honokiol induces apoptosis due to ER stress from an interaction with GRP78. The data are consistent with DSC results that suggest that HNK binds to GRP78 more effectively than EGCG. Therefore, HNK may warrant development as an antitumour drug.
Collapse
Affiliation(s)
- S Martin
- Newcastle Cancer Centre at the Northern Institute for Cancer Research, Medical School, Newcastle University, Newcastle upon Tyne, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Good DW, Khan N, Kiely E, Brady C. The impact of rolling theatre closures on core urology training. Ir Med J 2013; 106:149-151. [PMID: 23914579] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Since 2008, government funding of the Health Service Executive (HSE) has decreased significantly. Our hospital, Cork University Hospital (CUH), implemented "cost saving" measures including scheduled operating theatre closures. We studied their affect on urological surgical activity at the hospital. A retrospective review was performed using theatre log books and theatre records to determine the number, type and training status of procedures performed for years 2009 and 2011. Scheduled theatre closures in 2011 resulted in 33 more theatre session cancelations compared to 2009. There was a reduction in the total number of procedures performed from 555 cases in 2009 to 443 in 2011 a 20.2(%) reduction. The number of "training" cases reduced from 325 (58.9%) in 2009 to 216 (48.7%) in 2011 a 10.2% reduction (Table 2). Eight out of the nine "core urology training" procedures reduced in number from 2009 to 2011 (Table 1). We have shown that scheduled theatre closures have reduced the number of procedures performed and have impacted on urology training. Scheduled theatre closures are expected to become more frequent in the future. Potential solutions to lessen the impact include providing simulation training using the Royal College of Surgeons in Ireland (RCSI) mobile skills unit during these theatre closures.
Collapse
Affiliation(s)
- D W Good
- Department of Urology, Cork University Hospital, Wilton, Cork.
| | | | | | | |
Collapse
|
32
|
Marques P, O’ Donovan J, Williams E, Gutierrez J, Worrall S, McElroy M, Proctor A, Brady C, Sammin D, Bassett H, Buxton D, Maley S, Markey B, Nally J. Detection of Toxoplasma gondii antigens reactive with antibodies from serum, amniotic, and allantoic fluids from experimentally infected pregnant ewes. Vet Parasitol 2012; 185:91-100. [DOI: 10.1016/j.vetpar.2011.10.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 10/12/2011] [Accepted: 10/19/2011] [Indexed: 10/15/2022]
|
33
|
O’Donovan J, Proctor A, Gutierrez J, Worrell S, Nally J, Marques P, Brady C, McElroy M, Sammin D, Buxton D, Maley S, Bassett H, Markey B. Distribution of Lesions in Fetal Brains Following Experimental Infection of Pregnant Sheep With Toxoplasma gondii. Vet Pathol 2011; 49:462-9. [DOI: 10.1177/0300985811424732] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Six ovine fetal brains were harvested 33 to 35 days postchallenge from 5 ewes, each of which was given 3000 Toxoplasma gondii oocysts on day 90 of pregnancy. Histopathologic examination of transverse sections taken at 13 levels in the fetal brains revealed the presence of toxoplasmosis-related lesions in all 6 brains. However, lesions were not randomly distributed ( P = .007); they were most numerous at the level of the optic tract, the rostral margin of the pons, and 4 mm caudal to the ansate sulcus and were absent in all sections at the level of the caudal cerebellum. Lesion distribution may be due to hemodynamic factors, differences in the expression of endothelial surface receptor molecules at the level of the blood-brain barrier, or the presence of localized permissive/inhibitory factors within the brain. The results have implications for the selection of areas of brain from aborted ovine fetuses to be examined histopathologically for laboratory diagnosis.
