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Balıkçı E, Marques ASMC, Bauer LG, Seupel R, Bennett J, Raux B, Buchan K, Simelis K, Singh U, Rogers C, Ward J, Cheng C, Szommer T, Schützenhofer K, Elkins JM, Sloman DL, Ahel I, Fedorov O, Brennan PE, Huber KVM. Unexpected Noncovalent Off-Target Activity of Clinical BTK Inhibitors Leads to Discovery of a Dual NUDT5/14 Antagonist. J Med Chem 2024. [PMID: 38635563 DOI: 10.1021/acs.jmedchem.4c00072] [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: 04/20/2024]
Abstract
Cofactor mimicry represents an attractive strategy for the development of enzyme inhibitors but can lead to off-target effects due to the evolutionary conservation of binding sites across the proteome. Here, we uncover the ADP-ribose (ADPr) hydrolase NUDT5 as an unexpected, noncovalent, off-target of clinical BTK inhibitors. Using a combination of biochemical, biophysical, and intact cell NanoBRET assays as well as X-ray crystallography, we confirm catalytic inhibition and cellular target engagement of NUDT5 and reveal an unusual binding mode that is independent of the reactive acrylamide warhead. Further investigation of the prototypical BTK inhibitor ibrutinib also revealed potent inhibition of the largely unstudied NUDIX hydrolase family member NUDT14. By exploring structure-activity relationships (SARs) around the core scaffold, we identify a potent, noncovalent, and cell-active dual NUDT5/14 inhibitor. Cocrystallization experiments yielded new insights into the NUDT14 hydrolase active site architecture and inhibitor binding, thus providing a basis for future chemical probe design.
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Affiliation(s)
- Esra Balıkçı
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Anne-Sophie M C Marques
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Ludwig G Bauer
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Raina Seupel
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - James Bennett
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Brigitt Raux
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Karly Buchan
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Klemensas Simelis
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Usha Singh
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Catherine Rogers
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Jennifer Ward
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Carol Cheng
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Tamas Szommer
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Kira Schützenhofer
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, U.K
| | - Jonathan M Elkins
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - David L Sloman
- Departments of Discovery Chemistry, Merck & Co. Inc., 33 Avenue Louis Pasteur, Boston, Massachusetts 02115, United States
| | - Ivan Ahel
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, U.K
| | - Oleg Fedorov
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Paul E Brennan
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Alzheimer's Research UK Oxford Drug Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
| | - Kilian V M Huber
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, U.K
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Ibekwe TS, Rogers C, Ramma L. Comparing Hearing Loss in Children with Adults Living with Sickle Cell Disease and Sickle Cell Traits. Niger J Clin Pract 2024; 27:74-81. [PMID: 38317038 DOI: 10.4103/njcp.njcp_763_23] [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] [Received: 10/28/2023] [Accepted: 12/24/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Hearing loss is a neurological sequelae associated with sickle cell disease (SCD) and probably sickle cell trait (SCT) in children and adults but remains understudied. AIM This study aimed to compare the hearing impairment among children and adults living with SCD or SCT. METHODS A comparative cross-sectional study conducted in four departments with SCD outpatient clinic in a tertiary hospital in Nigeria. Participants with Sickle cell disease (HbSS) and Sickle cell trait (HbAS) (cohort) and HbAA (control) had comprehensive ear and hearing assessments for sensorineural hearing loss. Audiometric results were categorized according to WHO classifications and data analysed with Statistical Analysis System (SAS 9.4). RESULTS A total of 212 participants (106 cohort and control, respectively), aged 6 months to 55 years, were enrolled. Of these, 35% of children with SCD and 25% with SCT had hearing impairment, while 30% of adults with SCD, 36.1% with SCT, and 11% with HbAA had hearing impairment. There was asymmetry in the hearing impairment, with the left ear more affected in children and the right ear in adults. The odds ratio (OD) of hearing impairment was higher in HbSS (2.48 (95% confidence interval (CI):1.51-4.14); P = 0.0004) and HbAS (2.28 (95% CI: 1.1-4.58); P = 0.02) participants compared with HbAA but was not statistically significant when adjusted for frequency of hospitalization, crises, blood transfusion and routine drugs in HbAS (P = 0.49) unlike HbSS (P = 0.03). CONCLUSION The prevalence of hearing loss among children and adults with SCD is higher than in those with HbA genotype. The frequency of hospitalization, crises, blood transfusion and taking routine drugs may influence hearing impairment in SCT but may not in SCD.
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Affiliation(s)
- T S Ibekwe
- Department of Otorhinolaryngology, University of Abuja, South Africa
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - C Rogers
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - L Ramma
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
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Taylor A, Davidson G, Boyce M, Murphy C, Doole S, Rogers C, Fraser I. Background levels of body fluids and DNA on the shaft of the penis and associated underpants in the absence of sexual activity. Sci Justice 2023; 63:529-536. [PMID: 37453785 DOI: 10.1016/j.scijus.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/18/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023]
Abstract
This study examines the background of blood, saliva, semen and autosomal DNA on penile swabs and underpants from males in the absence of recent sexual activity. Based on the data collected by the AFSP Body Fluid Forum, the results of this study show that; there is a very low expectation of detecting blood on penile swabs and male underpants; a low expectation of detecting saliva on penile swabs and male underpants; and spermatozoa would be expected in less than a quarter of penile swabs and three quarters of male underpants. As none of the samples had detectable levels of DNA which were suitable for meaningful comparison that did not match the donor or their partner, the expectation of detecting a DNA profile from the cellular background on penile swabs or underpants from a male who has not been involved in recent sexual intercourse is very low. The results of this study are extremely informative when evaluating the significance of blood, saliva, semen and DNA detected on the penile swabs and underpants of males in cases of alleged sexual assault.
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Affiliation(s)
- A Taylor
- Formerly of Forensic Science Northern Ireland, 151 Belfast Road, Carrickfergus, Co. Antrim BT38 8PL, Northern Ireland
| | - G Davidson
- Cellmark Forensic Services, Buckshaw Link, Ordnance Road, Buckshaw Village, Chorley, Lancashire PR7 7EL, United Kingdom.
| | - M Boyce
- Formerly of Key Forensic Services, 207C Cavendish Place, Birchwood Park, Warrington WA3 6WU, United Kingdom
| | - C Murphy
- Department of Justice and Equality, Forensic Science Ireland, Garda Headquarters, Phoenix Park, Dublin 8, Ireland.
| | - S Doole
- Eurofins Forensic Services, Sir Alec Jeffreys Building, Peel Avenue, Calderpark, Wakefield WF2 7UA, United Kingdom.
| | - C Rogers
- SPA Forensic Services, Scottish Crime Campus, Craignethan Drive, Gartcosh G69 8AE. United Kingdom.
| | - I Fraser
- Forensic Science Northern Ireland, 151 Belfast Road, Carrickfergus, Co. Antrim BT38 8PL, Northern Ireland.
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4
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Raleigh D, Chen W, Choudhury A, Youngblood M, Polley MY, Lucas CH, Mirchia K, Maas S, Suwala A, Won M, Bayley J, Harmanci A, Harmanci A, Klisch T, Nguyen M, Vasudevan H, McCortney K, Yu T, Bhave V, Lam TC, Pu J, Leung G, Chang J, Perlow H, Palmer J, Haberler C, Berghoff A, Preusser M, Nicolaides T, Mawrin C, Agnihotri S, Resnick A, Rood B, Chew J, Young J, Boreta L, Braunstein S, Schulte J, Butowski N, Santagata S, Spetzler D, Bush NAO, Villanueva-Meyer J, Chandler J, Solomon D, Rogers C, Pugh S, Mehta M, Sneed P, Berger M, Horbinski C, McDermott M, Perry A, Bi W, Patel A, Sahm F, Magill S. Targeted gene expression profiling predicts meningioma outcomes and radiotherapy responses. Res Sq 2023:rs.3.rs-2663611. [PMID: 36993741 PMCID: PMC10055655 DOI: 10.21203/rs.3.rs-2663611/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Surgery is the mainstay of treatment for meningioma, the most common primary intracranial tumor, but improvements in meningioma risk stratification are needed and current indications for postoperative radiotherapy are controversial. Recent studies have proposed prognostic meningioma classification systems using DNA methylation profiling, copy number variants, DNA sequencing, RNA sequencing, histology, or integrated models based on multiple combined features. Targeted gene expression profiling has generated robust biomarkers integrating multiple molecular features for other cancers, but is understudied for meningiomas. Methods Targeted gene expression profiling was performed on 173 meningiomas and an optimized gene expression biomarker (34 genes) and risk score (0 to 1) was developed to predict clinical outcomes. Clinical and analytical validation was performed on independent meningiomas from 12 institutions across 3 continents (N = 1856), including 103 meningiomas from a prospective clinical trial. Gene expression biomarker performance was compared to 9 other classification systems. Results The gene expression biomarker improved discrimination of postoperative meningioma outcomes compared to all other classification systems tested in the independent clinical validation cohort for local recurrence (5-year area under the curve [AUC] 0.81) and overall survival (5-year AUC 0.80). The increase in area under the curve compared to the current standard of care, World Health Organization 2021 grade, was 0.11 for local recurrence (95% confidence interval [CI] 0.07-0.17, P < 0.001). The gene expression biomarker identified meningiomas benefiting from postoperative radiotherapy (hazard ratio 0.54, 95% CI 0.37-0.78, P = 0.0001) and re-classified up to 52.0% meningiomas compared to conventional clinical criteria, suggesting postoperative management could be refined for 29.8% of patients. Conclusions A targeted gene expression biomarker improves discrimination of meningioma outcomes compared to recent classification systems and predicts postoperative radiotherapy responses.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Minhee Won
- NRG Statistics and Data Management Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joshua Palmer
- The Ohios State University James Comprehensive Cancer Center
| | | | | | | | | | | | | | | | - Brian Rood
- Center for Cancer and Immunology Research, Children's National Research Institute
| | | | | | | | - Steve Braunstein
- Department of Radiation Oncology, University of California San Francisco, San Francisco California
| | | | | | | | | | | | | | | | | | - C Rogers
- NRG Statistics and Data Management Center
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Martinelli P, Schaaf O, Mantoulidis A, Martin LJ, Fuchs JE, Bader G, Gollner A, Wolkerstorfer B, Rogers C, Balıkçı E, Lipp JJ, Mischerikow N, Doebel S, Gerstberger T, Sommergruber W, Huber KVM, Böttcher J. Discovery of a Chemical Probe to Study Implications of BPTF Bromodomain Inhibition in Cellular and in vivo Experiments. ChemMedChem 2023; 18:e202200686. [PMID: 36649575 DOI: 10.1002/cmdc.202200686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/19/2023]
Abstract
The bromodomain and PHD-finger containing transcription factor (BPTF) is part of the nucleosome remodeling factor (NURF) complex and has been implicated in multiple cancer types. Here, we report the discovery of a potent and selective chemical probe targeting the bromodomain of BPTF with an attractive pharmacokinetic profile enabling cellular and in vivo experiments in mice. Microarray-based transcriptomics in presence of the probe in two lung cancer cell lines revealed only minor effects on the transcriptome. Profiling against a panel of cancer cell lines revealed that the antiproliferative effect does not correlate with BPTF dependency score in depletion screens. Both observations and the multi-domain architecture of BPTF suggest that depleting the protein by proteolysis targeting chimeras (PROTACs) could be a promising strategy to target cancer cell proliferation. We envision that the presented chemical probe and the related negative control will enable the research community to further explore scientific hypotheses with respect to BPTF bromodomain inhibition.
