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Windon CC, Jackson AJ, Aguirre GA, Tucker M, Amuiri A, Hill-Jarrett T, Chen M, Pina Escuedro SD, Lieu K, Lopez L, Mei D, Tee BL, Watson CW, Agwu C, Kramer J, Lanata S. Underrepresented and Underserved Populations in Neurological Research. Semin Neurol 2024; 44:168-177. [PMID: 38485127 DOI: 10.1055/s-0044-1782516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Underserved and underrepresented populations have historically been excluded from neurological research. This lack of representation has implications for translation of research findings into clinical practice given the impact of social determinants of health on neurological disease risk, progression, and outcomes. Lack of inclusion in research is driven by individual-, investigator-, and study-level barriers as well as larger systemic injustices (e.g., structural racism, discriminatory practices). Although strategies to increase inclusion of underserved and underrepresented populations have been put forth, numerous questions remain about the most effective methodology. In this article, we highlight inclusivity patterns and gaps among the most common neurological conditions and propose best practices informed by our own experiences in engagement of local community organizations and collaboration efforts to increase underserved and underrepresented population participation in neurological research.
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Affiliation(s)
- Charles C Windon
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Ashley J Jackson
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Gloria A Aguirre
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Miwa Tucker
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Alinda Amuiri
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Tanisha Hill-Jarrett
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Miranda Chen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Stefanie D Pina Escuedro
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Kevin Lieu
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Lucia Lopez
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Diana Mei
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Boon Lead Tee
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
- Memory and Aging Center, Department of Neurology, Global Brain Health Institute, University of California, San Francisco, California
| | - Caitlin W Watson
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Chidera Agwu
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
| | - Serggio Lanata
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, California
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Ho P, Yu WH, Tee BL, Lee W, Li C, Gu Y, Yokoyama JS, Reyes‐Dumeyer D, Choi Y, Yang H, Vardarajan BN, Tzuang M, Lieu K, Lu A, Faber KM, Potter ZD, Revta C, Kirsch M, McCallum J, Mei D, Booth B, Cantwell LB, Chen F, Chou S, Clark D, Deng M, Hong TH, Hwang L, Jiang L, Joo Y, Kang Y, Kim ES, Kim H, Kim K, Kuzma AB, Lam E, Lanata SC, Lee K, Li D, Li M, Li X, Liu C, Liu C, Liu L, Lupo J, Nguyen K, Pfleuger SE, Qian J, Qian W, Ramirez V, Russ KA, Seo EH, Song YE, Tartaglia MC, Tian L, Torres M, Vo N, Wong EC, Xie Y, Yau EB, Yi I, Yu V, Zeng X, St George‐Hyslop P, Au R, Schellenberg GD, Dage JL, Varma R, Hsiung GR, Rosen H, Henderson VW, Foroud T, Kukull WA, Peavy GM, Lee H, Feldman HH, Mayeux R, Chui H, Jun GR, Ta Park VM, Chow TW, Wang L. Asian Cohort for Alzheimer's Disease (ACAD) pilot study on genetic and non-genetic risk factors for Alzheimer's disease among Asian Americans and Canadians. Alzheimers Dement 2024; 20:2058-2071. [PMID: 38215053 PMCID: PMC10984480 DOI: 10.1002/alz.13611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/25/2023] [Accepted: 11/27/2023] [Indexed: 01/14/2024]
Abstract
INTRODUCTION Clinical research in Alzheimer's disease (AD) lacks cohort diversity despite being a global health crisis. The Asian Cohort for Alzheimer's Disease (ACAD) was formed to address underrepresentation of Asians in research, and limited understanding of how genetics and non-genetic/lifestyle factors impact this multi-ethnic population. METHODS The ACAD started fully recruiting in October 2021 with one central coordination site, eight recruitment sites, and two analysis sites. We developed a comprehensive study protocol for outreach and recruitment, an extensive data collection packet, and a centralized data management system, in English, Chinese, Korean, and Vietnamese. RESULTS ACAD has recruited 606 participants with an additional 900 expressing interest in enrollment since program inception. DISCUSSION ACAD's traction indicates the feasibility of recruiting Asians for clinical research to enhance understanding of AD risk factors. ACAD will recruit > 5000 participants to identify genetic and non-genetic/lifestyle AD risk factors, establish blood biomarker levels for AD diagnosis, and facilitate clinical trial readiness. HIGHLIGHTS The Asian Cohort for Alzheimer's Disease (ACAD) promotes awareness of under-investment in clinical research for Asians. We are recruiting Asian Americans and Canadians for novel insights into Alzheimer's disease. We describe culturally appropriate recruitment strategies and data collection protocol. ACAD addresses challenges of recruitment from heterogeneous Asian subcommunities. We aim to implement a successful recruitment program that enrolls across three Asian subcommunities.
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Affiliation(s)
- Pei‐Chuan Ho
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- The Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Wai Haung Yu
- Brain Health and Imaging Center and Geriatric Mental Health ServicesCentre for Addiction and Mental HealthTorontoOntarioCanada
- Department of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada
| | - Boon Lead Tee
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Wan‐Ping Lee
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Clara Li
- Alzheimer's Disease Research CenterDepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Yian Gu
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Jennifer S. Yokoyama
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Dolly Reyes‐Dumeyer
- Gertrude H. Sergievsky CenterTaub Institute of Aging Brain and Department of Neurology at Columbia UniversityNew YorkNew YorkUSA
| | - Yun‐Beom Choi
- Englewood HealthEnglewoodNew JerseyUSA
- Department of NeurologyRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
| | - Hyun‐Sik Yang
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
- Broad Institute of MIT and HarvardCambridgeMassachusettsUSA
| | - Badri N. Vardarajan
- Gertrude H. Sergievsky CenterTaub Institute of Aging Brain and Department of Neurology at Columbia UniversityNew YorkNew YorkUSA
| | - Marian Tzuang
- Department of Community Health SystemsUniversity of California San Francisco School of NursingSan FranciscoCaliforniaUSA
| | - Kevin Lieu
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Anna Lu
- Alzheimer's Disease Cooperative StudyUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Kelley M. Faber
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Zoë D. Potter
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Carolyn Revta
- Alzheimer's Disease Cooperative StudyUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Maureen Kirsch
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jake McCallum
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Diana Mei
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Briana Booth
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Laura B. Cantwell
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Fangcong Chen
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Sephera Chou
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Dewi Clark
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Michelle Deng
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Ting Hei Hong
- University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Ling‐Jen Hwang
- Stanford Alzheimer's Disease Research CenterStanfordCaliforniaUSA
| | - Lilly Jiang
- University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Yoonmee Joo
- Department of Community Health SystemsUniversity of California San Francisco School of NursingSan FranciscoCaliforniaUSA
| | - Younhee Kang
- College of NursingGraduate Program in System Health Science and EngineeringEwha Womans UniversitySeoulRepublic of Korea
| | - Ellen S. Kim
- Division of NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Hoowon Kim
- Department of NeurologyChosun University Hospital, Dong‐guGwangjuRepublic of Korea
| | - Kyungmin Kim
- Department of Child Development and Family StudiesCollege of Human EcologySeoul National UniversityJongno‐guSeoulRepublic of Korea
| | - Amanda B. Kuzma
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Eleanor Lam
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Serggio C. Lanata
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Kunho Lee
- Biomedical Science, College of Natural SciencesChosun UniversityGwanak‐guSeoulRepublic of Korea
| | - Donghe Li
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
| | - Mingyao Li
- Department of BiostatisticsEpidemiology and InformaticsPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Xiang Li
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Chia‐Lun Liu
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Collin Liu
- Department of NeurologyKeck School of Medicine at University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Linghsi Liu
- Alzheimer's Disease Research CenterDepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Jody‐Lynn Lupo
- Alzheimer's Disease Cooperative StudyUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Khai Nguyen
- Department of MedicineUniversity of California at San DiegoLa JollaCaliforniaUSA
| | - Shannon E. Pfleuger
- Division of NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - James Qian
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Winnie Qian
- Geriatric Mental Health Services, Centre for Addiction and Mental HealthTorontoOntarioCanada
| | - Veronica Ramirez
- Stanford Alzheimer's Disease Research CenterStanfordCaliforniaUSA
| | - Kristen A. Russ
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Eun Hyun Seo
- Premedical Science, College of MedicineChosun University, Dong‐guGwangjuRepublic of Korea
| | - Yeunjoo E. Song
- Department of Population & Quantitative Health SciencesSchool of MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative DiseasesUniversity of TorontoTorontoOntarioCanada
| | - Lu Tian
- Department of Biomedical Data ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Mina Torres
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical CenterLos AngelesCaliforniaUSA
| | - Namkhue Vo
- Alzheimer's Disease Cooperative StudyUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Ellen C. Wong
- Department of NeurologyKeck School of Medicine at University of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of NeurologyRancho Los Amigos National Rehabilitation CenterDowneyCaliforniaUSA
| | - Yuan Xie
- Department of NeurologyColumbia University Medical CenterNew YorkNew YorkUSA
| | - Eugene B. Yau
- Division of NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Isabelle Yi
- Stanford Alzheimer's Disease Research CenterStanfordCaliforniaUSA
| | - Victoria Yu
- Department of OphthalmologyKeck School of Medicine at University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Xiaoyi Zeng
- Alzheimer's Disease Research CenterDepartment of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Peter St George‐Hyslop
- Tanz Centre for Research in Neurodegenerative DiseasesUniversity of TorontoTorontoOntarioCanada
- Department of Neurology and the Taub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia UniversityNew YorkNew YorkUSA
| | - Rhoda Au
- Department of Anatomy and NeurobiologySlone Epidemiology CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Gerard D. Schellenberg
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jeffrey L. Dage
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
- Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical CenterLos AngelesCaliforniaUSA
| | - Ging‐Yuek R. Hsiung
- Division of NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Howard Rosen
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Victor W. Henderson
- Department of Epidemiology and Population HealthStanford UniversityStanfordCaliforniaUSA
- Department of Neurology & Neurological SciencesStanford UniversityStanfordCaliforniaUSA
| | - Tatiana Foroud
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Walter A. Kukull
- Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Guerry M. Peavy
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Haeok Lee
- Rory Meyers College of NursingNew York UniversityNew YorkNew YorkUSA
| | - Howard H. Feldman
- Alzheimer's Disease Cooperative StudyUniversity of California, San DiegoLa JollaCaliforniaUSA
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Richard Mayeux
- Department of Neurology and the Taub Institute for Research on Alzheimer's Disease and the Aging BrainColumbia University, Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Helena Chui
- Department of NeurologyKeck School of Medicine at University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Gyungah R. Jun
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
- Department of OphthalmologyBoston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Van M. Ta Park
- Department of Community Health SystemsUniversity of California San Francisco School of NursingSan FranciscoCaliforniaUSA
- Asian American Research Center on Health (ARCH)University of California San Francisco School of NursingSan FranciscoCaliforniaUSA
| | - Tiffany W. Chow
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Alector Inc.South San FranciscoCaliforniaUSA
| | - Li‐San Wang
- Penn Neurodegeneration Genomics CenterDepartment of PathologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Abstract
Precision medicine is an old concept, but it is not widely applied across human health conditions as yet. Numerous attempts have been made to apply precision medicine in epilepsy, this has been based on a better understanding of aetiological mechanisms and deconstructing disease into multiple biological subsets. The scope of precision medicine is to provide effective strategies for treating individual patients with specific agent(s) that are likely to work best based on the causal biological make-up. We provide an overview of the main applications of precision medicine in epilepsy, including the current limitations and pitfalls, and propose potential strategies for implementation and to achieve a higher rate of success in patient care. Such strategies include establishing a definition of precision medicine and its outcomes; learning from past experiences, from failures and from other fields (e.g. oncology); using appropriate precision medicine strategies (e.g. drug repurposing versus traditional drug discovery process); and using adequate methods to assess efficacy (e.g. randomised controlled trials versus alternative trial designs). Although the progress of diagnostic techniques now allows comprehensive characterisation of each individual epilepsy condition from a molecular, biological, structural and clinical perspective, there remain challenges in the integration of individual data in clinical practice to achieve effective applications of precision medicine in this domain.