Collapse
Affiliation(s)
- J. O’Donovan
- Regional Veterinary Laboratory, Department of Agriculture, Fisheries, and Food, Athlone, Ireland
| | - A. Proctor
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - J. Gutierrez
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - S. Worrell
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - J. Nally
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - P. Marques
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - C. Brady
- Central Veterinary Research Laboratory, Department of Agriculture, Fisheries, and Food, Celbridge, Ireland
| | - M. McElroy
- Central Veterinary Research Laboratory, Department of Agriculture, Fisheries, and Food, Celbridge, Ireland
| | - D. Sammin
- Central Veterinary Research Laboratory, Department of Agriculture, Fisheries, and Food, Celbridge, Ireland
| | - D. Buxton
- Moredun Research Institute, Pentland Science Park, Edinburgh, Scotland
| | - S. Maley
- Moredun Research Institute, Pentland Science Park, Edinburgh, Scotland
| | - H. Bassett
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - B. Markey
- School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland
| |
Collapse
|
34
|
Gutierrez J, O’Donovan J, Williams E, Proctor A, Brady C, Marques P, Worrall S, Nally J, McElroy M, Bassett H, Sammin D, Buxton D, Maley S, Markey B. Detection and quantification of Toxoplasma gondii in ovine maternal and foetal tissues from experimentally infected pregnant ewes using real-time PCR. Vet Parasitol 2010; 172:8-15. [DOI: 10.1016/j.vetpar.2010.04.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 04/19/2010] [Accepted: 04/27/2010] [Indexed: 11/17/2022]
|
35
|
Kalathingal SM, Shrout MK, Comer C, Brady C. Rating the extent of surface scratches on photostimulable storage phosphor plates in a dental school environment. Dentomaxillofac Radiol 2010; 39:179-83. [PMID: 20203281 DOI: 10.1259/dmfr/28972644] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The aims of this study were (1) to subjectively quantify the degree of scratching and smudging that had taken place in the junior clinic in the 9 months following the implementation of digital radiology; (2) to compare the findings with a previously published report; and (3) to identify areas in the protocol and training that can be refined to minimize future scratching and smudging. METHODS Seven sets of blank clinical photostimulable storage phosphor (PSP) plates were scanned after exposing them at 65 kV and 7 mA for 0.80 s. Scanned plates were lightly wiped with a soft cloth and alcohol, repackaged in plastic sleeves, re-exposed and rescanned. The two sets of resulting images were subjectively rated independently by two investigators for artefacts and placed in five categories. RESULTS Of all the images, approximately 75% were rated in the top 3 categories (most readable), leaving 17% and 8% in the poor and unsatisfactory categories, respectively. Mean rated values of the two image sets (before and after wiping) were not statistically different, but ratings slightly improved after cleaning the plates. CONCLUSIONS Wiping all plates to remove surface contamination may not always be necessary or desirable. Systems that are designed to minimize handling of the plates may help minimize scratching of them.
Collapse
Affiliation(s)
- S M Kalathingal
- Oral Diagnosis and Patient Services, School of Dentistry, Medical College of Georgia, Augusta, Georgia 30912-1241, USA.
| | | | | | | |
Collapse
|
36
|
Brady C, O'Grady D, O'Meara F, Egan J, Bassett H. Relationships between clinical signs, pathological changes and tissue distribution of Mycobacterium avium subspecies paratuberculosis in 21 cows from herds affected by Johne's disease. Vet Rec 2008; 162:147-52. [PMID: 18245746 DOI: 10.1136/vr.162.5.147] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Twenty-one cows from eight herds affected by Johne's disease were assigned to four groups: seven were not thriving and had persistent diarrhoea, six were not thriving and had intermittent diarrhoea, four were not thriving but did not have diarrhoea, and four were clinically normal. Postmortem, macroscopic lesions consistent with Johne's disease were identified in 17 of the cows and Mycobacterium avium subspecies paratuberculosis (MAP) was isolated from all of them. However, except for the fact that diarrhoea was correlated with the presence of lesions in the large intestine there was little correlation between the presence or absence of clinical signs and the lesions associated with Johne's disease. The tissue distribution of MAP was also poorly correlated with either the clinical signs or the lesions. The organism was widely distributed in 17 of the 21 cows, including three of the clinically normal animals, and was present in the mammary tissues of seven cows including two of the clinically normal animals. Three distinct histopathological patterns were observed in the affected intestines: infiltration of the lamina propria with giant cells, tuberculoid lesions, and lepromatous lesions; the lepromatous lesions were associated with extensive pathological changes.