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Affiliation(s)
- Paola Martinelli
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Otmar Schaaf
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Andreas Mantoulidis
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Laetitia J Martin
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Julian E Fuchs
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Gerd Bader
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Andreas Gollner
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Bernhard Wolkerstorfer
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Catherine Rogers
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, OX3 7FZ, Oxford, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, OX3 7FZ, Oxford, UK
| | - Esra Balıkçı
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, OX3 7FZ, Oxford, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, OX3 7FZ, Oxford, UK
| | - Jesse J Lipp
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Nikolai Mischerikow
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Sandra Doebel
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Thomas Gerstberger
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Wolfgang Sommergruber
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
| | - Kilian V M Huber
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, OX3 7FZ, Oxford, UK
- Centre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, OX3 7FZ, Oxford, UK
| | - Jark Böttcher
- Boehringer Ingelheim RCV GmbH & Co KG, Doktor-Boehringer-Gasse 5-11, 1120, Vienna, Austria
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6
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Ibekwe T, Nnodu O, Nnebe-Agumadu U, Dagwa I, Dahilo E, Ibekwe P, Rogers C, Ramma L. Scoping Review of Predisposing Factors Associated with Sensorineural Hearing Loss in Sickle Cell Disease. West Afr J Med 2023; 40:209-216. [PMID: 36861452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE Sickle cell disease (SCD) is a genetically inherited red blood cell disorder that affects people all over the world but is more common among blacks of African ancestry than other races. The condition is linked to sensorineural hearing loss (SNHL). This scoping review aims to evaluate studies that reported SNHL in SCD patients and to identify demographic and contextual risk factors for SNHL in SCD patients. METHODS We conducted scoping searches for relevant studies in PubMed, Embase, Web of Science, and Google Scholar. All articles were evaluated independently by two authors. The checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used. SNHL was detected at hearing levels above 20 decibels. RESULTS In terms of methodology, the studies reviewed were diverse, with 15 being prospective and four being retrospective. Fourteen of the 19 articles chosen from 18,937 search engine results were case-control studies. Sex, age, foetal haemoglobin (HbF), SCD type, painful vaso-occlusive crisis (PVO), blood parameters, flow-mediated vasodilation (FMV), and hydroxyurea use were all extracted. Few studies investigated SNHL risk factors with noticeable knowledge gaps. Age, PVO, and certain blood parameters appear to predispose to SNHL, whereas decreased FMV, the presence of HbF, and the use of hydroxyurea appear to have an inverse relationship with the development of SNHL in SCD. CONCLUSION There is a clear gap in the existing literature regarding the knowledge of demographic and contextual risk factors that is required for the prevention and management of SNHL in SCD.
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Affiliation(s)
- T Ibekwe
- Department of Otorhinolaryngology, University of Abuja, Abuja, Nigeria
- Department of Communication Sciences University of Capetown, South Africa
| | - O Nnodu
- Department of Haematology and Blood Transfusion, University of Abuja * Centre of Excellence for Sickle Cell Disease Research and Training University of Abuja, Abuja
| | - U Nnebe-Agumadu
- Department of Paediatrics , University of Abuja and University of Abuja Teaching Hospital, Abuja
| | - I Dagwa
- Department of Mechanical Engineering, University of Abuja, Abuja
| | - E Dahilo
- Department of Otorhinolaryngology, University of Abuja, Abuja, Nigeria
| | - P Ibekwe
- Department of Medicine, University of Abuja and University of Abuja Teaching Hospital, Abuja
| | - C Rogers
- Department of Communication Sciences University of Capetown, South Africa
| | - L Ramma
- Department of Communication Sciences University of Capetown, South Africa
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7
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Davis M, Stephens A, Morrison C, Majdalany S, Affas R, Arora S, Corsi N, Rakic I, Sood A, Rogers C, Abdollah F. Racial disparities in future development of lethal prostate cancer based on PSA levels in midlife. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01236-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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8
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Sharma G, Shah M, Ahluwalia P, Gautam G, Dasgupta P, Challacombe B, Bhandari M, Ahlawat R, Rawal S, Buffi N, Sivaraman A, Porter J, Rogers C, Mottire, Abaza R, Rha K, Moon D, Yuvaraja T, Parekh D, Capitanio U, Maes K, Porpiglia F, Turkeri L. Off-clamp versus on-clamp robot-assisted partial nephrectomy: A propensity-matched analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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9
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Davis M, Stephens A, Morrison C, Majdalany S, Affas R, Arora S, Corsi N, Rakic I, Sood A, Rogers C, Abdollah F. Baseline PSA levels in midlife & future development of lethal prostate cancer: A diverse North American cohort analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00307-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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10
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Rakic I, Davis M, Corsi N, Stephens A, Arora S, Rakic N, Morrison C, Malchow T, Affas R, Sood A, Rogers C, Abdollah F. Evaluating the role of lymphvascular invasion as an indicator for adverse outcomes for patients with upper tract urothelial carcinoma and its histological subtypes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00960-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Rymer J, Takagi H, Koweek L, Ng N, Douglas P, Fairbairn T, Berman D, De Bruyne B, Bax JJ, Nieman K, Rogers C, Noorgaard BL, Patel MR, Leipsic J, Daubert M. Anatomic and functional discordance among patients with non-obstructive coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Non-obstructive coronary artery disease (CAD) is associated with increased adverse cardiovascular (CV) events. However, it is unclear if functional stenosis, as assessed by FFRCT <0.80, further stratifies risk among patients with non-obstructive CAD and which factors contribute to this anatomic-functional discordance (stenosis <50% and FFRCT <0.80).
Purpose
We hypothesized that patients with anatomically non-obstructive CAD by CTA and an abnormal FFRCT value of ≤0.80 have a phenomenon termed anatomic-functional discordance, and this discordance would be associated with increased adverse outcomes.
Methods
Patients in the ADVANCE (Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care) Registry who had exclusively non-obstructive CAD (anatomic stenosis <50%) were stratified by FFRCT >0.80 in all coronary vessels (concordant) vs. FFRCT <0.80 in at least one vessel (discordant). Baseline patient demographics, coronary computed tomography angiography findings, downstream testing and clinical outcomes were compared between groups. The primary composite endpoint included revascularization, CV hospitalization, heart failure, arrhythmia, non-fatal myocardial infarction, unplanned hospitalization for an acute coronary syndrome leading to urgent revascularization, and all-cause death.
Results
Among 1,261 patients with non-obstructive CAD, 543 (43.1%) had functional stenosis with FFRCT <0.80. Patients in the discordant group were older, more likely to have hypertension, hyperlipidemia, and had significantly higher indexed left ventricular (LV) mass and significantly lower coronary volume-to-mass ratios when compared with patients in the concordant group. Downstream non-invasive testing was more common among patients with discordance (35.9% vs 20.2%, p<0.0001) and more frequently resulted in a positive downstream test (10.3% vs. 3.3%, p<0.0001). Invasive angiography was also more common among patients with discordance (25.2% vs. 11.6%, p<0.0001). Anatomic-functional discordance was associated with higher rates of CV hospitalization and percutaneous coronary intervention (both p<0.0001), but no significant difference in all-cause death. After adjustment, anatomic-functional discordance was associated with a significantly higher risk of the composite endpoint (adjusted HR 2.79, 95% CI 1.67–4.65), Figure 1. As shown in Figure 2, the more vessels with anatomic-functional discordance, the higher the rate of adverse cardiac events.
Conclusion
Anatomic-functional discordance was present in nearly half of patients with exclusively non-obstructive CAD. The lower coronary volume: LV mass ratio may reflect abnormal coronary physiology at lower thresholds of anatomical stenosis among those with discordance. Compared to patients with concordance, patients with discordance had worse clinical outcomes suggesting that anatomic-functional discordance may stratify risk for adverse CV events among patients with non-obstructive CAD.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The analysis was an investigator-initiated analysis sponsored by Heart Flow.
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Affiliation(s)
- J Rymer
- Duke University , Durham , United States of America
| | - H Takagi
- University of British Columbia , Vancouver , Canada
| | - L Koweek
- Duke University , Durham , United States of America
| | - N Ng
- Heart Flow , Mountain View , United States of America
| | - P Douglas
- Duke University , Durham , United States of America
| | - T Fairbairn
- Liverpool Heart and Chest Hospital , Liverpool , United Kingdom
| | - D Berman
- William Beaumont Hospital , Royal Oak , United States of America
| | | | - J J Bax
- Leiden University Medical Center , Leiden , The Netherlands
| | - K Nieman
- Stanford University Medical Center , Stanford , United States of America
| | - C Rogers
- Heart Flow , Mountain View , United States of America
| | | | - M R Patel
- Duke University , Durham , United States of America
| | - J Leipsic
- University of British Columbia , Vancouver , Canada
| | - M Daubert
- Duke University , Durham , United States of America
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12
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Madsen KT, Noergaard BL, Oevrehus KA, Parner E, Jensen JM, Grove EL, Fairbairn TA, Nieman K, Patel M, Rogers C, Mickley H, Rohold A, Boetker HE, Leipsic J, Sand NPR. Prognostic value of FFRCT in patients with stable chest pain – a 3-year follow-up of the ADVANCE-DK registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The short-term safety of using coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) to guide downstream testing after CTA is well documented. Whether the prognostic information provided by FFRCT can be extended to sustained follow-up and to patients with a high degree of coronary artery calcification (CAC) is unknown.