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Affiliation(s)
- S Balestrini
- Neuroscience Department, Meyer Children's Hospital IRCSS, Florence, Italy
- University of Florence, Florence, Italy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - D Mei
- Neuroscience Department, Meyer Children's Hospital IRCSS, Florence, Italy
| | - S M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Renzo Guerrini
- Neuroscience Department, Meyer Children's Hospital IRCSS, Florence, Italy.
- University of Florence, Florence, Italy.
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Gan PXL, Liao W, Linke KM, Mei D, Wu XD, Wong WSF. Targeting the renin angiotensin system for respiratory diseases. Adv Pharmacol 2023; 98:111-144. [PMID: 37524485 DOI: 10.1016/bs.apha.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Renin-angiotensin system (RAS) plays an indispensable role in regulating blood pressure through its effects on fluid and electrolyte balance. As an aside, cumulative evidence from experimental to clinical studies supports the notion that dysregulation of RAS contributes to the pro-inflammatory, pro-oxidative, and pro-fibrotic processes that occur in pulmonary diseases like asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and acute lung injury (ALI). Pharmacological intervention of the various RAS components can be a novel therapeutic strategy for the treatment of these respiratory diseases. In this chapter, we first give a recent update on the RAS, and then compile, review, and analyse recent reports on targeting RAS components as treatments for respiratory diseases. Inhibition of the pro-inflammatory renin, angiotensin-converting enzyme (ACE), angiotensin (Ang) II, and Ang II type 1 receptor (AT1R) axis, and activation of the protective ACE2, AT2R, Ang (1-7), and Mas receptor axis have demonstrated varying degrees of efficacies in experimental respiratory disease models or in human trials. The newly identified alamandine/Mas-related G-protein-coupled receptor member D pathway has shown some therapeutic promise as well. However, our understanding of the RAS ligand-and-receptor interactions is still inconclusive, and the modes of action and signaling cascade mediating the newly identified RAS receptors remain to be better characterized. Clinical data are obviously lacking behind the promising pre-clinical findings of certain well-established molecules targeting at different pathways of the RAS in respiratory diseases. Translational human studies should be the focus for RAS drug development in lung diseases in the next decade.
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Affiliation(s)
- Phyllis X L Gan
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Singapore, Singapore
| | - W Liao
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Singapore, Singapore; Singapore-HUJ Alliance for Research Enterprise, National University of Singapore, Singapore, Singapore
| | - Kira M Linke
- Department of Pharmacology, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - D Mei
- Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| | - X D Wu
- Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China
| | - W S Fred Wong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University Health System, Singapore, Singapore; Singapore-HUJ Alliance for Research Enterprise, National University of Singapore, Singapore, Singapore; Drug Discovery and Optimization Platform, National University Health System, Singapore, Singapore.
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5
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Xue M, Turpin W, Haim L, Lee SH, Neustaeter A, Mei D, Xu W, Espin-Garcia O, Madsen KL, Guttman DS, Griffiths AM, Huynh H, Turner D, Panancionne R, Steinhart H, Aumais G, Bitton A, Jacobson K, Mack D, Croitoru K. A198 THE LONG-TERM IMPACT OF ENVIRONMENTAL EXPOSURES ON HOST HEALTH AND THE RISK FACTORS OF CROHN'S DISEASE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991169 DOI: 10.1093/jcag/gwac036.198] [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: 03/09/2023] Open
Abstract
Background Several environmental factors are associated with Crohn’s disease (CD) in large case-control studies; however, it is not clear how these factors maybe be influenced by age of exposure and if they are related to alterations in pre-disease biological markers of CD risk. Purpose To investigate the association between environmental factors in different age groups with future risk of CD onset and assess their relation to other pre-disease biomarkers. Method We used an environmental risk assessment questionnaire (ERA) to collect information from healthy first-degree relatives(FDR) of CD enrolled in the CCC-GEM project. ERA was a multi-item questionnaire querying 69 questions under 7 section headings: background, cultural/ethnic, smoking history, medical history, family history, environmental history and pet history. For the environmental and pet sections, current and historical (<1, 2-4, 5-15 years old) data was captured at the time of recruitment. We used Cox proportional hazard models to identify exposures associated with future CD onset. Next, we used regression models to identify the relationship of exposures with biological factors associated with CD risk previously identified by our group i.e.: i) intestinal permeability using urinary fractional excretion of lactulose to mannitol ratio (LMR) with LMR≥0.025 defined as abnormal; ii) subclinical inflammation using fecal calprotectin (FCP) with FCP≥100µg/g; and iii) fecal microbiome composition and diversity using 16S rDNA sequencing. Two-sided p<0.05 (or false discovery rate corrected p<0.05) were considered significant. Result(s) A total of 4289 FDRs were recruited, 47% were male, median recruitment age was 17.0 years[6-35]. After a median follow-up of 5.6-years (IQR=3.42-8.67), 86 FDRs developed CD. Living with a dog between age 5-15 (Hazard Ratio (HR)=0.61; 95% confidence interval (CI)=0.39-0.95), and a large family size (>3) in the first year of life (HR=0.41; 95% CI=0.22-0.89) were protective against CD onset. Conversely, having a bird at time of survey (HR=2.84; CI=1.37-5.90), and having a sibling with CD (HR=2.07; 95% CI=1.18-3.63) were risk factors for CD onset. We found that owning a dog between age of 5-15 (Odd Ratio(OR)=0.77, 95% CI=0.65-0.90) was significantly associated with LMR, nine taxa bacterial and higher chao1 diversity index. Having a bird at time of survey was significantly associated with FCP (OR=2.04, 95% CI=1.33-3.11). There was no association between large family size and having a CD sibling with gut microbiome, FCP or LMR. Conclusion(s) The study identified four environmental factors associated with future development of CD. Among them, exposure to dogs during early life was protective against CD onset and might be explained by its association with normal gut permeability and microbiome. We also identified that having a bird at recruitment increased risk of CD onset which might be mediated by an increase in subclinical inflammation. Submitted on behalf of the CCC-GEM consortium Disclosure of Interest None Declared
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Affiliation(s)
- M Xue
- Lunenfeld-Tanenbaum Research Institute
| | - W Turpin
- Lunenfeld-Tanenbaum Research Institute
| | - L Haim
- Lunenfeld-Tanenbaum Research Institute
| | - S -H Lee
- Lunenfeld-Tanenbaum Research Institute
| | | | - D Mei
- Dalla Lana School of Public Health, University of Toronto, Toronto
| | - W Xu
- Dalla Lana School of Public Health, University of Toronto, Toronto
| | - O Espin-Garcia
- Dalla Lana School of Public Health, University of Toronto, Toronto
| | | | - D S Guttman
- Department of Cell & Systems Biology, University of Toronto
| | - A M Griffiths
- Paediatrics, The Hospital for Sick Children, Toronto, Canada
| | - H Huynh
- University of Alberta, Alberta
| | - D Turner
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | | | | | - K Jacobson
- University of British Columbia, Vancouver
| | - D Mack
- Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
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Caporalini C, Scagnet M, Giunti L, Cetica V, Mei D, Conti V, Moscardi S, Macconi L, Giordano F, D'Incerti L, Genitori L, Guerrini R, Buccoliero A. Myxoid glioneuronal tumor: Histopathologic, neuroradiologic, and molecular features in a single center series. Neoplasia 2023; 37:100885. [PMID: 36764090 PMCID: PMC9929589 DOI: 10.1016/j.neo.2023.100885] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Myxoid glioneuronal tumor (MGT) is a benign glioneuronal neoplasm recently introduced in the World Health Organization (WHO) classification of the central nervous system (CNS) tumors. MGTs are typically located in the septum pellucidum, foramen of Monro or periventricular white matter of the lateral ventricle. They were previously diagnosed as dysembryoplastic neuroepithelial tumors (DNT), showing histological features almost indistinguishable from classical cortical DNT. Despite that, MGTs have been associated with a specific dinucleotide substitution at codon 385 in the platelet-derived growth factor receptor alpha (PDGFRA) gene, replacing a lysine residue with either leucine or isoleucine (p. LysK385Leu/Iso). This genetic variation has never been described in any other CNS tumor. MATERIALS AND METHODS Thirty-one consecutive tumors, previously diagnosed as DNTs at the Meyer Children's Hospital IRCCS between January 2010 and June 2021 were collected for a comprehensive study of their clinical, imaging, pathological features, and molecular profile. RESULTS In six out of the thirty-one tumors we had previously diagnosed as DNTs, we identified the recurrent dinucleotide mutation in the PDGFRA. All six tumors were typically located within the periventricular white matter of the lateral ventricle and in the septum pellucidum. We then renamed these lesions as MGT, according to the latest WHO CNS classification. In all patients we observed an indolent clinical course, without recurrence. CONCLUSION MGT represent a rare but distinct group of neoplasm with a typical molecular profiling, a characteristic localization, and a relative indolent clinical course.