Collapse
Affiliation(s)
- C Brady
- Central Veterinary Research Laboratory, Abbotstown, Castleknock, Dublin 15, Ireland
| | | | | | | | | |
Collapse
|
37
|
Brady C, Brown M, Foley L, Cullen R, Yang S, Halet M, Spellman S. 7-OR: Results of the prospective cord blood high resolution typing project. Hum Immunol 2008. [DOI: 10.1016/j.humimm.2008.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Henry W, Coates CG, Brady C, Ronayne KL, Matousek P, Towrie M, Botchway SW, Parker AW, Vos JG, Browne WR, McGarvey JJ. The Early Picosecond Photophysics of Ru(II) Polypyridyl Complexes: A Tale of Two Timescales. J Phys Chem A 2008. [DOI: 10.1021/jp804511t] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
39
|
Arce-Lara CE, Cataland S, Brady C, Kraut E, Otterson G, Villalona-Calero M, Bekaii-Saab T. A single center review of the experience with mitomycin C (MMC) and the risk of thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15167 Background: MMC related TTP/HUS has been reported between 4 and 15%, with a higher incidence in patients receiving cumulative doses of 60 mg or higher. It tends to occur within 4 months of drug administration independently of patients’ cancer status. The ability of MMC to upregulate enzymes relevant for new cytototoxic agents (topoisomerase I for CPT-11 and thymidine phosphorylase for capecitabine) make phamacobiologically based therapeutic combinations including MMC attractive. Methods: All patients (n=100) that participated in four institutional clinical studies from 2000 through 2004 were included. The studies were OSU 9947 (phase I trial of CPT-11 and MMC in solid tumors, n=31) OSU 0151 (phase II trial of CPT-11 and MMC in advanced esophageal and stomach cancer, n=41) OSU 0155 (phase II trial of CPT-11 and MMC in patients with refractory breast cancer, n=26) OSU 0330 (phase I study of capecitabine and MMC in patients with advanced GI tumors n=2). In each study, the maximum cumulative dose of MMC was 36 mg/m2. All patients were followed for clinical signs or symptoms of TTP/HUS including the presence of anemia, thrombocytopenia and renal insufficiency and had a thorough review of the peripheral smear. Results: The median cumulative dose was 12 mg/m2 (range 3–36 mg/m2). No patients met the clinical diagnosis of TTP/HUS except for one patient had anemia, thrombocytopenia and renal insufficiency but did not manifest any other findings consistent with TTP/HUS such as changes in mental status, azotemia or any other clinical symptom. The laboratory abnormalities resolved without intervention within seven days with subsequent continuation on the clinical trial. Conclusions: In this study we have demonstrated that by capping the cumulative dose of MMC to 36 mg/m2, the incidence of TTP/HUS is minimal. Furthermore, our preliminary analysis of an additional 100 patients treated with MMC at OSU shows no reported cases of TTP/HUS (additional data will be presented at the meeting). Since MMC is effective in a wide variety of solid tumors including breast, lung and GI malignancies and is inexpensive and easy to administer, further exploration of MMC in the treatment of solid malignancies is indicated including rational combination studies. No significant financial relationships to disclose.