Purpose
To evaluate the association between FFRCT and clinical outcomes in new onset stable symptomatic patients with coronary stenosis up to 3 years after CTA index testing.
Methods
Multicenter 3-year follow-up study of 900 patients from the Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care (ADVANCE) registry at three Danish sites, the “ADVANCE-DK Registry”. All patients had at least one ≥30% coronary stenosis by CTA and underwent subsequent core laboratory FFRCT analysis by HeartFlow. The criterium for an abnormal FFRCT test result was an FFRCT value ≤0.80 (2 cm distal to stenosis). High CAC was defined as a CAC score ≥400. The primary endpoint (PE) was a composite of all-cause death and spontaneous myocardial infarction (MI). The secondary endpoint (SE) was a composite of cardiovascular (CV) death and spontaneous MI. Events were adjudicated by an independent clinical committee.
Results
Patient characteristics are given in Table 1. Coronary stenosis ≥50% was present in 750 (83%) patients. In total 36 patients suffered a PE (all-cause death, n=24; MI, n=12) and 22 an SE (CV death, n=10; MI, n=12). An abnormal vs a normal FFRCT test result was associated with an increased risk of the PE and of the SE both overall and in patients with high CAC; PE (all), 6.6% vs 2.1%, relative risk (RR): 3.1; 95% CI: 1.6–6.3, p<0.001, SE (all), 5.0% vs 0.6%, RR: 8.7; 95% CI: non assessable, p<0.001, PE (high CAC), 9.0% vs 2.2%, RR: 4.1; 85% CI: 1.4–11.8, p=0.001, and SE (high CAC), 6.6% vs 0.5%, RR: 12.0; 95% CI: non assessable, p=0.01, respectively, Figure 1. The observed increased risk in patients with an abnormal vs a normal FFRCT test result persisted after adjustment for degree of stenosis by CCTA (< / ≥50%) and amount of CAC (< / ≥400): PE, adjusted RR: 2.5; 95% CI: 1.2–5.2, p=0.02, and SE, adjusted RR: 8.0; 95% CI: 2.1–30.2, p=0.002.
Conclusion
Patients with stable chest pain, stenosis by CTA and a normal FFRCT test result have a low risk of adverse outcomes during 3 years of follow-up. An abnormal FFRCT identifies patients at increased risk of death or spontaneous MI. These associations are consistent in patients with high levels of CAC.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K T Madsen
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
| | - B L Noergaard
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - K A Oevrehus
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - E Parner
- Aarhus University, Department of Public Health, Section for Biostatistics , Aarhus , Denmark
| | - J M Jensen
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - E L Grove
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - T A Fairbairn
- Liverpool Heart and Chest Hospital, Department of Cardiology , Liverpool , United Kingdom
| | - K Nieman
- Stanford University Medical Center, Department of Cardiovascular Medicine and Radiology , Stanford , United States of America
| | - M Patel
- Duke University, Division of Cardiology, Department of Medicine , Durham , United States of America
| | - C Rogers
- HeartFlow inc., Redwood City , California , United States of America
| | - H Mickley
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - A Rohold
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
| | - H E Boetker
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - J Leipsic
- St Paul's Hospital, Department of Radiology , Vancouver , Canada
| | - N P R Sand
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
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13
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Madsen KT, Noergaard BL, Oevrehus KA, Parner E, Jensen JM, Grove EL, Fairbairn TA, Nieman K, Patel M, Rogers C, Mickley H, Thomsen KK, Boetker HE, Leipsic J, Sand NPR. FFRCT and recurrent symptoms in patients with stable chest pain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The major benefit of coronary revascularization when compared with optimal medical treatment (OMT) in patients with stable chest pain (CP) relates to improvement of symptoms and reduction of reinterventions. Non-invasive methods are warranted to discriminate between patients at low and high risk of recurrent CP for subsequent guidance of antianginal treatment (invasive or OMT).
Purpose
To evaluate the association between coronary CT angiography (CTA) derived fractional flow reserve (FFRCT), recurrent CP and quality of life (QOL) in patients with new onset stable CP and stenosis by CTA.
Methods
Multicenter cohort 3-year follow-up sub-study of 769 patients from the Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care (ADVANCE) registry at three Danish sites, the “ADVANCE-DK Registry”. All patients had at least one ≥30% coronary stenosis by CTA and underwent subsequent core laboratory FFRCT analysis by HeartFlow. An abnormal FFRCT was defined as the lowest in vessel FFRCT value ≤0.80. Patients were classified according to completeness of revascularization by FFRCT: 1) completely revascularized (CR-FFRCT), all coronary arteries with an abnormal FFRCT test result revascularized; 2) incompletely revascularized (IR-FFRCT), ≥1 coronary artery with an abnormal FFRCT test result not revascularized. All patients completed the Seattle Angina Questionnaire (SAQ-7), the EuroQol questionnaire (EQ-5D-5L) and graded (0–100) overall health using the EQ VAS scale at 3-year follow-up. Recurrent CP was defined as CP within the last 4 weeks prior to this follow-up.
Results
Patient characteristics are given in Table 1. At follow-up 23% patients reported recurrent CP. An abnormal vs a normal FFRCT increased the risk of recurrent CP, 27% vs 15%, RR: 1.82; 95% CI: 1.31–2.52, p<0.001. Amongst patients with abnormal FFRCT, revascularization (+/−) was associated to a numerical, but not statistical significantly, reduced risk of recurrent CP, 23% vs 30%, RR: 0.76; 95% CI: 0.56–1.03, p=0.07. IR-FFRCT vs CR-FFRCT had a higher risk for recurrent CP, 31% vs 13%, RR: 2.34; 95% CI: 1.48–3.68, p<0.001, whilst no difference was observed for CR-FFRCT vs normal FFRCT, 13% vs 15%, RR: 0.92; 95% CI: 0.54–1.54, p=0.74. IR-FFRCT vs CR-FFRCT or normal FFRCT, had lower SAQ-7, EQ-5D-5L and EQ-VAS scores, Table 1, all p<0.005. Scores for three selected SAQ-7 domains are shown in Figure 1. Use of antianginal medicine was higher in IR-FFRCT compared to CR-FFRCT and normal FFRCT, mean ± SD: 1.2±0.05 vs 1.0±0.04, p=0.02.
Conclusion
An abnormal FFRCT identifies patients with an increased risk of recurrent CP up to 3 years after index testing. Completeness of revascularization by FFRCT reclassifies patients with abnormal FFRCT into groups with low and high risk for recurrent CP and impaired QOL.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K T Madsen
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
| | - B L Noergaard
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - K A Oevrehus
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - E Parner
- Aarhus University, Department of Public Health, Section for Biostatistics , Aarhus , Denmark
| | - J M Jensen
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - E L Grove
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - T A Fairbairn
- Liverpool Heart and Chest Hospital, Department of Cardiology , Liverpool , United Kingdom
| | - K Nieman
- Stanford University Medical Center, Department of Cardiovascular Medicine and Radiology , Stanford , United States of America
| | - M Patel
- Duke University, Division of Cardiology, Department of Medicine , Durham , United States of America
| | - C Rogers
- HeartFlow inc., Redwood City , California , United States of America
| | - H Mickley
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - K K Thomsen
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
| | - H E Boetker
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - J Leipsic
- St Paul's Hospital, Department of Radiology , Vancouver , Canada
| | - N P R Sand
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
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14
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Madsen KT, Noergaard BL, Oevrehus KA, Parner E, Jensen JM, Grove EL, Fairbairn TA, Nieman K, Patel M, Rogers C, Mickley H, Rohold A, Boetker HE, Leipsic J, Sand NPR. Completeness of revascularization by FFRCT and prognosis in stable chest pain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Major randomized trials of patients with stable chest pain (CP) demonstrated no prognostic benefits of coronary revascularization over optimal medical treatment (OMT). However, in a recent large-scale study, completeness of revascularization was associated with a reduced risk of all-cause death and non-fatal myocardial infarction (MI).
Purpose
To evaluate the association between completeness of revascularization relative to the result of coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) and 3-year prognosis in patients with new onset stable CP and coronary stenosis.
Methods
Multicenter cohort 3-year follow-up sub-study of 900 patients from the Assessing Diagnostic Value of Non-invasive FFRCT in Coronary Care (ADVANCE) registry at three Danish sites, the “ADVANCE-DK Registry”. All patients had at least one ≥30% coronary stenosis by CTA and underwent subsequent core laboratory FFRCT analysis by HeartFlow. The FFRCT result was abnormal when ≤0.80 (2 cm distal to stenosis). Patients were classified according to completeness of revascularization by FFRCT: 1) completely revascularized (CR-FFRCT), all coronary arteries with an abnormal FFRCT test result revascularized; 2) incompletely revascularized (IR-FFRCT), ≥1 coronary artery with an abnormal FFRCT test result not revascularized. The primary endpoint (PE) was a composite of all-cause death and spontaneous MI. The secondary endpoint (SE) was a composite of cardiovascular (CV) death and spontaneous MI.
Results
Patient characteristics are given in Table 1. In total 36 (4.0%) patients suffered a PE (all-cause death, n=24; MI, n=12) and 22 (2.4%) an SE (CV death, n=10; MI, n=12). Overall, an abnormal vs a normal FFRCT test result was associated with an increased risk of both the PE, 6.6% vs 2.1%, relative risk (RR): 3.1; 95% CI: 1.6–6.3, p<0.001 and of the SE, 5.0% vs 0.6%, RR: 8.7; 95% CI: non assessable, p<0.001. In patients with abnormal FFRCT, revascularization vs no revascularization did not reduce the risk of the PE or the SE (data not shown). Patients with IR-FFRCT vs CR-FFRCT had a numerical, but not statistical significantly, increased risk of the PE, 8.6% vs 4.2%, RR: 2.14; 95% CI: 0.87–5.26, p=0.10), and an increased risk of the SE, 7.1% vs 2.4%, RR: 3.13; 95% CI: 1.02–9.63, p=0.04, Figure 1. In CR-FFRCT versus normal FFRCT no difference in the risk of the PE or the SE was observed, Figure 1. Univariate sensitivity analyses performed in the IR-FFRCT group did not reveal any differences in the risk of the PE or the SE after adjustment for neither statin therapy at follow-up (−/+), baseline risk variables (< / ≥3), amount of CAC (< / ≥400), degree of stenosis by CTA (< / ≥50%) nor referral to ICA (−/+).