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Affiliation(s)
- C. Caporalini
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy,Corresponding author.
| | - M. Scagnet
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Giunti
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Cetica
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - D. Mei
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Conti
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - S. Moscardi
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
| | - L. Macconi
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - F. Giordano
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. D'Incerti
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Genitori
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - R. Guerrini
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - A.M. Buccoliero
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
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Ge Y, Zhou J, Zhang B, Mei D, Xu YC, Ma XJ. [Focusing on patient safety and quality of care, exploring long-term antimicrobial stewardship]. Zhonghua Nei Ke Za Zhi 2022; 61:1091-1094. [PMID: 36207964 DOI: 10.3760/cma.j.cn112138-20220509-00351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Y Ge
- Department of Infectious Disease, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J Zhou
- Department of Medical Record, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - B Zhang
- Pharmacy Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - D Mei
- Pharmacy Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Y C Xu
- Laboratory Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X J Ma
- Department of Infectious Disease, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Monari D, Mei D, Mantovani F, Guiducci V, Navazio A. P107 MULTIMODALITY IMAGING IN ASCENDING AORTA PSEUDO–ANEURYSM COMPLICATED BY MOBILE TROMBUS SYMPTOMATIC FOR RECURRENT ISCHEMIC STROKE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.104] [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: 11/14/2022]
Abstract
Abstract
A 80–year–old male patient was admitted to hospital with a clinical picture of Broca‘s aphasia. The patient had arterial hypertension, diabetes, chronic kidney disease and peripheral vasculopathy. In remote cardiological history he presents long standing persistent atrial fibrillation on OAC and he had a biological aortic valve prosthesis (Medtronic 23). Overall time in the therapeutic range (INR 2.0–2.5) was adequate considering the presence of atrial fibrillation. A CT scan was performed on suspicion of stroke, showing a recent ischemic lesion in the left middle temporal region complicated by same–site subarachnoid blood suffusion. During the hospital stay there was a recurrence of the aforementioned symptoms: at the CT check a new acute ischemic same–site lesion and a new ischaemic lesion at the left temporal site was highlighted. In the suspicion of a cardio–embolic origin of cerebro–vascular events, it was decided to carry out imaging for the study of the aorta and heart cavities to exclude embolic sources. Given the patient‘s comorbidities and the reported allergies (contrast medium with angioedema–like reaction at a previous CT) it was decided to perform transesophageal echocardiography (TEE) first. TEE documented the presence of a saccular aneurysm of probable pseudo–aneurysmatic nature, which extends from 20 mm from the valvular plane, characterized by pedunculated, mobile thrombotic apposition, adhered to the internal collar, projecting into the psueudo–aneurysmatic cavity (image 1). This finding was confirmed and better characterized with the help of the real time three–dimensional echocardiographic method (image 2). To confirm and better characterize the extension of the pseudo–aneurysm and plan any strategy, a CT scan with contrast medium was required. Performing contrast–enhanced CT, after careful preparation with premedication with antihistamine and cortisone, confirmed the finding of pseudo–aneurysm of the ascending aorta, but the pedunculated thrombotic apposition was less clearly evidenced compared with TEE (giving the superior temporal resolution of TEE) (image 3). The case was therefore assessed in Heart Team and the patient was scheduled for surgically exclusion of the pseudo–aneurysm.
Conclusion
In our case a multimodality imaging approach was used to diagnose and confirm the presence of ascending aorta pseudo–aneurysm complicated by pedunculated thrombotic apposition inside it, symptomatic for recurrent ischaemic stroke.
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Affiliation(s)
- D Monari
- CARDIOLOGIA, AZIENDA USL, IRCCS DI REGGIO EMILIA E UNIVERSITÀ DEGLI STUDI DI MODENA E REGGIO EMILIA, REGGIO EMILIA; CARDIOLOGIA, AZIANDA USL, IRCCS DI REGGIO EMILIA, REGGIO EMILIA; AZIENDA USL, IRCCS, REGGIO EMILIA
| | - D Mei
- CARDIOLOGIA, AZIENDA USL, IRCCS DI REGGIO EMILIA E UNIVERSITÀ DEGLI STUDI DI MODENA E REGGIO EMILIA, REGGIO EMILIA; CARDIOLOGIA, AZIANDA USL, IRCCS DI REGGIO EMILIA, REGGIO EMILIA; AZIENDA USL, IRCCS, REGGIO EMILIA
| | - F Mantovani
- CARDIOLOGIA, AZIENDA USL, IRCCS DI REGGIO EMILIA E UNIVERSITÀ DEGLI STUDI DI MODENA E REGGIO EMILIA, REGGIO EMILIA; CARDIOLOGIA, AZIANDA USL, IRCCS DI REGGIO EMILIA, REGGIO EMILIA; AZIENDA USL, IRCCS, REGGIO EMILIA
| | - V Guiducci
- CARDIOLOGIA, AZIENDA USL, IRCCS DI REGGIO EMILIA E UNIVERSITÀ DEGLI STUDI DI MODENA E REGGIO EMILIA, REGGIO EMILIA; CARDIOLOGIA, AZIANDA USL, IRCCS DI REGGIO EMILIA, REGGIO EMILIA; AZIENDA USL, IRCCS, REGGIO EMILIA
| | - A Navazio
- CARDIOLOGIA, AZIENDA USL, IRCCS DI REGGIO EMILIA E UNIVERSITÀ DEGLI STUDI DI MODENA E REGGIO EMILIA, REGGIO EMILIA; CARDIOLOGIA, AZIANDA USL, IRCCS DI REGGIO EMILIA, REGGIO EMILIA; AZIENDA USL, IRCCS, REGGIO EMILIA
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Cursio I, Ronzano N, Asunis M, Dettori M, Cossu S, Murru S, Cau M, Incani F, Mei D, Bianchini C, Scioni M, Pruna D. A peculiar family with recurrent self-limited epileptic syndrome and associated developmental disorders in six girls. Epilepsy Behav Rep 2022; 19:100546. [PMID: 35637976 PMCID: PMC9142554 DOI: 10.1016/j.ebr.2022.100546] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/14/2022] [Accepted: 04/16/2022] [Indexed: 11/28/2022] Open
Abstract
Self-Limited Epilepsies may evolve to Developmental and/or Epileptic Encephalopathy. Family cases may present with recurrent phenotype and complex genetic background. Genetic testing could not provide useful elements for early aetiological diagnosis. This electroclinical phenotype had remarkable impact on development. It’s important an early identification of genetic risk factors of family cases.
We describe a complex family with two couples (two sisters who married two brothers) with consistent social and neuropsychiatric problems, originally from Sardinia. Each couple had three daughters, which shared electroclinical epileptic syndrome and developmental disorders. All patients suffered from mild to moderate intellectual disability, speech difficulties and behavioural disorders. Four out of six patients had epilepsy onset between 3 and 4 years of age. The epileptic history almost reflected the typical clinical course of a self-Limited Focal Epilepsy of Childhood. However, our patients don’t have the complete features characteristic of one of the four specific self-Limited Focal Epilepsies of Childhood; a progressive evolution into a Developmental and/or Epileptic Encephalopathy with spike-wave activation in sleep was observed in the two older sister of the first family, which developed more severe developmental disorder too. In the other epileptic patients, improvement of EEG pattern was not coincident with an improvement of the developmental disorders. Brain MRI, performed in three patients, showed normal findings. Genetic analysis carried out so far (SNP-array, study of Runs of homozygosity, FMR1 triplet-repeat primer-PCR assay, Next Generation Sequencing based gene panel for epilepsy and neurodevelopmental disorders and Exome Sequencing), did not provide useful elements for an aetiological diagnosis.
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11
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Wang W, Jiang Y, Wang D, Mei D, Xu H, Zhao B. Clinical efficacy of autogenous dentin grafts with guided bone regeneration for horizontal ridge augmentation: a prospective observational study. Int J Oral Maxillofac Surg 2021; 51:837-843. [PMID: 34924269 DOI: 10.1016/j.ijom.2021.06.012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/27/2021] [Accepted: 06/28/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to evaluate the efficacy of autogenous dentin grafts with guided bone regeneration (GBR) for horizontal ridge augmentation. Nineteen patients with dentition and bone defects in whom tooth/teeth extraction was indicated were recruited. Autogenous teeth were prepared, fixed on the buccal sides of the defects, and covered with bone powder and resorbable membranes before implantation. The horizontal bone mass at 0 mm (W1), 3 mm (W2), and 6 mm (W3) from the alveolar crest was recorded using cone beam computed tomography, before, immediately after, and 6 months after dentin grafting. All adverse effects were recorded. The implant stability quotient (ISQ) was measured 6 months after implantation. Twenty-eight implants were placed 6 months after dentin grafting. At this time point, the bone mass was 4.72 ± 0.72 mm (W1), 7.35 ± 1.57 mm (W2), and 8.96 ± 2.38 mm (W3), which was significantly different from that before the surgery (P < 0.05). The bone gain was 2.50 ± 0.72 mm (W1), 4.10 ± 1.42 mm (W2), and 4.56 ± 2.09 mm (W3). No soft tissue dehiscence or infection was observed. Overall, 26.3% of the patients experienced severe pain after dentin grafting. The ISQ was 78.31 ± 6.64 at 6 months after implantation. Autogenous tooth roots with GBR might be effective for horizontal ridge augmentation. This technique could be an alternative to augmentation using autogenous bone grafts.