Collapse
Affiliation(s)
| | - S. Cataland
- The Ohio State University Medical Center, Columbus, OH
| | - C. Brady
- The Ohio State University Medical Center, Columbus, OH
| | - E. Kraut
- The Ohio State University Medical Center, Columbus, OH
| | - G. Otterson
- The Ohio State University Medical Center, Columbus, OH
| | | | | |
Collapse
|
40
|
Devine P, Brady C. Emerging solutions: Clinical trial informed consent collaborative model. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. Devine
- Cancer Information & Support Network, Pleasanton, CA
| | - C. Brady
- Cancer Information & Support Network, Pleasanton, CA
| |
Collapse
|
41
|
Ali SM, Demers LM, Leitzel K, Harvey HA, Clemens D, Mallinak N, Engle L, Chinchilli V, Costa L, Brady C, Seaman J, Lipton A. Baseline serum NTx levels are prognostic in metastatic breast cancer patients with bone-only metastasis. Ann Oncol 2004; 15:455-9. [PMID: 14998848 DOI: 10.1093/annonc/mdh089] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND There is significant heterogeneity in survival of patients with metastatic breast cancer who have bone-only metastasis. We studied the correlation of serum N-telopeptide (NTx), a marker of bone resorption, and its correlation with clinical outcomes in patients with metastatic breast cancer with bone-only or bone plus soft tissue metastasis. PATIENTS AND METHODS Serum was taken from 250 metastatic breast cancer patients with bone-only or bone plus soft tissue metastasis who participated in two similar randomized studies of second-line hormone therapy. An enzyme-linked immunosorbent assay specific for NTx of type I bone collagen was used to detect serum levels. RESULTS Sixty patients (24%) had elevated serum NTx levels, using the mean + 2 standard deviations (26 nanomoles Bone Collagen Equivalents per liter) of healthy women as a cut-off. The median duration of clinical benefit was significantly shorter in the group with elevated serum NTx levels compared with the group that had normal serum NTx levels (P=0.0004). Time to progression (TTP) was also significantly shorter in the patients with elevated serum NTx at 139 days compared with 220 days (P=0.0006). Median survival was also significantly shorter in patients with elevated baseline serum NTx levels at 663 days compared with 941 days (P<0.0001). CONCLUSION In this study, breast cancer patients with bone-only or bone plus soft tissue metastasis and elevated serum NTx levels have a shorter duration of clinical benefit, TTP and overall survival.
Collapse
Affiliation(s)
- S M Ali
- VA Medical Center, Lebanon, PA 17042, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Lipton A, Leitzel K, Demers L, Harvey H, Ali S, Chaudri-Ross H, Wyld P, Brady C, Carney W. In Reply:. J Clin Oncol 2003. [DOI: 10.1200/jco.2003.99.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Lipton
- The M.S. Hershey Medical Center, Hershey, PA
| | - K. Leitzel
- The M.S. Hershey Medical Center, Hershey, PA
| | - L. Demers
- The M.S. Hershey Medical Center, Hershey, PA
| | - H.A. Harvey
- The M.S. Hershey Medical Center, Hershey, PA
| | | | | | - P. Wyld
- Novartis Pharma AG, Basel, Switzerland
| | - C. Brady
- Novartis Pharmaceutical Corp, East Hanover, NJ
| | | |
Collapse
|
43
|
Lipton A, Ali SM, Leitzel K, Demers L, Harvey HA, Chaudri-Ross HA, Brady C, Wyld P, Carney W. Serum HER-2/neu and response to the aromatase inhibitor letrozole versus tamoxifen. J Clin Oncol 2003; 21:1967-72. [PMID: 12743150 DOI: 10.1200/jco.2003.09.098] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.5] [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: 11/20/2022] Open
Abstract
PURPOSE To determine the effect of elevated serum HER-2/neu on the response of metastatic breast cancer patients to an aromatase inhibitor versus an antiestrogen. PATIENTS AND METHODS Five hundred sixty-two estrogen receptor-positive metastatic breast cancer patients were randomized to first-line hormone therapy with either letrozole or tamoxifen. An automated enzyme-linked immunosorbent assay was used to detect serum HER-2/neu. RESULTS For patients with normal serum HER-2/neu (70.5%), objective response rate (ORR; 39% in letrozole-treated patients v 26% in tamoxifen-treated patients; P =.008), clinical benefit (CB; 57% v 45%; P =.016), time to progression (TTP; median, 12.2 v 8.5 months; P =.0019), and time to treatment failure (TTF; median, 11.6 v 6.2 months; P =.0066) were significantly better in patients treated with letrozole. In the elevated HER-2/neu group (29.5%), there was no significant difference in ORR (17% in letrozole-treated patients v 13% in tamoxifen-treated patients; P =.45) or CB (33% v 26%; P =.31), but there was a strong trend in favor of a longer TTP with letrozole (median, 6.1 v 3.3 months; P =.0596) and a significantly longer TTF with letrozole (median, 6.0 v 3.2 months; P =.0418). Multivariate analysis revealed that elevated serum HER-2/neu was a negative predictor for ORR and TTP. CONCLUSION Patients with normal serum HER-2/neu receiving letrozole demonstrated a significantly greater ORR and CB and longer TTP and TTF than patients receiving tamoxifen. Although in patients with elevated serum HER-2/neu there was no significant difference between letrozole and tamoxifen in ORR or CB, there was a strong trend favoring longer TTP and significantly longer TTF with letrozole.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/therapeutic use
- Aromatase Inhibitors
- Breast Neoplasms/blood
- Breast Neoplasms/drug therapy
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Disease-Free Survival
- Double-Blind Method
- Enzyme-Linked Immunosorbent Assay
- Estrogen Antagonists/therapeutic use
- Female
- Humans
- Letrozole
- Middle Aged
- Neoplasm Metastasis
- Neoplasm Recurrence, Local/blood
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Neoplasms, Hormone-Dependent/blood
- Neoplasms, Hormone-Dependent/drug therapy
- Neoplasms, Hormone-Dependent/mortality
- Neoplasms, Hormone-Dependent/pathology
- Nitriles/therapeutic use
- Receptor, ErbB-2/blood
- Switzerland
- Tamoxifen/therapeutic use
- Treatment Outcome
- Triazoles/therapeutic use
- United States
Collapse
Affiliation(s)
- A Lipton
- Penn State Milton S. Hershey Medical Center, Department of Medicine, Division of Hematology/Oncology HO46, 500 University Dr, PO Box 850, Hershey, PA 17033, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Lipton A, Ali SM, Leitzel K, Demers L, Chinchilli V, Engle L, Harvey HA, Brady C, Nalin CM, Dugan M, Carney W, Allard J. Elevated serum Her-2/neu level predicts decreased response to hormone therapy in metastatic breast cancer. J Clin Oncol 2002; 20:1467-72. [PMID: 11896093 DOI: 10.1200/jco.2002.20.6.1467] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.5] [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: 11/20/2022] Open
Abstract
PURPOSE To determine the effect of elevation of serum HER-2/neu on response to hormone therapy. PATIENTS AND METHODS Seven hundred nineteen metastatic patients with estrogen receptor-positive (ER(+)), progesterone receptor-positive, or both or ER status unknown breast cancer were randomized in three independent clinical trials to receive second-line hormone therapy with either megestrol acetate or an aromatase inhibitor (fadrozole or letrozole). An automated enzyme-linked immunosorbent assay specific for the extracellular domain of the HER-2/neu (c-erbB-2) oncoprotein product was used to detect serum levels. RESULTS Two hundred nineteen patients (30%) had elevated serum HER-2/neu protein levels, using the mean + 2 SD (15 ng/mL) from the serum of healthy women as an upper limit. Response to treatment was available for 711 patients. The response rate (complete responses plus partial responses plus stable disease) to endocrine therapy was 45% in 494 patients with non-elevated and 23% in 217 patients with elevated serum HER-2/neu levels (P <.0001). Median duration of treatment response (using the time to progression [TTP] variable for patients who responded) was shorter in the group with elevated serum HER-2/neu levels (11.7 months) compared with the patient group with non-elevated levels (17.4 months). TTP, time to treatment failure, and median survival (17.2 months v 29.6 months) were also significantly shorter in the patients with elevated serum HER-2/neu levels (P <.0001). CONCLUSION Patients with ER(+) and serum HER-2/neu-positive metastatic breast cancer are less likely to respond to hormone treatment and have a shorter duration of response than ER(+) and serum HER-2/neu-negative patients. Their survival duration is also shorter.
