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Jacoby P, Glover C, Damon C, Fathima P, Pillsbury A, Durrheim D, Gold MS, Leeb A, Snelling T. Timeliness of signal detection for adverse events following influenza vaccination in young children: a simulation case study. BMJ Open 2020; 10:e031851. [PMID: 32122906 PMCID: PMC7050305 DOI: 10.1136/bmjopen-2019-031851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To determine how soon after commencement of the seasonal influenza vaccination programme, the AusVaxSafety active vaccine safety surveillance system, currently in use across Australia, would have detected a safety signal had it been operating in 2010 when there was an unprecedented number of febrile seizures in young children associated with one specific influenza vaccine brand, Fluvax (CSL Biotherapies). DESIGN Simulation study. SETTING Western Australian vaccine influenza coverage and adverse event surveillance data. OUTCOME MEASURES Simulated solicited responses from caregivers who would have received an SMS survey about adverse events experienced following seasonal influenza vaccination of their children aged 6 months to <5 years. PARTICIPANTS None. RESULTS We estimated a >90% probability of a safety signal being detected by AusVaxSafety based on solicited reports for either fever or medical attendance at or before the week ending 28 March 2010, 3 weeks after the start of vaccine distribution. Suspension of the national paediatric influenza vaccination programme as a result of the passive adverse events surveillance operating at the time did not occur until 23 April 2010. CONCLUSIONS Active vaccine safety surveillance leading to rapid detection of a safety signal would likely have resulted in earlier suspension of Fluvax from the vaccination programme, prevention of many febrile convulsions and maintenance of public confidence in influenza vaccination for young children.
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Affiliation(s)
- Peter Jacoby
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Catherine Glover
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Chloe Damon
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Alexis Pillsbury
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - David Durrheim
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Michael S Gold
- Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Alan Leeb
- SmartVax, c/o Illawarra Medical Centre, Ballajura, Western Australia, Australia
- Illawarra Medical Centre, Ballajura, Western Australia, Australia
| | - Tom Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
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Damon C, Pallet N. Reply to "Predictive Modeling of Tacrolimus Dose Requirements: All That Is Gold Does Not Glitter". Am J Transplant 2017; 17:1146. [PMID: 27862995 DOI: 10.1111/ajt.14117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- C Damon
- Hypercube Institute, Paris, France
| | - N Pallet
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France.,Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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Damon C, Luck M, Toullec L, Etienne I, Buchler M, Hurault de Ligny B, Choukroun G, Thierry A, Vigneau C, Moulin B, Heng AE, Subra JF, Legendre C, Monnot A, Yartseva A, Bateson M, Laurent-Puig P, Anglicheau D, Beaune P, Loriot MA, Thervet E, Pallet N. Predictive Modeling of Tacrolimus Dose Requirement Based on High-Throughput Genetic Screening. Am J Transplant 2017; 17:1008-1019. [PMID: 27597269 DOI: 10.1111/ajt.14040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 01/25/2023]
Abstract
Any biochemical reaction underlying drug metabolism depends on individual gene-drug interactions and on groups of genes interacting together. Based on a high-throughput genetic approach, we sought to identify a set of covariant single-nucleotide polymorphisms predictive of interindividual tacrolimus (Tac) dose requirement variability. Tac blood concentrations (Tac C0 ) of 229 kidney transplant recipients were repeatedly monitored after transplantation over 3 mo. Given the high dimension of the genomic data in comparison to the low number of observations and the high multicolinearity among the variables (gene variants), we developed an original predictive approach that integrates an ensemble variable-selection strategy to reinforce the stability of the variable-selection process and multivariate modeling. Our predictive models explained up to 70% of total variability in Tac C0 per dose with a maximum of 44 gene variants (p-value <0.001 with a permutation test). These models included molecular networks of drug metabolism with oxidoreductase activities and the multidrug-resistant ABCC8 transporter, which was found in the most stringent model. Finally, we identified an intronic variant of the gene encoding SLC28A3, a drug transporter, as a key gene involved in Tac metabolism, and we confirmed it in an independent validation cohort.