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Affiliation(s)
- W Wang
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China; School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Y Jiang
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - D Wang
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - D Mei
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - H Xu
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - B Zhao
- Department of Oral Implantology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China; State Key Laboratory of Military Stomatology, Shanxi, China.
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12
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Zhu Z, Zhang B, Tang Y, Mei D, Li DK. [Peking Union Medical College Hospital and Its Training of Pharmaceutical Staff in the Republican Period]. Zhonghua Yi Shi Za Zhi 2021; 51:282-288. [PMID: 34794267 DOI: 10.3760/cma.j.cn112155-20200702-00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Several training programs for the pharmacy staff in the Pharmacy Department of Beijing Union Medical College Hospital were implemented over 1910's to 1942, such as apprenticeships, prior courses on pharmaceutical sciences,vocational training, study overseas, and developing the Beiping Pharmacy Evening School in collaboration with the North China Pharmaceutical Society around the 1930's. These programs explored training models for the hospital, developed practical talent with competence ensuring the needs and requirements within the hospital, established practical education on pharmacy in Beiping and therefore contributed to promoting future pharmaceutical training systems in China.
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Affiliation(s)
- Z Zhu
- Department of Pharmacy, Peking Union Medical College Hospital,Chinese Academy Institute of Medical Sciences-Peking Union Medical College, Beijing 100730, China
| | - B Zhang
- Department of Pharmacy, Peking Union Medical College Hospital,Chinese Academy Institute of Medical Sciences-Peking Union Medical College, Beijing 100730, China
| | - Y Tang
- Department of Pharmacy, Peking Union Medical College Hospital,Chinese Academy Institute of Medical Sciences-Peking Union Medical College, Beijing 100730, China
| | - D Mei
- Department of Pharmacy, Peking Union Medical College Hospital,Chinese Academy Institute of Medical Sciences-Peking Union Medical College, Beijing 100730, China
| | - D K Li
- Department of Pharmacy, Peking Union Medical College Hospital,Chinese Academy Institute of Medical Sciences-Peking Union Medical College, Beijing 100730, China
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13
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Bu B, Yi K, Wang H, Yang M, Wu M, Ping L, Xie Y, Qiu J, Zhao L, Mei D, Wang X, Song Y, Zhu J, Liu W. Hepatitis B virus infection status is not associated with poor prognosis in classical Hodgkin lymphoma patients. Neoplasma 2019; 67:203-208. [PMID: 31829022 DOI: 10.4149/neo_2019_190211n113] [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] [Received: 02/11/2019] [Accepted: 07/09/2019] [Indexed: 11/08/2022]
Abstract
Few studies focused on the relationship between hepatitis B virus (HBV) infection and classical Hodgkin lymphoma (cHL). This study was to evaluate the impact of HBV infection on the treatment outcome and survival of cHL patients. Clinical data of 352 cHL patients treated with ABVD regimen (doxorubicin, bleomycin, vincristine and dacarbazine) between January 2002 and January 2018 were retrospectively collected. According to HBV infection status, the patients were divided into three groups: with HBV infection [hepatitis B surface antigen (HBsAg)-positive], with past HBV infection [HBsAg-negative but anti-hepatitis B core antigen (anti-HBc)-positive], and without HBV infection (HBsAg-negative and anti-HBc-negative). The incidence of HBV infection and past HBV infection in cHL patients were 7.4% (26/352) and 16.5% (58/352), respectively. The median age of patients without HBV infection was lower than those in other two groups (p<0.001). The complete remission rates after first-line therapy were different among 3 groups (65.4% for the group with HBV infection, 87.9% for the group with past HBV infection, and 76.1% for the group without HBV infection, respectively, p=0.049). After a median follow-up of 34.6 months, the 3-year progression-free survival rates for the three groups were 69%, 74% and 80%, respectively (p=0.566) and the 3-year overall survival rates were 72%, 91% and 87%, respectively (p=0.096). No HBV reactivation was observed during chemotherapy among 3 groups, but 1 patient in the group with HBV infection experienced delayed HBV reactivation when prophylactic entecavir was discontinued 12 months after the last cycle of chemotherapy. HBV infection status did not affect the clinical outcome and prognosis of cHL patients, especially in the era of prophylactic antiviral therapy.
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Affiliation(s)
- B Bu
- Department of Medical Oncology, Shandong Cancer Hospital affiliated to Shandong University, Shandong University, Jinan, China
| | - K Yi
- Department of Lymphoma and Hematology, Jiangxi Cancer Hospital, Nanchang University, Nanchang, China
| | - H Wang
- Department of Pediatric Hematology and Oncology, Shandong Provincial Qianfoshan Hospital, First Hospital Affiliated with Shandong First Medical University, Shandong First Medical University, Jinan, China
| | - M Yang
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - M Wu
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - L Ping
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - Y Xie
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - J Qiu
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China
| | - L Zhao
- Department of Lymphoma, Peking University International Hospital, Peking University, Beijing, China
| | - D Mei
- Department of Lymphoma, Peking University International Hospital, Peking University, Beijing, China
| | - X Wang
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - Y Song
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - J Zhu
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
| | - W Liu
- Department of Lymphoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Peking University, Beijing, China
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14
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Giunti L, Cetica V, De Gregorio V, Mei D, Barba C, Buccoliero A, Genitori L, Guerrini R, Giglio S, Sardi I, Guidi M, Censullo M. P04.08 The role of SCN1A in glioblastomas and mixed neuronal glial tumors of pediatric age. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.103] [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: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
Low and high grade gliomas, are the most common pediatric central nervous system (CNS) tumors and they show an extremely broad range of clinical behavior. Pediatric glioma is distinct from its adult counterpart with different genetic/epigenetic profile and biological features. Recently, several studies have shown the involvement of voltage-gated Na+ channels (VGSC) in different types of cancer, including gliomas. VGSC are multimeric transmembrane complexes, responsible for membrane depolarization in excitable cells playing an important role also in cell proliferation, migration, apoptosis and differentiation. VGSC are therapeutic targets in cardiovascular and neurological disorders and, in cancers, they could be a novel target for the development of promising anticancer therapy
MATERIAL AND METHODS
Firstly, we explored the genetic background of 9 pediatric glioblastomas (1–9 pGBMs), through whole-exome sequencing (WES) using HiSeq1000 platform (Illumina) with paired-end approach. On the basis of our results, we extended our study in another group of 16 epileptogenic mixed neuronal-glial tumors of pediatric age, (WHO grade I and II), through an amplicon approach (TSCA) using MiniSeq System platform (Illumina)
RESULTS
We identified variants in SCN1A gene in 3/9 pGBMs: case 3 had c.5782C>G in tumor and blood; case 5 showed c.2278G>T and two mosaic variants (c.5933C>T, 22% and c.4942C>T, 14%); case 6 showed c.667G>T variant only in tumor, and not in other non tumoral tissues (blood, urine and buccal swab). No variants in SCN1A were identified in a group of 16 pediatric mixed gliomas
CONCLUSION
In this study, we explore the genetic background of two groups of pediatric neuroepithelial brain tumors, through Next generation sequencing approach. We identified only in pGBMs variants in SCN1A gene that encoded for VGSCs and is involved in a spectrum of early-onset epileptic encephalopathies. None of our mutated patients showed history of epilepsy. Now, it is not clear the significance of these variants in pGBMs but interestingly, these variants are present in pGBM and not in mixed gliomas. Further studies on a big cohort of patients are needed to establish if they could play a role in pGBMs aggressiveness, migration and progression. Moreover, VGSCs could be a pharmacological target in pGBMs treatment
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Affiliation(s)
- L Giunti
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - V Cetica
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - V De Gregorio
- Neuro-Oncology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - D Mei
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - C Barba
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - A Buccoliero
- Pathology Unit Meyer Children’s University Hospital, Firenze, Italy
| | - L Genitori
- Neurosurgery Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - R Guerrini
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - S Giglio
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - I Sardi
- Neuro-Oncology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - M Guidi
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - M Censullo
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
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15
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Bai JF, Mei D, Han HX, Zhang S, Feng R, Li JT, Wang T, Zhang CL, Ning SY, Liu H. [The prognosis value of comprehensive geriatric assessment in elder patients with acute myeloid leukemia in a single center]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:200-203. [PMID: 30929386 PMCID: PMC7342533 DOI: 10.3760/cma.j.issn.0253-2727.2019.03.007] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
目的 评价综合老年学评估(CGA)在老年急性髓系白血病(AML)患者中预后价值。 方法 纳入73例北京医院诊断的年龄≥ 60岁的AML患者,CGA评估选取日常活动功能量表、工具性日常活动功能量表以及改良老年疾病累计评分表。以评分量表及患者年龄为标准,将患者分为适合、不适合以及脆弱组。 结果 73例患者中男46例,女27例,中位年龄75(60~89)岁。适合组37例(50.1%),不适合组14例(19.2%),脆弱组22例(30.7%),三组分别有33例(89.2%)、8例(57.1%)、10例(45.5%)患者接受化疗(标准化疗或去甲基化治疗),三组患者总反应率分别为68.7%、62.5%、75.0%(χ2=0.615,P=0.769)。适合组、不适合组、脆弱组的早期死亡率(8周死亡率)分别为5.4%、7.1%、27.3%(P<0.05),1年预计总生存率分别为64.9%、28.6%、22.7%(P<0.05)。单因素生存分析显示CGA评分、年龄、ECOG评分、WHO分型(2016)均是影响AML患者生存时间的因素(P<0.05)。 结论 CGA可预测老年AML患者的早期死亡率及远期生存。
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Affiliation(s)
- J F Bai
- Department of Hematology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
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16
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Zhao B, Mei D, Zhang J, Zou S, Lu H, Xu H, Huang B. The prognostic significance of macroscopic serosal change in subserosal invasion (stage T3) gastric cancer. Ann R Coll Surg Engl 2019; 101:249-255. [PMID: 30602290 DOI: 10.1308/rcsann.2018.0217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND For patients with gastric cancer intraoperative macroscopic serosal change is not always consistent with pathological T stage. We investigated whether macroscopic serosal change is associated with unfavourable prognosis of patients with gastric cancer. METHODS We reviewed 856 patients with stage T3 gastric cancer who underwent curative gastrectomy in our institution. All patients were classified as serosa negative and serosa positive according to the macroscopic serosal change during the operation. The prognostic difference between two groups was compared and clinicopathologic features were analysed. RESULTS The percentage of macroscopic serosal change accounted for 55.7% of all patients. Compared with normal serosal surface, the patients with macroscopic serosal change had larger tumour size, more extensive stomach involvement and more advanced stage N. The prognosis of stage T3 with macroscopic serosal change was significantly poorer than that of those with normal serosal surface, especially for those with stages T3N0 and T3N1. Multivariate analysis identified macroscopic serosal change as an independent factor associated with unfavourable prognosis of stage T3 cancer. CONCLUSION Although the depth of tumour invasion mainly depends on pathological evaluation after surgery, the prognostic significance of intraoperative macroscopic serosal change should not be ignored for those patients with subserosal invasion.