Collapse
Affiliation(s)
- Allan Lipton
- Department of Hematology and Oncology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Affiliation(s)
- C Brady
- Division of Nursing, Regis College, 235 Wellesley St, Weston, MA 02493-1571, USA
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Ellis MJ, Coop A, Singh B, Mauriac L, Llombert-Cussac A, Jänicke F, Miller WR, Evans DB, Dugan M, Brady C, Quebe-Fehling E, Borgs M. Letrozole is more effective neoadjuvant endocrine therapy than tamoxifen for ErbB-1- and/or ErbB-2-positive, estrogen receptor-positive primary breast cancer: evidence from a phase III randomized trial. J Clin Oncol 2001; 19:3808-16. [PMID: 11559718 DOI: 10.1200/jco.2001.19.18.3808] [Citation(s) in RCA: 739] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Expression of ErbB-1 and ErbB-2 (epidermal growth factor receptor and HER2/neu) in breast cancer may cause tamoxifen resistance, but not all studies concur. Additionally, the relationship between ErbB-1 and ErbB-2 expression and response to selective aromatase inhibitors is unknown. A neoadjuvant study for primary breast cancer that randomized treatment between letrozole and tamoxifen provided a context within which these issues could be addressed prospectively. PATIENTS AND METHODS Postmenopausal patients with estrogen- and/or progesterone receptor-positive (ER+ and/or PgR+) primary breast cancer ineligible for breast-conserving surgery were randomly assigned to 4 months of neoadjuvant letrozole 2.5 mg daily or tamoxifen 20 mg daily in a double-blinded study. Immunohistochemistry (IHC) for ER and PgR was conducted on pretreatment biopsies and assessed by the Allred score. ErbB-1 and ErbB-2 IHC were assessed by intensity and completeness of membranous staining according to published criteria. RESULTS For study biopsy-confirmed ER+ and/or PgR+ cases that received letrozole, 60% responded and 48% underwent successful breast-conserving surgery. The response to tamoxifen was inferior (41%, P =.004), and fewer patients underwent breast conservation (36%, P =.036). Differences in response rates between letrozole and tamoxifen were most marked for tumors that were positive for ErbB-1 and/or ErbB-2 and ER (88% v 21%, P =.0004). CONCLUSION ER+, ErbB-1+, and/or ErbB-2+ primary breast cancer responded well to letrozole, but responses to tamoxifen were infrequent. This suggests that ErbB-1 and ErbB-2 signaling through ER is ligand-dependent and that the growth-promoting effects of these receptor tyrosine kinases on ER+ breast cancer can be inhibited by potent estrogen deprivation therapy.
Collapse
Affiliation(s)
- M J Ellis
- Duke University Breast Cancer Program, Duke University Comprehensive Cancer Center, Durham, NC 27710, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Ellis M, Sing B, Miller W, Llombart-Cussac A, Janicke F, Evans D, Borgs M, Quebe-Fehling E, Brady C, Dugan M, Coop A. Letrozole (femara) is a more effective inhibitor of estrogen activity than tamoxifen: Evidence from a randomized phase III trial of 4 months preoperative endocrine therapy for postmenopausal women with primary invasive breast cancer. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)80054-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
48
|
Buzdar A, Douma J, Davidson N, Elledge R, Morgan M, Smith R, Porter L, Nabholtz J, Xiang X, Brady C. Phase III, multicenter, double-blind, randomized study of letrozole, an aromatase inhibitor, for advanced breast cancer versus megestrol acetate. J Clin Oncol 2001; 19:3357-66. [PMID: 11454883 DOI: 10.1200/jco.2001.19.14.3357] [Citation(s) in RCA: 284] [Impact Index Per Article: 12.3] [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: 11/20/2022] Open
Abstract
PURPOSE To compare two doses of letrozole (0.5 mg and 2.5 mg every day) and megestrol acetate (40 mg qid) as endocrine therapy in postmenopausal women with advanced breast cancer previously treated with antiestrogens. PATIENTS AND METHODS This double-blind, randomized, multicenter, multinational study enrolled 602 patients, all of whom were included in the primary analysis in the protocol. Patients had advanced or metastatic breast cancer with evidence of disease progression while receiving continuous adjuvant antiestrogen therapy, had experienced relapse within 12 months of stopping adjuvant antiestrogen therapy given for at least 6 months, or had experienced disease progression while receiving antiestrogen therapy for advanced disease. Tumors were required to be estrogen receptor- and/or progesterone receptor-positive or of unknown status. Confirmed objective response rate was the primary efficacy variable. Karnofsky Performance Status and European Organization for Research and Treatment of Cancer quality-of-life assessments were collected for 1 year. RESULTS There were no statistically significant differences among the three treatment groups for overall objective tumor response. Patients treated with letrozole 0.5 mg had improvements in disease progression (P =.044) and a decreased risk of treatment failure (P =.018), compared with patients treated with megestrol acetate. Letrozole 0.5 mg showed a trend (P =.053) for survival benefit when compared with megestrol acetate. Megestrol acetate was more likely to produce weight gain, dyspnea, and vaginal bleeding, and the letrozole groups were more likely to experience headache, hair thinning, and diarrhea. CONCLUSION Given a favorable tolerability profile, once-daily dosing, and evidence of clinically relevant benefit, letrozole is equivalent to megestrol acetate and should be considered for use as an alternative treatment of advanced breast cancer in postmenopausal women after treatment failure with antiestrogens.