Conclusion
In symptomatic patients with coronary stenosis by CTA, incomplete revascularization determined by FFRCT is associated with an increased risk of adverse cardiovascular outcomes compared to complete revascularization.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K T Madsen
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
| | - B L Noergaard
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - K A Oevrehus
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - E Parner
- Aarhus University, Department of Public Health, Section for Biostatistics , Aarhus , Denmark
| | - J M Jensen
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - E L Grove
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - T A Fairbairn
- Liverpool Heart and Chest Hospital, Department of Cardiology , Liverpool , United Kingdom
| | - K Nieman
- Stanford University Medical Center, Department of Cardiovascular Medicine and Radiology , Stanford , United States of America
| | - M Patel
- Duke University, Division of Cardiology, Department of Medicine , Durham , United States of America
| | - C Rogers
- HeartFlow inc., Redwood City , California , United States of America
| | - H Mickley
- Odense University Hospital, Department of Cardiology , Odense , Denmark
| | - A Rohold
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
| | - H E Boetker
- Aarhus University Hospital, Department of Cardiology , Aarhus , Denmark
| | - J Leipsic
- St Paul's Hospital, Department of Radiology , Vancouver , Canada
| | - N P R Sand
- University Hospital of Southern Denmark, Department of Cardiology , Esbjerg , Denmark
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15
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Varma J, Foxall-Smith M, Donovan R, Whitehouse M, Rogers C, Acharya M. 850 Surgical Versus Non-Surgical Treatment of Unstable Lateral Compression Injuries of the Pelvis with Complete Sacral Fractures (LC1) in Non-Fragility Fracture Patients: A Systematic Review. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.433] [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: 11/06/2022]
Abstract
Abstract
Background
Lateral compression type 1 (LC1) injuries comprise two-thirds of pelvic fractures. Approximately one third of LC1 fractures are unstable and may benefit from surgical fixation to improve stability but it is not clear if this leads to better clinical or cost-effectiveness outcomes.
Method
We performed a systematic review to determine whether surgical or non-surgical treatment yielded better clinical and cost-effectiveness for the treatment of unstable LC1 pelvic injuries with complete sacral fracture, excluding fragility fractures. We searched Medline, Embase and Cochrane databases from inception to June 2021, as well as clinical trials registries.
Results
Five observational studies met the inclusion criteria. 183 patients were treated surgically, and 314 patients treated non-surgically. Patients treated surgically had lower pain levels (Visual Analogue Scale) and fewer days to mobilisation. Quality of life (EQ-5D and SF-36 questionnaires) was better in the surgical group, but not statistically significant. No statistical differences in length of hospital stay or complication rates were found. Formal meta-analysis was not possible due to available study designs and heterogeneity.
Conclusions
This review highlights the low quantity and quality of existing data on patients with unstable LC1 pelvic fractures and the need for a definitive randomised controlled trial to determine whether surgical or non-surgical care should be the preferred treatment in terms of clinical and cost-effective care.
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Affiliation(s)
- J Varma
- North Bristol NHS Trust , Bristol , United Kingdom
| | | | - R Donovan
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Learning & Research Building (Level 1) , Bristol , United Kingdom
| | - M Whitehouse
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Learning & Research Building (Level 1) , Bristol , United Kingdom
| | - C Rogers
- Musculoskeletal Research Unit, Translational Health Sciences, University of Bristol, Learning & Research Building (Level 1) , Bristol , United Kingdom
| | - M Acharya
- North Bristol NHS Trust , Bristol , United Kingdom
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16
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Gruber D, DiCarlo-Meacham A, Welch E, Rogers C, Brooks D, Dengler K. Younger women with more pronounced benefit from combination liposomal bupivacaine pudendal block during posterior colporrhaphy. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Husband G, D"amico A, Hasnie U, Batra N, Cochrun S, Gann A, Li E, Nguyen D, Philip George A, Soto M, Rogers C, Ahmed M, Andrikopoulou E. Machine learning analysis including social determinants of health for predication of mortality following transcatheter aortic valve implantation: a single center experience. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Social determinants of health (SDOH) are increasingly being recognized as critical, independent prognosticators in cardiovascular disease. Despite this, little is known about the role of SDOH in predicting outcomes following transcatheter aortic valve implantation (TAVI).
Purpose
To assess the value of adding census-derived SDOH in developing machine learning (ML) models for prediction of all-cause mortality in patients following TAVI.
Methods
A total of 398 patients, who underwent TAVI in 2019, were studied. Clinical, demographic, echocardiographic (echo) and census-derived SDOH data were collected. All-cause mortality at 1 year was the endpoint. A general linear ML model was fit with 100 iterations and a 70:30 training-test split. We compared the predictive performance of the model with and without adding SDOH. The SDOH included in the ML model were race (white vs. non-white), % zip code population as female, and zip code average yearly income less than $45,000.
Results
Baseline SDOH, demographic, clinical, and echo data are shown in Table 1. Following univariate and multivariate predictor analysis, the following input data were used for the ML model without the SDOH: post TAVI all-cause hospitalizations, history of outpatient hemodialysis, atrial fibrillation, heart failure with reduced ejection fraction, myocardial infarction, coronary artery disease and beta-blockers. The ML model with SDOH used the same input as well as the SDOH variables. The model with vs. without SDOH had a median AUC of 0.75 vs. 0.73 (p = 0.9957).
Conclusions
Despite not reaching statistical significance, our ML model provides a holistic picture of mortality predictors. Larger studies are needed to more assess the predictive value of SDOH post TAVI. Abstract Figure. Baseline patient characteristics Abstract Figure. ML Model: Area Under Curve
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Affiliation(s)
- G Husband
- UAB Hospital, Birmingham, United States of America
| | - A D"amico
- UAB Hospital, Birmingham, United States of America
| | - U Hasnie
- UAB Hospital, Birmingham, United States of America
| | - N Batra
- UAB Hospital, Birmingham, United States of America
| | - S Cochrun
- UAB Hospital, Birmingham, United States of America
| | - A Gann
- University of South Alabama, Mobile, United States of America
| | - E Li
- UAB Hospital, Birmingham, United States of America
| | - D Nguyen
- The Johns Hopkins Hospital, Baltimore, United States of America
| | | | - M Soto
- UAB Hospital, Birmingham, United States of America
| | - C Rogers
- UAB Hospital, Birmingham, United States of America
| | - M Ahmed
- UAB Hospital, Birmingham, United States of America
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18
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Abdollah F, Piontkowski A, Morisetty S, Corsi N, Majdalany S, Rakic I, Sood A, Jamil M, Dalela D, Arora S, Rogers C. The impact of adjuvant chemotherapy on overall survival in patients with node-positive Upper Tract Urothelial Carcinoma (UTUC): Improving precision in medicine with a risk-stratified approach. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00387-6] [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: 11/17/2022]
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19
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Piontkowski A, Corsi N, Morisetty S, Majdalany S, Rakic I, Arora S, Jamil M, Dalela D, Rogers C, Abdollah F. Benefit of lymph node dissection in cn+ patients in the treatment of upper tract urothelial carcinoma: Analysis of ncdb registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00382-7] [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: 11/04/2022]
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20
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Butaney M, Patel A, Qi J, Singh K, Johnson A, Levy A, Noyes S, Ghani K, Rogers C, Lane B. Assessing renal mass management of patients with increased comorbidities: Results from a statewide registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00306-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Corsi N, Rakic I, Ginsburg K, Jamil M, Sood A, Dalela D, Piontkowski A, Majdalany S, Rogers C, Abdollah F. External validation of the Bladder Cancer Research Consortium (BCRC) nomogram for predicting survival after radical cystectomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00977-0] [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: 12/01/2022]
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22
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Dai Z, Jambor I, Taimen P, Pantelic M, Elshaikh M, Dabaja A, Rogers C, Ettala O, Boström P, Aronen H, Merisaari H, Wen N. Accurate Prostate Cancer Detection and Segmentation Using Non-Local Mask R-CNN With Histopathological Ground Truth. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Corsi N, Sood A, Keeley J, Dalela D, Bronkema C, Rakic N, Stricker M, Novara G, Rogers C, Abdollah F. Recurrence-free survival following resection of low-grade, Non-Muscle-Invasive Urothelial Cancer (NMIBC): A Southwest Oncology Group (SWOG) S0337 post-hoc analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01124-6] [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: 11/28/2022]
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24
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Corsi N, Sood A, Keeley J, Dalela D, Bronkema C, Rakic N, Stricker M, Novara G, Rogers C, Abdollah F. Estimating recurrence free survivability of Non-Muscle Invasive Bladder Cancer (NMIBC) after intravesical therapy: A clinical-based recursive partition analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01130-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lorito CD, Duff C, Rogers C, Tuxworth J, Bell J, Fothergill R, Wilkinson L, Bosco A, Howe L, O’Brien R, Godfrey M, Dunlop M, Van Der Wardt V, Booth V, Logan P, Harwood R. Tele-rehabilitation for people with dementia in the COVID-19 pandemic: A case-study. Eur Psychiatry 2021. [PMCID: PMC9470968 DOI: 10.1192/j.eurpsy.2021.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionThe Promoting Activity, Independence and Stability in Early Dementia (PrAISED) is delivering an exercise programme for people with dementia. The Lincolnshire partnership NHS foundation Trust successfully delivered PrAISED through a video-calling platform during the COVID-19 pandemic.ObjectivesThis qualitative case-study identified participants that video delivery worked for, and highlighted its benefits and challenges.MethodsInterviews were conducted with participants with dementia, caregivers and therapists, and analysed through thematic analysis.ResultsVideo delivery worked best when participants had a supporting carer, when therapists showed enthusiasm and had an established rapport with the client. Benefits included time-efficiency of sessions, enhancing participants’ motivation, caregivers’ dementia awareness and therapists’ creativity. Limitations included users’ poor IT skills and resources.ConclusionsThe COVID-19 pandemic required innovative ways of delivering rehabilitation. This study supports that people with dementia can use tele rehab, but success is reliant on having a caregiver and an enthusiastic and known therapist.