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Affiliation(s)
- B Zhao
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
| | - D Mei
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
| | - J Zhang
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
| | - S Zou
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
| | - Hn Lu
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
| | - H Xu
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
| | - B Huang
- Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China
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17
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Liu H, Gao M, Mei D, Han HX, Li JT, Bai JF, Zhang CL, Feng R, Wei JP, Tian Y, Wang T. [A comparative study of comprehensive geriatric assessment in elder patients with non-Hodgkin's lymphoma]. Zhonghua Nei Ke Za Zhi 2018; 57:330-334. [PMID: 29747287 DOI: 10.3760/cma.j.issn.0578-1426.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To measure the comprehensive geriatric assessment (CGA) in elder non-Hodgkin's Lymphoma (NHL) patients in a cross-sectional study; to compare the differences between Eastern Cooperative Oncology Group (ECOG)-performance status (PS) and CGA. Methods: CGA stratification included the following 3 instrument assessments: activity of daily living (ADL);instrumental activity of daily living (IADL);comorbidity score according to the modified cumulative illness rating score for geriatrics (MCIRS-G). According to CGA and age, NHL patients, aged ≥60 years, were classified as"fit","unfit"and"frail"groups. ECOG-PS was evaluated and compared with CGA. Results: According to CGA, 51.6% senior NHL patients (33 cases) were classified as"fit", 12.5%(8 cases) as"unfit"and 35.9%(23 cases) as"frail". Several comorbidities were observed in majority patients, such as cardiovascular disease, diabetes mellitus and hypertension. In the"younger aged"patients between 60 to 64ys, 25%(3/12) was considered as"frail". However, this proportion increased to 42.9%(6/14) in patients older than 80ys. Moreover, impaired CGA was observed in 38.9%(21/54) of ECOG-PS ≤1 patient. Conclusions: Impaired CGA is as common as approximately half in elderly NHL patients and more than one third even in ECOG-PS ≤1 patients. ECOG-PS may underestimate the impaired fitness function in elder NHL patients.
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Affiliation(s)
- H Liu
- Department of Hematology, Beijing Hospital, Beijing 100730, China
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18
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Zhao B, Li M, Ren C, Liu XY, Mei D. Aggravated nausea and vomiting induced by fat emulsion for hyperemesis gravidarum: A case report. J Clin Pharm Ther 2017; 42:618-620. [PMID: 28474354 DOI: 10.1111/jcpt.12545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/03/2017] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Total parental nutrition (TPN) for hyperemesis gravidarum (HG) is generally effective and well-tolerated. We report a case of aggravated nausea and vomiting caused by fat emulsion. CASE DESCRIPTION A 40-year-old pregnant woman through IVF was admitted to the hospital at 11-week gestation and diagnosed with HG. During TPN treatment, the patient suffered from aggravated nausea and vomiting. We identified fat emulsion as the most likely culprit using challenge, dechallenge and rechallenge. WHAT IS NEW AND CONCLUSION This is the first report of fat emulsion aggravating nausea and vomiting in such situation.
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Affiliation(s)
- B Zhao
- Department of Pharmacy, Peking Union Medical College Hospital, Beijing, China
| | - M Li
- Department of Pharmacy, Peking Union Medical College Hospital, Beijing, China.,Department of Pharmacy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - C Ren
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - X Y Liu
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - D Mei
- Department of Pharmacy, Peking Union Medical College Hospital, Beijing, China
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19
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Wallen SP, Lee J, Mei D, Chong C, Kevrekidis PG, Boechler N. Discrete breathers in a mass-in-mass chain with Hertzian local resonators. Phys Rev E 2017; 95:022904. [PMID: 28297872 DOI: 10.1103/physreve.95.022904] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Indexed: 11/07/2022]
Abstract
We report on the existence of discrete breathers in a one-dimensional, mass-in-mass chain with linear intersite coupling and nonlinear, precompressed Hertzian local resonators, which is motivated by recent studies of the dynamics of microspheres adhered to elastic substrates. After predicting theoretically the existence of discrete breathers in the continuum and anticontinuum limits of intersite coupling, we use numerical continuation to compute a family of breathers interpolating between the two regimes in a finite chain, where the displacement profiles of the breathers are localized around one lattice site. We then analyze the frequency-amplitude dependence of the breathers by performing numerical continuation on a linear eigenmode (vanishing amplitude) solution of the system near the upper band gap edge. Finally, we use direct numerical integration of the equations of motion to demonstrate the formation and evolution of the identified localized modes in energy-conserving and dissipative scenarios, including within settings that may be relevant to future experimental studies.
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Affiliation(s)
- S P Wallen
- Department of Mechanical Engineering, University of Washington, Seattle, Washington 98195, USA
| | - J Lee
- Department of Mathematics and Statistics, University of Massachusetts, Amherst, Massachusetts 01003-4515, USA
| | - D Mei
- Department of Mathematics and Statistics, University of Massachusetts, Amherst, Massachusetts 01003-4515, USA
| | - C Chong
- Department of Mathematics, Bowdoin College, Brunswick, Maine 04011, USA
| | - P G Kevrekidis
- Department of Mathematics and Statistics, University of Massachusetts, Amherst, Massachusetts 01003-4515, USA
| | - N Boechler
- Department of Mechanical Engineering, University of Washington, Seattle, Washington 98195, USA
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20
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Capuano A, Vollono C, Rubino M, Mei D, Calì C, De Angelis A, Di Trapani G, Servidei S, Della Marca G. Hypnic Headache: Actigraphic and Polysomnographic Study of a Case. Cephalalgia 2016; 25:466-9. [PMID: 15910573 DOI: 10.1111/j.1468-2982.2005.00871.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- A Capuano
- Institute of Neurology, Department of Neurosciences, Catholic University, 8-00168 Rome, Italy
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21
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Conti V, Pantaleo M, Barba C, Baroni G, Mei D, Buccoliero AM, Giglio S, Giordano F, Baek ST, Gleeson JG, Guerrini R. Focal dysplasia of the cerebral cortex and infantile spasms associated with somatic 1q21.1-q44 duplication including the AKT3 gene. Clin Genet 2014; 88:241-7. [PMID: 25091978 DOI: 10.1111/cge.12476] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/15/2014] [Accepted: 07/30/2014] [Indexed: 02/01/2023]
Abstract
Somatic and germline duplications or activating mutations of AKT3 have been reported in patients with hemimegalencephaly and megalencephaly. We performed array comparative genomic hybridization on brain tissue and blood in 16 consecutive patients with symptomatic epilepsy due to focal or multilobar malformations of cortical development who underwent surgical treatment of epilepsy. One patient with infantile spasms and a dysplastic left frontal lobe harboured a somatic trisomy of the 1q21.1-q44 chromosomal region, encompassing the AKT3 gene, in the dysplastic brain tissue but not in blood and saliva. Histopathology revealed severe cortical dyslamination, a thin cortex in the premotor area with microgyri and microsulci, immature neurons with disoriented dendrites and areas of cortical heterotopia in the sub-cortical white matter. These cytoarchitectural changes are close to those defining type Ib focal cortical dysplasia. Immunohistochemistry in brain specimens showed hyperactivation of the PI3K/AKT/mTOR pathway. These findings indicate that AKT3 upregulation may cause focal malformations of cortical development. There appears to be an etiologic continuum between hemimegalencephaly and focal cortical dysplastic lesions. The extent of brain malformations due to AKT3 upregulation may be related to the embryonic stage when the post-zygotic gene alteration occurs.
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Affiliation(s)
- V Conti
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - M Pantaleo
- Medical Genetics Unit, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - C Barba
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - G Baroni
- Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
| | - D Mei
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - A M Buccoliero
- Pathology Unit, A. Meyer Children's Hospital, Florence, Italy
| | - S Giglio
- Medical Genetics Unit, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - F Giordano
- Division of Neurosurgery, A. Meyer Children's Hospital, Florence, Italy
| | - S T Baek
- Department of Neurosciences, Howard Hughes Medical Institute, University of California San Diego, La Jolla, CA, USA
| | - J G Gleeson
- Department of Neurosciences, Howard Hughes Medical Institute, University of California San Diego, La Jolla, CA, USA
| | - R Guerrini
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy.,Epilepsy and Clinical Neurophysiology Laboratory, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
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Righini A, Frassoni C, Inverardi F, Parazzini C, Mei D, Doneda C, Re TJ, Zucca I, Guerrini R, Spreafico R, Triulzi F. Bilateral cavitations of ganglionic eminence: a fetal MR imaging sign of halted brain development. AJNR Am J Neuroradiol 2013; 34:1841-5. [PMID: 23598830 DOI: 10.3174/ajnr.a3508] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
SUMMARY Ganglionic eminence is the main transitory proliferative structure of the ventral telencephalon in human fetal brain and it contributes for at least 35% to the population of cortical interneurons; however data on the human GE anomalies are scarce. We report 5 fetal MR imaging observations with bilateral symmetric cavitations in their GE regions resembling an inverted open C shape and separating the GE itself form the deeper parenchyma. Imaging, neuropathology, and follow-up features suggested a malformative origin. All cases had in common characteristics of lissencephaly with agenesis or severe hypoplasia of corpus callosum of probable different genetic basis. From our preliminary observation, it seems that GE cavitations are part of conditions which are also accompanied by severe cerebral structure derangement.