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Affiliation(s)
- C Damon
- Hypercube Institute, Paris, France
| | - M Luck
- Hypercube Institute, Paris, France.,Paris Descartes University, Paris, France
| | - L Toullec
- Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - I Etienne
- Department of Nephrology, Rouen University Hospital, Rouen, France
| | - M Buchler
- Department of Nephrology, Tours University Hospital, Tours, France
| | | | - G Choukroun
- Department of Nephrology, Amiens University Hospital, Amiens, France
| | - A Thierry
- Department of Nephrology, Poitiers University Hospital, Poitiers, France
| | - C Vigneau
- Department of Nephrology, Rennes University Hospital, Rennes, France
| | - B Moulin
- Department of Nephrology, Strasbourg University Hospital, Strasbourg, France
| | - A-E Heng
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - J-F Subra
- Department of Nephrology, Angers University Hospital, Angers, France
| | - C Legendre
- Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - A Monnot
- Hypercube Institute, Paris, France
| | | | | | - P Laurent-Puig
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France
| | - D Anglicheau
- Department of Nephrology, Necker Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Beaune
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France
| | - M A Loriot
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France
| | - E Thervet
- Paris Descartes University, Paris, France.,Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - N Pallet
- Paris Descartes University, Paris, France.,Department of Clinical Chemistry, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.,Institut National pour la Santé et la Recherche Médicale (INSERM) U1147, Paris, France.,Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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Damon C. [Vaginal template implant for cervical carcinoma with vaginal stenosis]. Zhonghua Fu Chan Ke Za Zhi 1997; 32:399-401. [PMID: 9639723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE For cervical carcinoma patients with poor geometry for conventional intracavitary radiotherapy, a simple vaginal template for interstitial implantation as a substitute was used. This is a report of the treatment results. METHODS Patients with vaginal stenosis were treated over from July 1987 to June 1991 with this vaginal template implant as part of the treatment. The applicator consisted of a front piece and an end piece. Holes were drilled in the front piece to guide the implantation of the cervix or vaginal vault. The diameter of applicators varied from 2.0 cm to 3.5 cm. Depending on the diameter of the applicators, six to eight needles on the periphery, or eight peripheral plus one central needle were used. The activity of the needles were around 8 mCi with a total length of 5.5 cm. The end piece was locked onto the front piece by a bayonet-type locking device. The purpose of the end piece was two-fold: to make up the length of the whole applicator to fit the vagina and to keep the implanted needles in place without being extruded. The implantation was performed under general anesthesia. RESULTS One of the twelve patients treated with the vaginal template implant for vaginal stenosis had relapsed centrally but subsequently died of intercurrent disease. Two other patients died of intercurrent disease at 26.2 and 41.9 months, respectively, without evidence of relapse. Nine other patients had been followed with no evidence of local relapse for 23.7 to 54.6 months. CONCLUSION This vaginal template implantation is satisfactory in treating cervical carcinoma patients with vaginal stenosis.
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Affiliation(s)
- C Damon
- Department of Radiotherapy and Oncology, Queen Mary Hospital, Hong Kong
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Abstract
Patients with scapholunate advanced collapse (SLAC) wrist do not have to undergo total wrist arthrodesis; the SLAC pattern spares the radiolunate articulation, providing a basis for salvage. We report the results of 100 cases in which a technique comprised of scaphoid excision and limited wrist arthrodesis was used. The average followup period of 44 months revealed excellent functional status and a high rate of patient satisfaction. The majority of employed patients were able to return to their original jobs, and many chose to resume wrist-related recreational activities. Pain relief was good to excellent in most cases. Extension/flexion averaged 72 degrees (53% of a normal opposite wrist), radioulnar deviation 37 degrees (59%), and grip strength 80% of the opposite side. X-ray films revealed only two instances of radiolunate destruction, both in conjunction with ulnar translation of the carpus. The other 98 patients demonstrated a well-preserved radiolunate joint regardless of followup interval. Complications were few. Nonunion occurred in three cases. A dorsal impingement of the capitate and radius (12%) was felt to be technique-related and avoidable by careful capitolunate alignment.
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Affiliation(s)
- D Ashmead
- Connecticut Combined Hand Surgery Service, Hartford Hospital, University of Connecticut, Newington Children's Hospital
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