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Olson M, Rogers C, Anderson W, Barake S, Arjuna A. A Case of Unremitting Cellulitis in a Lung Transplant Recipient: What is the Infectious Etiology? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Wattoo G, Nayak S, Khan S, Morgan J, Hocking H, MacInnes E, Kolar KM, Rogers C, Olubowale O, Rigby K, Kazzazi NH, Wyld L. Long-term outcomes of latissimus dorsi flap breast reconstructions: A single-centre observational cohort study with up to 12 years of follow up. J Plast Reconstr Aesthet Surg 2020; 74:2202-2209. [PMID: 33451948 DOI: 10.1016/j.bjps.2020.12.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/22/2020] [Accepted: 12/19/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The Latissimus Dorsi Myocutaneous Flap (LDMF) is used in post-mastectomy reconstruction. This study has evaluated long-term (up to 12 years) surgical- and patient-reported outcomes from LDMF procedures. METHOD A retrospective analysis of consecutive LDMF procedures in two UK hospitals, performed between 2006 and 2016. Case notes were reviewed for indications and outcomes. Patients were sent the BREAST-QⓇ survey by post. Outcomes, including surgical adverse events, revision, and implant loss rates, were correlated with patient risk factors. RESULTS A BREAST-Q was posted to 199/248 LDMF patients in 2018, (excluding 49 patients due to death, reduced cognitive function and incorrect coding) of whom 77 patients responded (38.7%). In 188 cases (representing 208 LDMFs), surgical outcomes were assessable. Median time since LDMF surgery was 7 years (range 2-12). Rates of acute implant loss were 9/139 (6.4%), flap necrosis 7/208 (3.4%), shoulder stiffness 4/208 (1.9%), chronic pain 24/208 (11.5%) and unplanned revision surgery 13/208 (7%). Median satisfaction levels were high with 78% of patients satisfied with treatment outcomes, 65% of patients satisfied with their breasts, 71% of patients satisfied psychosocially and 75% of patients satisfied with their chest. Receipt of radiotherapy was not associated with a higher risk of flap necrosis or capsule formation. CONCLUSION Long-term follow-up of a large cohort of LDMF reconstruction patients show relatively low levels of adverse events and unplanned revision surgery and high patient satisfaction, which demonstrates how temporally robust the technique is. With the rise in popularity of acellular dermal matrix reconstructions, the LDMF has relatively fallen out of favour but its potential in primary and delayed reconstruction is demonstrated.
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Affiliation(s)
- G Wattoo
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - S Nayak
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - S Khan
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - J Morgan
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom; Department of Oncology and Metabolism, E Floor, Medical School, Beech Hill Road, University of Sheffield, S10 2RX, United Kingdom
| | - H Hocking
- Clinical Audit Department, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - E MacInnes
- Leeds Teaching Hospitals NHS FT, Leeds, United Kingdom
| | - K M Kolar
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - C Rogers
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - O Olubowale
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - K Rigby
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - N H Kazzazi
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom
| | - L Wyld
- Jasmine Breast Unit, Doncaster and Bassetlaw Teaching Hospitals NHS FT, Armthorpe Road, Doncaster, United Kingdom; Department of Oncology and Metabolism, E Floor, Medical School, Beech Hill Road, University of Sheffield, S10 2RX, United Kingdom.
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Rogers C, Ruggeri T, Schief WK. On relativistic gasdynamics: invariance under a class of reciprocal-type transformations and integrable Heisenberg spin connections. Proc Math Phys Eng Sci 2020. [DOI: 10.1098/rspa.2020.0487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A classical system of conservation laws descriptive of relativistic gasdynamics is examined. In the two-dimensional stationary case, the system is shown to be invariant under a novel multi-parameter class of reciprocal transformations. The class of invariant transformations originally obtained by Bateman in non-relativistic gasdynamics in connection with lift and drag phenomena is retrieved as a reduction in the classical limit. In the general 3+1-dimensional case, it is demonstrated that Synge’s geometric characterization of the pressure being constant along streamlines encapsulates a three-dimensional extension of an integrable Heisenberg spin equation.
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Affiliation(s)
- C. Rogers
- School of Mathematics and Statistics, The University of New South Wales, Sydney, New South Wales 2052, Australia
| | - T. Ruggeri
- Department of Mathematics and Alma Mater Research Center on Applied Mathematics AM2, University of Bologna, Bologna, Italy
| | - W. K. Schief
- School of Mathematics and Statistics, The University of New South Wales, Sydney, New South Wales 2052, Australia
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Jamil M, Keeley J, Sood A, Dalela D, Arora S, Peabody J, Trinh Q, Menon M, Rogers C, Abdollah F. Long-term risk of recurrence in surgically treated renal cell carcinoma: A post-hoc analysis of the Eastern Cooperative Oncology Group - American College of Radiology Imaging Network E2805 Trial cohort. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Dalela D, Sood A, Jamil M, Arora S, Keeley J, Palma-Zamora I, Rakic N, Bronkema C, Peabody J, Rogers C, Menon M, Elshaikh M, Abdollah F. External validity of the Stephenson nomogram predicting the outcomes of prostate cancer patients treated salvage radiotherapy after radical prostatectomy: The importance of genomic data. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33292-4] [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: 11/28/2022] Open
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Waldman G, Gift T, Turvey K, Ho J, Shah R, Thomas S, Carlson W, Ton V, Ibrahim N, Rogers C, Nayor M, Spahillari A, Coglianese E, D'Alessandro D, Lewis G. Optimal Dosing of Enoxaparin to Achieve Therapeutic Anticoagulation in Heart Transplant Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.836] [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: 10/24/2022] Open
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MacGowan A, Grier S, Stoddart M, Reynolds R, Rogers C, Pike K, Smartt H, Wilcox M, Wilson P, Kelsey M, Steer J, Gould FK, Perry JD, Howe R, Wootton M. Impact of rapid microbial identification on clinical outcomes in bloodstream infection: the RAPIDO randomized trial. Clin Microbiol Infect 2020; 26:1347-1354. [PMID: 32220636 DOI: 10.1016/j.cmi.2020.01.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Bloodstream infection has a high mortality rate. It is not clear whether laboratory-based rapid identification of the organisms involved would improve outcome. METHODS The RAPIDO trial was an open parallel-group multicentre randomized controlled trial. We tested all positive blood cultures from hospitalized adults by conventional methods of microbial identification and those from patients randomized (1:1) to rapid diagnosis in addition to matrix-assisted desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) performed directly on positive blood cultures. The only primary outcome was 28-day mortality. Clinical advice on patient management was provided to members of both groups by infection specialists. RESULTS First positive blood culture samples from 8628 patients were randomized, 4312 into rapid diagnosis and 4136 into conventional diagnosis. After prespecified postrandomization exclusions, 2740 in the rapid diagnosis arm and 2810 in the conventional arm were included in the mortality analysis. There was no significant difference in 28-day survival (81.5% 2233/2740 rapid vs. 82.3% 2313/2810 conventional; hazard ratio 1.05, 95% confidence interval 0.93-1.19, p 0.42). Microbial identification was quicker in the rapid diagnosis group (median (interquartile range) 38.5 (26.7-50.3) hours after blood sampling vs. 50.3 (47.1-72.9) hours after blood sampling, p < 0.01), but times to effective antimicrobial therapy were no shorter (respectively median (interquartile range) 24 (2-78) hours vs. 13 (2-69) hours). There were no significant differences in 7-day mortality or total antibiotic consumption; times to resolution of fever, discharge from hospital or de-escalation of broad-spectrum therapy or 28-day Clostridioides difficile incidence. CONCLUSIONS Rapid identification of bloodstream pathogens by MALDI-TOF MS in this trial did not reduce patient mortality despite delivering laboratory data to clinicians sooner.
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Affiliation(s)
- A MacGowan
- Department of Pathology Sciences, North Bristol NHS Trust, Southmead Hospital, Bristol, UK.
| | - S Grier
- Department of Pathology Sciences, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - M Stoddart
- Department of Pathology Sciences, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - R Reynolds
- Population Health Sciences, Bristol Medical School, Bristol, UK
| | - C Rogers
- Bristol Royal Infirmary, Clinical Support Unit, Bristol, UK
| | - K Pike
- Bristol Royal Infirmary, Clinical Support Unit, Bristol, UK
| | - H Smartt
- Bristol Royal Infirmary, Clinical Support Unit, Bristol, UK
| | - M Wilcox
- Department of Microbiology, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - P Wilson
- Department of Clinical Microbiology, UCLH NHS Foundation Trust, London, UK
| | - M Kelsey
- Department of Medical Microbiology, Whittington Hospital, Whittington NHS Trust, London, UK
| | - J Steer
- Department of Microbiology, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - F K Gould
- Department of Medical Microbiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England, UK
| | - J D Perry
- Department of Medical Microbiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, England, UK
| | - R Howe
- Department of Microbiology, Public Health Wales, Cardiff University Hospital of Wales, Cardiff, Wales, UK
| | - M Wootton
- Department of Microbiology, Public Health Wales, Cardiff University Hospital of Wales, Cardiff, Wales, UK
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Wheeler SB, Rodriguez-O'Donnell J, Rogers C, Fulcher J, Deal A, Manning ML, Gellin M, Padilla N, Rosenstein DL. Reducing Cancer-related Financial Toxicity through Financial Navigation: Results from a Pilot Intervention. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1055-9965.epi-20-0067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Our purpose was to pilot a novel patient-centered financial navigation (FN) intervention to decrease the burden of financial toxicity (FT) among uninsured and underinsured patients with cancer treated at the North Carolina Cancer Hospital (NCCH). Methods: Participants were recruited by cancer clinic nurses and social workers at the NCCH. Eligible patients scored less than 22 points (indicating significant FT) on the COmprehensive Score for financial Toxicity (COST) instrument. Fifty patients were enrolled in the intervention, which included an intake assessment of financial needs and vulnerability, initial one-on-one consultation with a trained financial navigator (i.e., financial counselor or social worker), triage to financial support services matching patients' needs, and multiple follow-up appointments. Navigator recommendations were based upon a detailed review of patients' financial status, billing information, insurance, and other indicators used to refer patients to appropriate financial and social services resources offered by the hospital, government, nonprofits and private corporations. Following the initial appointment, patients were given a checklist of resources they were eligible for and the required paperwork to complete applications. During follow-up appointments, application status was reviewed, and practical assistance was provided. Patients were re-contacted at 2-week intervals to assess progress toward financial assistance goals. Outcome data collection included pre/post-intervention COST scores, patient satisfaction with the intervention, and intervention fidelity and retention. Results: The first fifty patients approached all screened positive for FT (COST < 22). Baseline COST scores ranged from 0–19. Results indicated a significant improvement in COST scores following the FN intervention (average increase = 6.86, 95% CI = 4.30–9.42), P < 0.0001). Post-intervention questionnaires indicated excellent patient satisfaction and retention with the FN intervention, and navigator logs indicated high fidelity to the intervention protocol. Conclusions: A novel FN intervention was feasible, acceptable, and effective in reducing FT among uninsured and underinsured oncology patients.