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Affiliation(s)
- A Righini
- Radiology and Neuroradiology Department, Children's Hospital V. Buzzi, Milan, Italy
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23
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Clapham KR, Yu TW, Ganesh VS, Barry B, Chan Y, Mei D, Parrini E, Funalot B, Dupuis L, Nezarati MM, du Souich C, van Karnebeek C, Guerrini R, Walsh CA. FLNA genomic rearrangements cause periventricular nodular heterotopia. Neurology 2012; 78:269-78. [PMID: 22238415 DOI: 10.1212/wnl.0b013e31824365e4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify copy number variant (CNV) causes of periventricular nodular heterotopia (PNH) in patients for whom FLNA sequencing is negative. METHODS Screening of 35 patients from 33 pedigrees on an Affymetrix 6.0 microarray led to the identification of one individual bearing a CNV that disrupted FLNA. FLNA-disrupting CNVs were also isolated in 2 other individuals by multiplex ligation probe amplification. These 3 cases were further characterized by high-resolution oligo array comparative genomic hybridization (CGH), and the precise junctional breakpoints of the rearrangements were identified by PCR amplification and sequencing. RESULTS We report 3 cases of PNH caused by nonrecurrent genomic rearrangements that disrupt one copy of FLNA. The first individual carried a 113-kb deletion that removes all but the first exon of FLNA. A second patient harbored a complex rearrangement including a deletion of the 3' end of FLNA accompanied by a partial duplication event. A third patient bore a 39-kb deletion encompassing all of FLNA and the neighboring gene EMD. High-resolution oligo array CGH of the FLNA locus suggests distinct molecular mechanisms for each of these rearrangements, and implicates nearby low copy repeats in their pathogenesis. CONCLUSIONS These results demonstrate that FLNA is prone to pathogenic rearrangements, and highlight the importance of screening for CNVs in individuals with PNH lacking FLNA point mutations.
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Affiliation(s)
- K R Clapham
- Harvard-MIT Division of Health Sciences and Technology, Boston, MA, USA
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24
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Marini C, Mei D, Parmeggiani L, Norci V, Calado E, Ferrari A, Moreira A, Pisano T, Specchio N, Vigevano F, Battaglia D, Guerrini R. Protocadherin 19 mutations in girls with infantile-onset epilepsy. Neurology 2010; 75:646-53. [PMID: 20713952 DOI: 10.1212/wnl.0b013e3181ed9e67] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore the causative role of PCDH19 gene (Xq22) in female patients with epilepsy. METHODS We studied a cohort of 117 female patients with febrile seizures (FS) and a wide spectrum of epilepsy phenotypes including focal and generalized forms with either sporadic or familial distribution. RESULTS PCDH19 screening showed point mutations in 13 probands (11%). Mean age at seizure onset was 8.5 months; 8 patients (62%) presented with FS, 4 (33%) with cluster of focal seizures, and 1 with de novo status epilepticus (SE). Subsequent seizure types included afebrile tonic-clonic, febrile, and afebrile SE, absences, myoclonic, and focal seizures. Seven patients (54%) had a clinical diagnosis consistent with Dravet syndrome (DS); 6 (46%) had focal epilepsy. In most patients, seizures were particularly frequent at onset, manifesting in clusters and becoming less frequent with age. Mental retardation was present in 11 patients, ranging from mild (7; 64%) to moderate (1; 9%) to severe (3; 27%). Five patients (38%) had autistic features in association to mental retardation. Mutations were missense (6), truncating (2), frameshift (3), and splicing (2). Eleven were new mutations. Mutations were inherited in 3 probands (25%): 2 from apparently unaffected fathers and 1 from a mother who had had generalized epilepsy. CONCLUSIONS PCDH19 is emerging as a major gene for infantile-onset familial or sporadic epilepsy in female patients with or without mental retardation. In our cohort, epileptic encephalopathy with DS-like features and focal epilepsy of variable severity were the associated phenotypes and were equally represented.
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Affiliation(s)
- C Marini
- Child Neurology Unit, Children's Hospital A. Meyer, Viale Pieraccini 24, 50139 Firenze, Italy
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25
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Kwak JH, Hu J, Mei D, Yi CW, Kim DH, Peden CHF, Allard LF, Szanyi J. Coordinatively Unsaturated Al3+ Centers as Binding Sites for Active Catalyst Phases of Platinum on -Al2O3. Science 2009; 325:1670-3. [DOI: 10.1126/science.1176745] [Citation(s) in RCA: 634] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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26
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Mei D, Lewis R, Parrini E, Lazarou LP, Marini C, Pilz DT, Guerrini R. High frequency of genomic deletions--and a duplication--in the LIS1 gene in lissencephaly: implications for molecular diagnosis. J Med Genet 2008; 45:355-61. [DOI: 10.1136/jmg.2007.056507] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Mei D, Parrini E, Pasqualetti M, Tortorella G, Franzoni E, Giussani U, Marini C, Migliarini S, Guerrini R. Multiplex ligation-dependent probe amplification detects DCX gene deletions in band heterotopia. Neurology 2007; 68:446-50. [PMID: 17283321 DOI: 10.1212/01.wnl.0000252945.75668.5d] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Subcortical band heterotopia (SBH, or double cortex syndrome) is a neuronal migration disorder consisting of heterotopic bands of gray matter located between the cortex and the ventricular surface, with or without concomitant pachygyria. Most cases show diffuse or anteriorly predominant (A>P) migration abnormality. All familial and 53% to 84% of sporadic cases with diffuse or A>P SBH harbor a mutation of the DCX gene, leaving the genetic causes unexplained, and genetic counseling problematic, in the remaining patients. Our purpose was to verify the extent to which exonic deletions or duplications of the DCX gene would account for sporadic SBH with A>P gradient but normal gene sequencing. METHODS We identified 23 patients (22 women, 1 man) with sporadic, diffuse, or anteriorly predominant SBH. After sequencing the DCX gene and finding mutations in 12 (11 women, 1 man), we used multiplex ligation-dependent probe amplification (MLPA) to search for whole-exon deletions or duplications in the 11 remaining women. We used semiquantitative fluorescent multiplex PCR (SQF-PCR) and Southern blot to confirm MLPA findings. RESULTS MLPA assay uncovered two deletions encompassing exons 3 to 5, and one involving exon 6, in 3 of 11 women (27%) and raised the percentage of DCX mutations from 52% to 65% in our series. SQF-PCR performed in all three women and Southern blot analysis performed in two confirmed the deletions. CONCLUSIONS MLPA uncovers large genomic deletions of the DCX gene in a subset of patients with SBH in whom no mutations are found after gene sequencing. Deletions of DCX are an underascertained cause of SBH.
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Affiliation(s)
- D Mei
- Pediatric Neurology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, via Luca Giordano 13, 50123, Florence, Italy
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28
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Parrini E, Ramazzotti A, Dobyns WB, Mei D, Moro F, Veggiotti P, Marini C, Brilstra EH, Dalla Bernardina B, Goodwin L, Bodell A, Jones MC, Nangeroni M, Palmeri S, Said E, Sander JW, Striano P, Takahashi Y, Van Maldergem L, Leonardi G, Wright M, Walsh CA, Guerrini R. Periventricular heterotopia: phenotypic heterogeneity and correlation with Filamin A mutations. Brain 2006; 129:1892-906. [PMID: 16684786 DOI: 10.1093/brain/awl125] [Citation(s) in RCA: 232] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Periventricular heterotopia (PH) occurs when collections of neurons lay along the lateral ventricles or just beneath. Human Filamin A gene (FLNA) mutations are associated with classical X-linked bilateral periventricular nodular heterotopia (PNH), featuring contiguous heterotopic nodules, mega cisterna magna, cardiovascular malformations and epilepsy. FLNA encodes an F-actin-binding cytoplasmic phosphoprotein and is involved in early brain neurogenesis and neuronal migration. A rare, recessive form of bilateral PNH with microcephaly and severe delay is associated with mutations of the ADP-ribosylation factor guanine nucleotide-exchange factor-2 (ARFGEF2) gene, required for vesicle and membrane trafficking from the trans-Golgi. However, PH is a heterogeneous disorder. We studied clinical and brain MRI of 182 patients with PH and, based on its anatomic distribution and associated birth defects, identified 15 subtypes. Classical bilateral PNH represented the largest group (98 patients: 54%). The 14 additional phenotypes (84 patients: 46%) included PNH with Ehlers-Danlos syndrome (EDS), temporo-occipital PNH with hippocampal malformation and cerebellar hypoplasia, PNH with fronto-perisylvian or temporo-occipital polymicrogyria, posterior PNH with hydrocephalus, PNH with microcephaly, PNH with frontonasal dysplasia, PNH with limb abnormalities, PNH with fragile-X syndrome, PNH with ambiguous genitalia, micronodular PH, unilateral PNH, laminar ribbon-like and linear PH. We performed mutation analysis of FLNA in 120 patients, of whom 72 (60%) had classical bilateral PNH and 48 (40%) other PH phenotypes, and identified 25 mutations in 40 individuals. Sixteen mutations had not been reported previously. Mutations were found in 35 patients with classical bilateral PNH, in three with PNH with EDS and in two with unilateral PNH. Twenty one mutations were nonsense and frame-shift and four missense. The high prevalence of mutations causing protein truncations confirms that loss of function is the major cause of the disorder. FLNA mutations were found in 100% of familial cases with X-linked PNH (10 families: 8 with classical bilateral PNH, 1 with EDS and 1 with unilateral PH) and in 26% of sporadic patients with classical bilateral PNH. Overall, mutations occurred in 49% of individuals with classical bilateral PNH irrespective of their being familial or sporadic. However, the chances of finding a mutation were exceedingly gender biased with 93% of mutations occurring in females and 7% in males. The probability of finding FLNA mutations in other phenotypes was 4% but was limited to the minor variants of PNH with EDS and unilateral PNH. Statistical analysis considering all 42 mutations described so far identifies a hotspot region for PNH in the actin-binding domain (P < 0.05).