Collapse
Affiliation(s)
- A Buzdar
- University of Texas M.D. Anderson Cancer Center and Baylor College of Medicine, Houston, TX, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
OBJECTIVES To determine the presence, distribution and molecular forms of the vanilloid receptor VR1, and confirm the presence and distribution of the ATP-gated ion channel P2X3 in the human urinary bladder. Materials and methods Normal urinary bladder tissues were obtained at postmortem from four subjects. Eight urinary bladder biopsies were also taken from patients with detrusor hyper-reflexia treated with intravesical resiniferatoxin. The specimens were studied using affinity-purified specific antibodies to VR1 and P2X3 by Western blotting and immunocytochemistry, and compared with immunostaining using antibodies to the pan-neuronal marker PGP 9.5 and Schwann cell marker S-100. RESULTS VR1- and P2X3-immunoreactive fine nerve fibres were scattered throughout the suburothelium of the normal bladder and cystoscopic biopsies, and traversed the muscle layer. They had a similar distribution to PGP 9.5-immunoreactive fibres, but there were fewer, suggesting localization in subsets of axons. Western blot studies showed an expected 100-kDa VR1 protein and a P2X3-immunoreactive 66-kDa protein. Conclusion VR1 and P2X3 are present in the human urinary bladder and may contribute to distinct pathophysiological states of bladder overactivity, in accord with their differential expression in sensory neurones. Intravesical vanilloids act via VR1 and are effective in the treatment of detrusor hyper-reflexia. P2X3 may represent a selective therapeutic target for other causes of overactive bladder.
Collapse
Affiliation(s)
- Y Yiangou
- Peripheral Neuropathy Unit, Imperial College School of Medicine, Hammersmith Hospital, London
| | | | | | | | | | | | | |
Collapse
|
50
|
van Adelsberg J, Sehgal S, Kukes A, Brady C, Barasch J, Yang J, Huan Y. Activation of hepatocyte growth factor (HGF) by endogenous HGF activator is required for metanephric kidney morphogenesis in vitro. J Biol Chem 2001; 276:15099-106. [PMID: 11032833 DOI: 10.1074/jbc.m006634200] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [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: 11/06/2022] Open
Abstract
The interaction of hepatocyte growth factor (HGF) with c-Met has been implicated in morphogenesis of the kidney, lung, mammary gland, liver, placenta, and limb bud. HGF is secreted as an inactive zymogen and must be cleaved by a serine protease to initiate Met signaling. We show here that a serine protease specific for HGF, HGF activator (HGFA), is expressed and activated by the ureteric bud of the developing kidney in vivo and in vitro. Inhibition of HGFA activity with serine protease inhibitors reduced ureteric bud branching and inhibited glomerulogenesis and nephrogenesis. Activated HGF rescued developing kidneys from the effects of inhibitors. HGFA was localized around the tips of the ureteric bud in developing kidneys, while HGF was expressed diffusely throughout the mesenchyme. These data show that expression of HGF is not sufficient for development, but that its activation is also required. The localization of HGFA to the ureteric bud and the mesenchyme immediately adjacent to it suggests that HGFA creates a gradient of HGF activity in the developing kidney. The creation and shape of gradients of activated HGF by the localized secretion of HGF activators could play an important role in pattern formation by HGF responsive tissues.
Collapse
Affiliation(s)
- J van Adelsberg
- Columbia University College of Physicians and Surgeons, Department of Medicine, New York, New York 10032, USA.
| | | | | | | | | | | | | |
Collapse
|