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Gunther C, Rogers C, Holloman C, Hopkins LC, Anderson SE, Miller CK, Copeland KA, Dollahite JS, Pratt KJ, Webster A, Labyk AN, Penicka C. Child diet and health outcomes of the simple suppers program: a 10-week, 2-group quasi-experimental family meals trial. BMC Public Health 2019; 19:1657. [PMID: 31823753 PMCID: PMC6902334 DOI: 10.1186/s12889-019-7930-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2). METHODS Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2). RESULTS One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills. CONCLUSIONS Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity. TRIAL REGISTRATION NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.
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Affiliation(s)
- Carolyn Gunther
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Catherine Rogers
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Wood Building, Cleveland, OH 44106 USA
| | - Christopher Holloman
- Department of Statistics, The Ohio State University, Columbus, USA
- Present Address: Information Control Company (ICC), 2500 Corporate Exchange Dr, Columbus, OH 43231 USA
| | - Laura C. Hopkins
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Sarah E. Anderson
- Division of Epidemiology, The Ohio State University, 1841 Neil Avenue, Cunz Hall, Columbus, OH 43210 USA
| | - Carla K. Miller
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Kristen A. Copeland
- Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229 USA
| | - Jamie S. Dollahite
- Division of Nutritional Sciences, Cornell University, 408 Savage Hall, Ithaca, NY 14853 USA
| | - Keeley J. Pratt
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Alison Webster
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Food Directions, 1101 K St NW #650, Washington, DC 20005 USA
| | - Allison N. Labyk
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
| | - Christine Penicka
- Department of Human Sciences, The Ohio State University, 1787 Neil Ave, 313 Campbell Hall, Columbus, OH 43210 USA
- Present Address: Albany Medical Center, 43 New Scotland Ave, Albany, NY 12208 USA
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Peh C, White J, Mahmood A, Bates D, Rogers C, Alfred S, Warrell D, Thwin K, Htay K, Kyaw K. MON-245 ENORMOUS CLINICAL AND PUBLIC HEALTH BURDEN OF ACUTE KIDNEY INJURY, MORBIDITY AND MORTALITY DUE TO SNAKEBITE ENVENOMING IN MYANMAR. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1047] [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] Open
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Barkoukis H, Swain J, Rogers C, Harris SR. Culinary Medicine and the Registered Dietitian Nutritionist: Time for a Leadership Role. J Acad Nutr Diet 2019; 119:1607-1612. [PMID: 30926437 DOI: 10.1016/j.jand.2019.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Indexed: 01/26/2023]
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Abstract
For the last 30 years, muon experiments at ISIS pulsed neutron and muon facility at the Rutherford Appleton Laboratory, Oxfordshire have been making a significant contribution to a number of scientific fields. The muon facilities at ISIS consist of eight experimental areas. The European Commission Muon facility consists of three experimental areas with a fixed momentum (28 MeV c-1). The RIKEN-RAL facility has a variable momentum (17-90 MeV c-1) and a choice of negative or positive muons delivering muons to four experimental areas. There is also an area recently used for a muon ionization cooling experiment. In this paper, the ISIS pulsed muon facilities are reviewed, including the beam characteristics that could be useful for muography experiments.This article is part of the Theo Murphy meeting issue 'Cosmic-ray muography'.
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Affiliation(s)
- A D Hillier
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
| | - J S Lord
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
| | - K Ishida
- RIKEN Nishina Center, RIKEN, Wako, Saitama, Japan
| | - C Rogers
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory, Didcot OX11 0QX, UK
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Herrick R, Rogers C, Jones T, McEvers T, Brown T, Maxwell C, Lawrence T. 481 Association of liver abscess presence and severity with trim loss, harvest yield, carcass grading performance, lung lesions, and value of fed Holsteins. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Herrick
- Beef Carcass Research Center/West Texas A&M University,Canyon, TX, United States
| | - C Rogers
- West Texas A&M University,Canyon, TX, United States
| | - T Jones
- West Texas A&M University,Canyon, TX, United States
| | - T McEvers
- Dean Cluck Feedyard,Canyon, TX, United States
| | - T Brown
- Cargill Meat Solutions,Canyon, TX, United States
| | - C Maxwell
- Elanco Animal Health,Canyon, Texas, United States
| | - T Lawrence
- Beef Carcass Research Center/West Texas A&M University,Canyon, TX, United States
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Herrick R, Rogers C, McEvers T, Amachawadi R, Nagaraja T, Maxwell C, Lawrence T. 484 Exploratory observational quantification of liver abscess incidence, specific to region and cattle type, and their associations to viscera value and bacterial flora. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.592] [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)
- R Herrick
- Beef Carcass Research Center/West Texas A&M University,Canyon, TX, United States
| | - C Rogers
- West Texas A&M University,Canyon, TX, United States
| | - T McEvers
- Dean Cluck Feedyard,Canyon, TX, United States
| | - R Amachawadi
- Kansas State University College of Veterinary Science,Manhattan, KS, United States
| | - T Nagaraja
- Kansas State University,Manhattan, KS, United States
| | - C Maxwell
- Elanco Animal Health,Canyon, TX, United States
| | - T Lawrence
- Beef Carcass Research Center/West Texas A&M University,Canyon, TX, United States
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Armstrong R, Squire Y, Rogers C, Hinchcliffe R, Mouton R. Mode of anaesthesia for endovascular abdominal aortic aneurysm repair. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hrdinka M, Schlicher L, Dai B, Pinkas DM, Bufton JC, Picaud S, Ward JA, Rogers C, Suebsuwong C, Nikhar S, Cuny GD, Huber KV, Filippakopoulos P, Bullock AN, Degterev A, Gyrd-Hansen M. Small molecule inhibitors reveal an indispensable scaffolding role of RIPK2 in NOD2 signaling. EMBO J 2018; 37:embj.201899372. [PMID: 30026309 PMCID: PMC6120666 DOI: 10.15252/embj.201899372] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 06/17/2018] [Accepted: 06/22/2018] [Indexed: 01/06/2023] Open
Abstract
RIPK2 mediates inflammatory signaling by the bacteria‐sensing receptors NOD1 and NOD2. Kinase inhibitors targeting RIPK2 are a proposed strategy to ameliorate NOD‐mediated pathologies. Here, we reveal that RIPK2 kinase activity is dispensable for NOD2 inflammatory signaling and show that RIPK2 inhibitors function instead by antagonizing XIAP‐binding and XIAP‐mediated ubiquitination of RIPK2. We map the XIAP binding site on RIPK2 to the loop between β2 and β3 of the N‐lobe of the kinase, which is in close proximity to the ATP‐binding pocket. Through characterization of a new series of ATP pocket‐binding RIPK2 inhibitors, we identify the molecular features that determine their inhibition of both the RIPK2‐XIAP interaction, and of cellular and in vivoNOD2 signaling. Our study exemplifies how targeting of the ATP‐binding pocket in RIPK2 can be exploited to interfere with the RIPK2‐XIAP interaction for modulation of NOD signaling.
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Affiliation(s)
- Matous Hrdinka
- Nuffield Department of Clinical Medicine, Ludwig Institute for Cancer Research, University of Oxford, Oxford, UK
| | - Lisa Schlicher
- Nuffield Department of Clinical Medicine, Ludwig Institute for Cancer Research, University of Oxford, Oxford, UK
| | - Bing Dai
- Department of Developmental, Molecular & Chemical Biology, Tufts University School of Medicine, Boston, MA, USA
| | - Daniel M Pinkas
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK
| | - Joshua C Bufton
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK
| | - Sarah Picaud
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK
| | - Jennifer A Ward
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK.,Nuffield Department of Clinical Medicine, Target Discovery Institute, University of Oxford, Oxford, UK
| | - Catherine Rogers
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK.,Nuffield Department of Clinical Medicine, Target Discovery Institute, University of Oxford, Oxford, UK
| | | | - Sameer Nikhar
- Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, TX, USA
| | - Gregory D Cuny
- Department of Pharmacological and Pharmaceutical Sciences, University of Houston, Houston, TX, USA
| | - Kilian Vm Huber
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK.,Nuffield Department of Clinical Medicine, Target Discovery Institute, University of Oxford, Oxford, UK
| | - Panagis Filippakopoulos
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK
| | - Alex N Bullock
- Nuffield Department of Clinical Medicine, Structural Genomics Consortium, University of Oxford, Oxford, UK
| | - Alexei Degterev
- Department of Developmental, Molecular & Chemical Biology, Tufts University School of Medicine, Boston, MA, USA
| | - Mads Gyrd-Hansen
- Nuffield Department of Clinical Medicine, Ludwig Institute for Cancer Research, University of Oxford, Oxford, UK
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Liu J, Nicum S, Reichardt P, Croitoru K, Illek B, Schmidinger M, Rogers C, Whalen C, Jayson GC. Assessment and management of diarrhea following VEGF receptor TKI treatment in patients with ovarian cancer. Gynecol Oncol 2018; 150:173-179. [DOI: 10.1016/j.ygyno.2018.03.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/20/2018] [Accepted: 03/23/2018] [Indexed: 12/24/2022]
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Panozzo CA, Welch EC, Woodworth TS, Huang TY, Her QL, Gagne JJ, Sun JW, Rogers C, Menzin TJ, Ehrmann M, Freitas KE, Haug NR, Toh S. Assessing the impact of the new ICD-10-CM coding system on pharmacoepidemiologic studies-An application to the known association between angiotensin-converting enzyme inhibitors and angioedema. Pharmacoepidemiol Drug Saf 2018; 27:829-838. [PMID: 29947045 DOI: 10.1002/pds.4550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/14/2017] [Revised: 03/29/2018] [Accepted: 04/09/2018] [Indexed: 11/06/2022]
Abstract
PURPOSE To replicate the well-established association between angiotensin-converting enzyme inhibitors versus beta blockers and angioedema in the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) era. METHODS We conducted a retrospective, inception cohort study in a large insurance database formatted to the Sentinel Common Data Model. We defined study periods spanning the ICD-9-CM era only, ICD-10-CM era only, and ICD-9-CM and ICD-10-CM era and conducted simple-forward mapping (SFM), simple-backward mapping (SBM), and forward-backward mapping (FBM) referencing the General Equivalence Mappings to translate the outcome (angioedema) and covariates from ICD-9-CM to ICD-10-CM. We performed propensity score (PS)-matched and PS-stratified Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS In the ICD-9-CM and ICD-10-CM eras spanning April 1 to September 30 of 2015 and 2016, there were 152 017 and 145 232 angiotensin-converting enzyme inhibitor initiators and 115 073 and 116 652 beta-blocker initiators, respectively. The PS-matched HR was 4.19 (95% CI, 2.82-6.23) in the ICD-9-CM era, 4.37 (2.92-6.52) in the ICD-10-CM era using SFM, and 4.64 (3.05-7.07) in the ICD-10-CM era using SBM and FBM. The PS-matched HRs from the mixed ICD-9-CM and ICD-10-CM eras ranged from 3.91 (2.69-5.68) to 4.35 (3.33-5.70). CONCLUSION The adjusted HRs across different diagnostic coding eras and the use of SFM versus SBM and FBM produced numerically different but clinically similar results. Additional investigations as ICD-10-CM data accumulate are warranted.