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Affiliation(s)
- E Parrini
- Research Institute, I.R.C.C.S, Stella Maris Foundation, University of Pisa, Italy
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29
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Abstract
The aim of the study is to evaluate the efficacy and tolerability of the five triptans that are commercially available in Italy (zolmitriptan 2.5 mg, rizatriptan 10 mg, sumatriptan 100 mg, almotriptan 12.5 mg and eletriptan 40 mg). The study was conducted in single-blind versus placebo and its duration was 18 months. At the Headache Centre of the 'Agostino Gemelli' Hospital in Rome we selected 42 patients, suffering from headache with and without aura (International Headache Society Committee on Headache Classification, 1988 Cephalalgia 8:1-96), whose headache frequency ranged between 1- and 4-monthly crises. For a total of 25 crises, for every five consecutive crises, a different triptan was taken. The end-points of the study were as follows: response at 2 h, 'pain free' at 2 h and 'sustained pain free' (at 24 h). The intra-patient consistency and the tolerability were also evaluated. Thirty patients completed the study and the statistical analysis was only applied to these patients. No substantial difference in terms of the efficacy of the triptans was noted; all triptans were well tolerated. These results suggest the possibility of testing different triptans in the same patient in order to identify the ideal drug for every patient.
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Affiliation(s)
- C Vollono
- Headache Center, Università Cattolica del Sacro Cuore, Rome, Italy
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30
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Aalseth C, Anderson D, Arthur R, Avignone F, Baktash C, Ball T, Barabash A, Bertrand F, Brodzinski R, Brudanin V, Bugg W, Champagne A, Chan YD, Cianciolo T, Collar J, Creswick R, Descovich M, Di Marco M, Doe P, Dunham G, Efremenko Y, Egerov V, Ejiri H, Elliott S, Emanuel A, Fallon P, Farach H, Gaitskell R, Gehman V, Grzywacz R, Hallin A, Hazma R, Henning R, Hime A, Hossbach T, Jordan D, Kazkaz K, Kephart J, King G, Kochetov O, Konovalov S, Kouzes R, Lesko K, Luke P, Luzum M, Macchiavelli A, McDonald A, Mei D, Miley H, Mills G, Mokhtarani A, Nomachi M, Orrell J, Palms J, Poon A, Radford D, Reeves J, Robertson R, Runkle R, Rykaczewski K, Saburov K, Sandukovsky Y, Sonnenschein A, Tornow W, Tull C, van de Water R, Vanushin I, Vetter K, Warner R, Wilkerson J, Wouters J, Young A, Yumatov V. The proposed Majorana 76Ge double-beta decay experiment. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.nuclphysbps.2004.11.052] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [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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31
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Mei D, Capuano A, Vollono C, Evangelista M, Ferraro D, Tonali P, Di Trapani G. Topiramate in migraine prophylaxis: a randomised double-blind versus placebo study. Neurol Sci 2004; 25:245-50. [PMID: 15624081 DOI: 10.1007/s10072-004-0350-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2004] [Accepted: 11/25/2004] [Indexed: 10/26/2022]
Abstract
The objectives of this paper are to evaluate the efficacy and tolerability of topiramate, given at the dose of 100 mg/day, in the prophylactic treatment of migraine. The hypothesis that migraine is the result of a condition of neuronal hyperexcitability and the quest for drugs that are able to limit the number of crises justifies the attempt to utilise the new antiepileptic drugs in the prophylaxis of this pathology, which is so important due to its high prevalence and due to the high disability it causes. The study was randomised double-blind versus placebo, lasting 16 weeks, and was preceded by a run-in period of 4 weeks. One hundred and fifteen patients were randomly allocated to treatment with topiramate (TPM) or placebo: 35 patients completed the study in the TPM group and 37 patients in the placebo group. At the end of the double-blind phase of study, in the TPM group, we recorded a significant reduction in the frequency of migraine crises (from 5.26 at baseline to 2.60 in the last 4 weeks), a significant reduction in the quantity of symptomatic drugs taken as compared to the placebo control group (from 6.17+/-1.80 SD to 2.57+/-0.80) and a significant downward trend in the number of days of disability over the 16-week period of therapy. In the TPM group, side effects were transient and well tolerated. TPM has thus proven its efficacy and tolerability in the prophylaxis of migraine.
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Affiliation(s)
- D Mei
- Center for the Study of Headaches, Policlinico Universitario Agostino Gemelli, Istituto di Neurologia, L.go Agostino Gemelli 8, I-00168 Rome, Italy.
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32
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Guerrini R, Mei D, Sisodiya S, Sicca F, Harding B, Takahashi Y, Dorn T, Yoshida A, Campistol J, Krämer G, Moro F, Dobyns WB, Parrini E. Germline and mosaic mutations of FLN1 in men with periventricular heterotopia. Neurology 2004; 63:51-6. [PMID: 15249610 DOI: 10.1212/01.wnl.0000132818.84827.4d] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To describe the phenotypic spectrum and genetics of periventricular nodular heterotopia (PNH) caused by FLN1 mutations in four men. BACKGROUND X-linked PNH caused by FLN1 mutations (MIM #300049) implies prenatal or early postnatal lethality in boys and 50% recurrence risk in daughters of affected women. METHODS Clinical examination, cognitive testing, MRI, and mutation analysis (denaturing high-performance liquid chromatography and direct sequencing) on blood lymphocytes and single hair roots were performed for nine affected individuals, including three men. Neuropathologic study of the brain was performed for an affected boy. RESULTS In two families, missense mutations were transmitted from mother to son (Met102Val) and from father to daughter (Ser149Phe), causing mild phenotypes in both genders, including unilateral PNH. In a third family, a man was mosaic for an A>G substitution (intron 11 acceptor splice site) on leukocyte DNA and hair roots (mutant = 42% and 69%). Single hair root analysis confirmed that the mutation was not present in all ectodermal derivative cells. A healthy daughter had inherited the X chromosome from her father's wild-type germinal cell population. In the fourth family, an eight-base deletion (AGGAGGTG, intron 25 donor splice site) led to early deaths of boys. Postmortem study in a newborn boy revealed PNH and cardiovascular, genitourinary, and gut malformations. CONCLUSIONS Periventricular nodular heterotopia caused by FLN1 mutations in men has a wide clinical spectrum and is caused by different genetic mechanisms, including somatic mosaicism. Mutation analysis of FLN1 should support genetic counseling in men with periventricular nodular heterotopia.
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MESH Headings
- Abnormalities, Multiple/genetics
- Brain Diseases/genetics
- Cell Movement/genetics
- Cerebral Ventricles/abnormalities
- Child, Preschool
- Choristoma/genetics
- Chromosomes, Human, X/genetics
- Cisterna Magna/abnormalities
- Contractile Proteins/deficiency
- Contractile Proteins/genetics
- DNA Mutational Analysis
- Dosage Compensation, Genetic
- Female
- Filamins
- Genes, Lethal
- Genetic Diseases, X-Linked/diagnosis
- Genetic Diseases, X-Linked/genetics
- Germ-Line Mutation
- Hair Follicle/chemistry
- Humans
- Infant, Newborn
- Introns/genetics
- Male
- Microfilament Proteins/deficiency
- Microfilament Proteins/genetics
- Middle Aged
- Mosaicism
- Mutation, Missense
- Neurons/pathology
- Pedigree
- Phenotype
- Point Mutation
- RNA Splice Sites/genetics
- Sequence Deletion
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Affiliation(s)
- R Guerrini
- Division of Child Neurology and Psychiatry, University of Pisa and IRCCS Fondazione Stella Maris, via dei Giacinti 2, 56018 Calambrone Pisa, Italy.
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33
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Capuano A, Vollono C, Mei D, Pierguidi L, Ferraro D, Di Trapani G. Antiepileptic drugs in migraine prophylaxis: state of the art. Clin Ter 2004; 155:79-87. [PMID: 15244112] [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: 04/30/2023]
Abstract
Antiepileptic drugs have proven their efficacy in the prophylactic treatment of migraine. Our study comprises a clinical trial that examines the efficacy of gabapentin and topiramate and a description of the pharmacologic characteristics and the efficacy of tiagabine, lamotrigine, levetiracetam and zonisamide. Antiepileptic drugs have multiple modes of action which can explain their efficacy in reducing neuronal excitability which is proven in epilepsy and postulated in migraine. The relationship between epilepsy and migraine has, in fact, been much debated but never convincingly proven. Antiepileptic drugs could be useful in migraine prophylaxis as some of these have determined a reduction in the monthly frequency and intensity of crises in subjects suffering from migraine with and without aura. These are the aims that have been proposed by the U.S. Headache Consortium Evidence-Based Guidelines. Further double-blind placebo-controlled studies are necessary in order to assess their safety and efficacy.