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Affiliation(s)
- Catherine A Panozzo
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Emily C Welch
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Tiffany S Woodworth
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Ting-Ying Huang
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Qoua L Her
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Joshua J Gagne
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jenny W Sun
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Catherine Rogers
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Talia J Menzin
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Max Ehrmann
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Katherine E Freitas
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Nicole R Haug
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Sengwee Toh
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
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Panozzo CA, Woodworth TS, Welch EC, Huang TY, Her QL, Haynes K, Rogers C, Menzin TJ, Ehrmann M, Freitas KE, Haug NR, Toh S. Early impact of the ICD-10-CM transition on selected health outcomes in 13 electronic health care databases in the United States. Pharmacoepidemiol Drug Saf 2018; 27:839-847. [PMID: 29947033 DOI: 10.1002/pds.4563] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [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: 08/17/2017] [Revised: 02/28/2018] [Accepted: 04/29/2018] [Indexed: 11/06/2022]
Abstract
PURPOSE To describe the consistency in the frequency of 5 health outcomes across the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) eras in the US. METHODS We examined the incidence of 3 acute conditions (acute myocardial infarction [AMI], angioedema, ischemic stroke) and the prevalence of 2 chronic conditions (diabetes, hypertension) during the final 5 years of the ICD-9-CM era (January 2010-September 2015) and the first 15 months of the ICD-10-CM era (October 2015-December 2016) in 13 electronic health care databases in the Sentinel System. For each health outcome reviewed during the ICD-10-CM era, we evaluated 4 definitions, including published algorithms derived from other countries, as well as simple-forward, simple-backward, and forward-backward mapping using the General Equivalence Mappings. For acute conditions, we also compared the incidence between April to December 2014 and April to December 2016. RESULTS The analyses included data from approximately 172 million health plan members. While the incidence or prevalence of AMI and hypertension performed similarly across the 2 eras, the other 3 outcomes did not demonstrate consistent trends for some or all the ICD-10-CM definitions assessed. CONCLUSIONS When using data from both the ICD-9-CM and ICD-10-CM eras, or when using results from ICD-10-CM data to compare to results from ICD-9-CM data, researchers should test multiple ICD-10-CM outcome definitions as part of sensitivity analysis. Ongoing assessment of the impact of ICD-10-CM transition on identification of health outcomes in US electronic health care databases should occur as more data accrue.
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Affiliation(s)
- Catherine A Panozzo
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Tiffany S Woodworth
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Emily C Welch
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Ting-Ying Huang
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Qoua L Her
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Kevin Haynes
- Translational Research for Affordability and Quality, HealthCore, Inc., Wilmington, DE, USA
| | - Catherine Rogers
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Talia J Menzin
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Max Ehrmann
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Katherine E Freitas
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Nicole R Haug
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - Sengwee Toh
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
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Thorlacius L, Garg A, Ingram J, Villumsen B, Theut Rii P, Gottlieb A, Merola J, Dellavalle R, Ardon C, Baba R, Bechara F, Cohen A, Daham N, Davis M, Emtestam L, Fernández-Peñas P, Filippelli M, Gibbons A, Grant T, Guilbault S, Gulliver S, Harris C, Harvent C, Houston K, Kirby J, Matusiak L, Mehdizadeh A, Mojica T, Okun M, Orgill D, Pallack L, Parks-Miller A, Prens E, Randell S, Rogers C, Rosen C, Choon S, van der Zee H, Christensen R, Jemec G. 化脓性汗腺炎研究的核心结果的全球共识:历史性共识会议I和II的更新. Br J Dermatol 2018. [DOI: 10.1111/bjd.16462] [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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Thorlacius L, Garg A, Ingram J, Villumsen B, Theut Rii P, Gottlieb A, Merola J, Dellavalle R, Ardon C, Baba R, Bechara F, Cohen A, Daham N, Davis M, Emtestam L, Fernández-Peñas P, Filippelli M, Gibbons A, Grant T, Guilbault S, Gulliver S, Harris C, Harvent C, Houston K, Kirby J, Matusiak L, Mehdizadeh A, Mojica T, Okun M, Orgill D, Pallack L, Parks-Miller A, Prens E, Randell S, Rogers C, Rosen C, Choon S, van der Zee H, Christensen R, Jemec G. Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II. Br J Dermatol 2018. [DOI: 10.1111/bjd.16396] [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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Thorlacius L, Garg A, Ingram JR, Villumsen B, Theut Riis P, Gottlieb AB, Merola JF, Dellavalle R, Ardon C, Baba R, Bechara FG, Cohen AD, Daham N, Davis M, Emtestam L, Fernández-Peñas P, Filippelli M, Gibbons A, Grant T, Guilbault S, Gulliver S, Harris C, Harvent C, Houston K, Kirby JS, Matusiak L, Mehdizadeh A, Mojica T, Okun M, Orgill D, Pallack L, Parks-Miller A, Prens EP, Randell S, Rogers C, Rosen CF, Choon SE, van der Zee HH, Christensen R, Jemec GBE. Towards global consensus on core outcomes for hidradenitis suppurativa research: an update from the HISTORIC consensus meetings I and II. Br J Dermatol 2018; 178:715-721. [PMID: 29080368 DOI: 10.1111/bjd.16093] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items. OBJECTIVES To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains. METHODS The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey. RESULTS Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments. CONCLUSIONS The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings.
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Affiliation(s)
- L Thorlacius
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Denmark.,Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, the Capital Region of Denmark, Copenhagen, Denmark
| | - A Garg
- Department of Dermatology, Hofstra Northwell School of Medicine, New Hyde Park, NY, U.S.A
| | - J R Ingram
- Institute of Infection and Immunity, University Hospital of Wales, Heath Park, Cardiff, U.K
| | - B Villumsen
- Patient Representative, The Patients' Association HS Denmark, Denmark
| | - P Theut Riis
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Denmark
| | - A B Gottlieb
- Department of Dermatology, New York Medical College, Valhalla, NY, U.S.A
| | - J F Merola
- Harvard Medical School, Boston, MA, U.S.A.,Department of Dermatology and Department of Medicine, Division of Rheumatology
| | - R Dellavalle
- Dermatology Service, U.S. Department of Veteran Affairs Medical Centre, Denver, CO, U.S.A
| | - C Ardon
- Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - R Baba
- Former National Advisor to the Ministry of Health, Malaysia
| | - F G Bechara
- Department of Dermatologic Surgery, St Josef Hospital, Ruhr-University, Bochum, Germany
| | - A D Cohen
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Chief Physician's Office, Department of Quality Measurements and Research, Clalit Health Services, Tel-Aviv, Israel
| | - N Daham
- Department of Dermatology, Tufts Medical Center, Boston, MA, U.S.A
| | - M Davis
- Department of Dermatology, Mayo Clinic, Rochester, MN, 5590, U.S.A
| | - L Emtestam
- Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden
| | - P Fernández-Peñas
- Department of Dermatology, Westmead Hospital, Sydney Medical School, The University of Sydney, Sydney, Australia
| | | | - A Gibbons
- Patient Representatives, The Hidradenitis Suppurativa Trust, Rochester, U.K
| | - T Grant
- Patient Representative, Tucson, AZ, U.S.A
| | - S Guilbault
- Patient Representative, Hope for HS, Detroit, MI, U.S.A
| | - S Gulliver
- Department of Research, Newlab Clinical Research, NL, Canada
| | - C Harris
- Patient Representative, Cardiff, U.K
| | - C Harvent
- Patient Representative, Patients' Association: La Maladie de Verneuil en Belgique, Erbisoeul, Belgium
| | - K Houston
- Patient Representatives, The Hidradenitis Suppurativa Trust, Rochester, U.K
| | - J S Kirby
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, PA, U.S.A
| | - L Matusiak
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - A Mehdizadeh
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - T Mojica
- Patient Representative, Brick, NJ, U.S.A
| | - M Okun
- Fort HealthCare, Fort Atkinson, WI, U.S.A
| | - D Orgill
- Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA, U.S.A
| | - L Pallack
- Patient Representative, Longmont, CO, U.S.A
| | - A Parks-Miller
- Hope for HS, Detroit, MI, U.S.A.,Hidradenitis Suppurativa Foundation, Inc., Santa Monica, CA, U.S.A.,Department of Dermatology, Henry Ford Hospital, Detroit, MI, U.S.A
| | - E P Prens
- Dermatology Service, U.S. Department of Veteran Affairs Medical Centre, Denver, CO, U.S.A
| | - S Randell
- Patient Representative, Hope for HS, Detroit, MI, U.S.A
| | - C Rogers
- Patient Representative, HS Aware, Toronto, ON, Canada
| | - C F Rosen
- Division of Dermatology, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - S E Choon
- Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - H H van der Zee
- Dermatology Service, U.S. Department of Veteran Affairs Medical Centre, Denver, CO, U.S.A.,Department of Dermatology, Havenziekenhuis, Rotterdam, the Netherlands
| | - R Christensen
- Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, the Capital Region of Denmark, Copenhagen, Denmark
| | - G B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Denmark
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Lee JH, Gregory A, Hogarth P, Rogers C, Hayflick SJ. Looking Deep into the Eye-of-the-Tiger in Pantothenate Kinase-Associated Neurodegeneration. AJNR Am J Neuroradiol 2018; 39:583-588. [PMID: 29371252 DOI: 10.3174/ajnr.a5514] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 10/31/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND PURPOSE A detailed delineation of the MR imaging changes in the globus pallidus in pantothenate kinase-associated neurodegeneration will be helpful for diagnosis and monitoring of patients. The aim of this study was to determine the morphologic spectrum of the "eye-of-the-tiger" sign and the topographic pattern of iron deposition in a group of patients with pantothenate kinase-associated neurodegeneration. MATERIALS AND METHODS Seventy-four MR imaging scans from 54 individuals with PANK2 mutations were analyzed for signal patterns in the globus pallidus. Sixteen SWI data from 15 patients who underwent 1.5T (n = 7), 3T (n = 7), and 7T (n = 2) MR imaging were included to visualize the iron topography. RESULTS The linear hyperintensity alongside the medial border of the globus pallidus was the earliest T2 signal change. This finding was evident before SWI changes from iron deposition became visible. T2WI performed in early childhood mostly showed isolated hyperintense signal. In adult patients, marked signal reduction within an earlier hyperintense center resulting from iron accumulation led to the loss of signal difference between the central and surrounding areas. Signal hypointensity on SWI progressed from the medial to the lateral portion of the globus pallidus with increasing age. The fiber connections between the medial globus pallidus and the anteromedial aspect of the substantia nigra and subthalamic nucleus were markedly hypointense on SWI. CONCLUSIONS In pantothenate kinase-associated neurodegeneration, the globus pallidus MR imaging changes using SWI develop as region-specific and age-dependent phenomena. Signal inhomogeneity was observed across the globus pallidus in pantothenate kinase-associated neurodegeneration and should be considered when determining the concentration of iron.
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Affiliation(s)
- J-H Lee
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.) .,Department of Neurology (J.-H.L.), Pusan National University Yangsan Hospital, Medical Research Institute, Pusan National University School of Medicine, Yangsan, South Korea
| | - A Gregory
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.)
| | - P Hogarth
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.).,Neurology (P.H., S.J.H.)
| | - C Rogers
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.)
| | - S J Hayflick
- From the Departments of Molecular and Medical Genetics (J.-H.L., A.G., P.H., C.R., S.J.H.) .,Neurology (P.H., S.J.H.).,Pediatrics (S.J.H.), Oregon Health & Science University, Portland, Oregon
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Chrischilles EA, Gagne JJ, Fireman B, Nelson J, Toh S, Shoaibi A, Reichman ME, Wang S, Nguyen M, Zhang R, Izem R, Goulding MR, Southworth MR, Graham DJ, Fuller C, Katcoff H, Woodworth T, Rogers C, Saliga R, Lin ND, McMahill-Walraven CN, Nair VP, Haynes K, Carnahan RM. Prospective surveillance pilot of rivaroxaban safety within the US Food and Drug Administration Sentinel System. Pharmacoepidemiol Drug Saf 2018; 27:263-271. [DOI: 10.1002/pds.4375] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/22/2017] [Accepted: 11/15/2017] [Indexed: 01/06/2023]
Affiliation(s)
| | - Joshua J. Gagne
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine; Brigham and Women's Hospital and Harvard Medical School; Boston MA USA
| | - Bruce Fireman
- Kaiser Permanente Northern California; Oakland CA USA
| | - Jennifer Nelson
- Biostatistics Unit, Group Health Research Institute and Department of Biostatistics; University of Washington; Seattle WA USA
| | - Sengwee Toh
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
| | - Azadeh Shoaibi
- Center for Biologics Evaluation and Research; US Food and Drug; Rockville MD USA
| | - Marsha E. Reichman
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research; US Food and Drug Administration; Silver Spring MD USA
| | - Shirley Wang
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine; Brigham and Women's Hospital and Harvard Medical School; Boston MA USA
| | - Michael Nguyen
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research; US Food and Drug Administration; Silver Spring MD USA
| | - Rongmei Zhang
- Division of Biometric VII, Office of Biostatistics, Office of Translation Sciences; US Food and Drug Administration; Silver Spring MD USA
| | - Rima Izem
- Division of Biometric VII, Office of Biostatistics, Office of Translation Sciences; US Food and Drug Administration; Silver Spring MD USA
| | - Margie R. Goulding
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research; US Food and Drug Administration; Silver Spring MD USA
| | - Mary Ross Southworth
- Center for Drug Evaluation and Research; US Food and Drug Administration; Silver Spring MD USA
| | - David J. Graham
- Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research; US Food and Drug Administration; Silver Spring MD USA
| | - Candace Fuller
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
| | - Hannah Katcoff
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
| | - Tiffany Woodworth
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
| | - Catherine Rogers
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
| | - Ryan Saliga
- Department of Population Medicine; Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston MA USA
| | | | | | | | | | - Ryan M. Carnahan
- Department of Epidemiology, College of Public Health; University of Iowa; Iowa City IA USA
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50
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Meier JC, Tallant C, Fedorov O, Witwicka H, Hwang SY, van Stiphout RG, Lambert JP, Rogers C, Yapp C, Gerstenberger BS, Fedele V, Savitsky P, Heidenreich D, Daniels DL, Owen DR, Fish PV, Igoe NM, Bayle ED, Haendler B, Oppermann UC, Buffa F, Brennan PE, Müller S, Gingras AC, Odgren PR, Birnbaum MJ, Knapp S. Selective Targeting of Bromodomains of the Bromodomain-PHD Fingers Family Impairs Osteoclast Differentiation. ACS Chem Biol 2017; 12:2619-2630. [PMID: 28849908 PMCID: PMC5662925 DOI: 10.1021/acschembio.7b00481] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [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] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 08/29/2017] [Indexed: 01/16/2023]
Abstract
Histone acetyltransferases of the MYST family are recruited to chromatin by BRPF scaffolding proteins. We explored functional consequences and the therapeutic potential of inhibitors targeting acetyl-lysine dependent protein interaction domains (bromodomains) present in BRPF1-3 in bone maintenance. We report three potent and selective inhibitors: one (PFI-4) with high selectivity for the BRPF1B isoform and two pan-BRPF bromodomain inhibitors (OF-1, NI-57). The developed inhibitors displaced BRPF bromodomains from chromatin and did not inhibit cell growth and proliferation. Intriguingly, the inhibitors impaired RANKL-induced differentiation of primary murine bone marrow cells and human primary monocytes into bone resorbing osteoclasts by specifically repressing transcriptional programs required for osteoclastogenesis. The data suggest a key role of BRPF in regulating gene expression during osteoclastogenesis, and the excellent druggability of these bromodomains may lead to new treatment strategies for patients suffering from bone loss or osteolytic malignant bone lesions.
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Affiliation(s)
- Julia C. Meier
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Cynthia Tallant
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Oleg Fedorov
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Hanna Witwicka
- Department of Cell and Developmental Biology, University of Massachusetts Medical School, Worcester, Massachusetts, United States
| | - Sung-Yong Hwang
- Department of Cell and Developmental Biology, University of Massachusetts Medical School, Worcester, Massachusetts, United States
| | - Ruud G. van Stiphout
- Department of Oncology, Oxford University, Old Road Campus Research Building, Oxford OX3 7DQ, United Kingdom
| | - Jean-Philippe Lambert
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada
| | - Catherine Rogers
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Clarence Yapp
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Brian S. Gerstenberger
- Pfizer Worldwide Medicinal
Chemistry, 610 Main Street, Cambridge, Massachusetts 02139, United States
| | - Vita Fedele
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Pavel Savitsky
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - David Heidenreich
- Goethe-University Frankfurt, Institute of Pharmaceutical Chemistry, Riedberg Campus, 60438 Frankfurt am Main, Germany
| | | | - Dafydd R. Owen
- Pfizer Worldwide Medicinal
Chemistry, 610 Main Street, Cambridge, Massachusetts 02139, United States
| | - Paul V. Fish
- Department
of Pharmaceutical & Biological Chemistry, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, United
Kingdom
| | - Niall M. Igoe
- Department
of Pharmaceutical & Biological Chemistry, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, United
Kingdom
| | - Elliott D. Bayle
- Department
of Pharmaceutical & Biological Chemistry, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, United
Kingdom
| | - Bernard Haendler
- Drug Discovery, Bayer Pharma
AG, Müllerstrasse
178, D-13353 Berlin, Germany
| | | | - Francesca Buffa
- Department of Oncology, Oxford University, Old Road Campus Research Building, Oxford OX3 7DQ, United Kingdom
| | - Paul E. Brennan
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
| | - Susanne Müller
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
- Buchmann Institute for Life Sciences (BMLS), Riedberg Campus, 60438 Frankfurt am Main, Germany
| | - Anne Claude Gingras
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario M5S 1A8, Canada
| | - Paul R. Odgren
- Department of Cell and Developmental Biology, University of Massachusetts Medical School, Worcester, Massachusetts, United States
| | - Mark J. Birnbaum
- Department of Biology, Merrimack College, North Andover, Massachusetts, United States
| | - Stefan Knapp
- Target Discovery
Institute and Structural Genomics Consortium, Oxford University, Oxford, United Kingom
- Buchmann Institute for Life Sciences (BMLS), Riedberg Campus, 60438 Frankfurt am Main, Germany
- Goethe-University Frankfurt, Institute of Pharmaceutical Chemistry, Riedberg Campus, 60438 Frankfurt am Main, Germany
- German Cancer Network (DKTK), Frankfurt site, 60438 Frankfurt am Main, Germany
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