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Affiliation(s)
- A Capuano
- Neurology Institute, Headache Center, Università Cattolica Sacro Cuore Roma, Italia
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34
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Sicca F, Kelemen A, Genton P, Das S, Mei D, Moro F, Dobyns WB, Guerrini R. Mosaic mutations of the LIS1 gene cause subcortical band heterotopia. Neurology 2003; 61:1042-6. [PMID: 14581661 DOI: 10.1212/wnl.61.8.1042] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Subcortical band heterotopia (SBH) is a neuronal migration disorder. DCX mutations are responsible for almost all familial cases, 80% of sporadic female cases, and 25% of sporadic male cases of SBH, and are associated with more severe gyral and migration abnormality over the anterior brain regions. Somatic mosaicism has previously been hypothesized in a patient with posteriorly predominant SBH and a mutation of the LIS1 gene, which is usually mutated in patients with severe lissencephaly. The authors identified mosaic mutations of LIS1 in two patients (Patients 1 and 2) with predominantly posterior SBH. METHODS After ruling out DCX mutations, the authors performed sequencing of the LIS1 gene in lymphocyte DNA. Because sequence peaks in both patients were suggestive of mosaic mutations, they followed up with denaturing high-pressure liquid chromatography analysis on blood and hair root DNA and compared the areas of heteroduplex and homoduplex peaks. A third patient showing the same mutation as Patient 2 but with no evidence of mosaicism was used for comparing the phenotype of mosaic vs full mutation. RESULTS The two patients with posterior SBH harbored a missense (Arg241Pro) and a nonsense (R8X) mosaic mutation of LIS1. The rate of mosaicism in Patient 1 was 18% in the blood and 21% in the hair roots, whereas in Patient 2 it was 24% and 31% in the same tissues. The patient with a full R8X mutation of LIS1 had severe lissencephaly. CONCLUSIONS Subcortical band heterotopia can occur with mosaic mutations of the LIS1 gene. Mutation analysis of LIS1, using highly sensitive techniques such as denaturing high-pressure liquid chromatography, should be considered for patients with posteriorly predominant subcortical band heterotopia and pachygyria.
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Affiliation(s)
- F Sicca
- Division of Child Neurology and Psychiatry, University of Pisa, Italy
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35
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Abstract
We report the case of a policeman who suffered a severe head injury to the right temporoparietal lobe while driving a police car. Four years later, the patient developed a neoplasm at the precise site of the meningocerebral scar. Histological examination confirmed a glioblastoma multiforme adjacent to the dural scar. Radiological documentation of the absence of tumor at the time of injury, exact localization of the neoplasm in the injured cerebral area, and latency of the cancer supported the hypothesis of a causal relationship with brain trauma. Physicians faced with brain neoplasms in adults should carefully investigate the patient's personal history of head trauma. When a relationship with occupational head injury is probable, reporting of suspect occupational illness is compelling.
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Affiliation(s)
- N Magnavita
- Institute of Occupational Medicine, Catholic University School of Medicine, Rome, Italy
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36
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Mazza S, Anzelmo V, Bianco P, Di Trapani G, Mei D, Bizzarro A, Castellino N. [Work capacity of an epileptic patient receiving pharmacological therapy]. G Ital Med Lav Ergon 2001; 23:47-57. [PMID: 11775376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- S Mazza
- Istituto di Neurologia Università Cattolica S. Cuore, Roma
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37
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Abstract
Background
Carbon monoxide (CO) is produced by reaction of isoflurane, enflurane, and desflurane in desiccated carbon dioxide absorbents. The inspiratory CO concentration depends on the dryness and identity of the absorbent and anesthetic. The adaptation of existing mathematical models to a rebreathing circuit allows identification of patient factors that predispose to more severe exposures, as identified by carboxyhemoglobin concentration.
Methods
From our companion study, the authors used quantitative in vitro CO production data for 60 min at 7.5% desflurane or 1.5% isoflurane at 1 l/min fresh gas flow. The carboxyhemoglobin concentration was calculated by iteratively solving the Coburn Forster Kane equation modified for a rebreathing system that incorporates the removal of CO by patient absorption. Demonstrating good fit of predicted carboxyhemoglobin concentrations to published data from animal and human exposures validated the model. Carboxyhemoglobin concentrations were predicted for exposures of various severity, patients of different sizes, hematocrit, and fraction of inspired oxygen.
Results
The calculated carboxyhemoglobin concentrations closely predicted the experimental results of other investigators, thereby validating the model. These equations indicate the severity of CO poisoning is inversely related to the hemoglobin quantity of a subject. Fraction of inspired oxygen had the greatest effect in patients of small size with low hematocrit values, where equilibrium and not the rate of uptake determined carboxyhemoglobin concentrations.
Conclusion
This model predicts that patients with low hemoglobin quantities will have more severe CO exposures based on the attainment of a higher carboxyhemoglobin concentration. This includes patients of small size (pediatric population) and patients with anemia.
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Affiliation(s)
- H J Woehlck
- Department of Anesthesiology, Medical College of Wisconsin and Froedtert Memorial Lutheran Hospital, Milwaukee 53226, USA.
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Di Trapani G, Mei D, Marra C, Mazza S, Capuano A. Gabapentin in the prophylaxis of migraine: a double-blind randomized placebo-controlled study. Clin Ter 2000; 151:145-8. [PMID: 10958046] [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: 02/17/2023]
Abstract
OBJECTIVE Gabapentin is an antiepileptic drug of new generation that increases brain GABA levels. We report the results of a three-month randomised double-blind placebo-controlled study on the effects of gabapentin in the prophylaxis of patients with migraine meeting the IHS criteria. PATIENTS AND METHODS We treated 63 patients suffering from migraine with or without aura. Patients treated their attack at home using symptomatic drugs and clinical assessment was recorded on a diary. After a washout of 8 week from any other prophylactic treatment, all patients were treated with 1200 mg/day of gabapentin; this is our therapeutic plan: 400 mg/day from 1st to 3rd day, 800 mg/day from 4th to 6th day and 1200 mg/day from 7th day. RESULTS No patients withdrew, gabapentin was well tolerated; adverse events (somnolence, dizziness, tremor, fatigue and ataxia) generally were transient and mild to moderate in severity and in 13 patients (27%) only occurred. At the end of treatment, in such case, we reported a significative reduction of frequency and intensity of migraine in 30 patients treated with gabapentin. DISCUSSION Our observations indicate that gabapentin is well tolerated by patients and that reduces headache frequency and use of symptomatic drugs in both groups. Gabapentin shows to have an effective therapeutic action in the prophylactic treatment of migraine.
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Affiliation(s)
- G Di Trapani
- Institute of Neurology, Catholic University, Rome, Italy.
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Mei D, Xu B, Sun K, Wang LH, Zhang W. [Changes of serum biochemical parameters during hypothermia and hypoxia in rats]. Space Med Med Eng (Beijing) 1999; 12:274-6. [PMID: 11542710] [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: 02/21/2023]
Abstract
OBJECTIVE To study the effects of hypothermia and hypoxia on serum biochemical parameters. Method Acute hypobaric hypoxia experiment in cold environment was carried out in 48 healthy Wistar rats to observe changes of hepatic, cardiac and renal functions. RESULT Hepatic, cardiac and renal functions changed non-prominently after acute hypoxia exposure under cold condition. Under hypoxic exposure of the same degree, serum lactic dehydrogenase(LDH), alanine transaminase(ALT), blood urea nitrogen (BUN) and creatinine (Cr) increased more significantly at 10 degrees C than those at 20 degrees C (P < 0.01) while creatine kinase (CK) decreased significantly at 10 degrees C than that at 20 degrees C. CONCLUSION After acute hypoxia in cold environment, the changes in cardiac function did not simply equal to the changes by cold environment plus changes by acute hypoxia.
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Affiliation(s)
- D Mei
- Air Force Medical College, Jilin, China
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Cavani A, Mei D, Guerra E, Corinti S, Giani M, Pirrotta L, Puddu P, Girolomoni G. Patients with allergic contact dermatitis to nickel and nonallergic individuals display different nickel-specific T cell responses. Evidence for the presence of effector CD8+ and regulatory CD4+ T cells. J Invest Dermatol 1998; 111:621-8. [PMID: 9764843 DOI: 10.1046/j.1523-1747.1998.00334.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To investigate the mechanisms underlying the expression of allergic contact dermatitis, we compared the characteristics of nickel (Ni)-specific T cell responses in 10 patients with allergic contact dermatitis to Ni and in 10 healthy, nonallergic individuals. CD4+ T cells purified from peripheral blood of both allergic and nonallergic subjects proliferated similarly to NiSO4 in vitro, with the responses mostly restricted to CD4+ CD45RO+ memory T cells. In contrast, Ni-specific CD8+ T cell responses were detected only in allergic patients. Limiting dilution assay confirmed a high frequency of Ni-specific CD4+ T cells in both individual categories, and of Ni-specific CD8+ T cells in allergic patients, but not in nonallergic persons. Ni-specific CD4+ T cell clones prepared from nonallergic subjects displayed lower interferon-gamma and higher interleukin-10 production compared with T cell clones from allergic patients. The T cell skin-homing receptor, cutaneous lymphocyte-associated antigen, was expressed on the large majority of specific CD4+ clones from both the groups. Finally, Ni-specific CD8+ clones prepared from patients also expressed the cutaneous lymphocyte-associated antigen receptor, and released high interferon-gamma and no interleukin-4. In aggregate, the results suggest that the presence of specific CD8+ T cells and a distinct pattern of cytokine release (e.g., an augmented production of interleukin-10) by CD4+ T cells can be important elements in determining whether a hapten induces allergy or a silent immune response.
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Affiliation(s)
- A Cavani
- Laboratory of Immunology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
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Di Trapani D, Mazza S, Gregori B, Mei D. 3-21-11 Gabapentin: A novel treatment for migraine prophylaxis. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)85682-1] [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: 11/16/2022]
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Di Trapani G, Carnevale A, Scerrati M, Colosimo C, Vaccario ML, Mei D. Post-traumatic malignant glioma. Report of a case. Ital J Neurol Sci 1996; 17:283-6. [PMID: 8915759 DOI: 10.1007/bf01997787] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Only a few cases reported in the literature fulfil the currently established criteria for accepting the traumatic origin of some intracranial tumors. A case of post-traumatic glioma is presented. Several years after sustaining a commotive left parietal trauma, our patient developed symptoms of intracranial tumor. Neuroimaging (CT and MRI) showed a large neoplasia in the left temporo-parietal-occipital region, and stereotactic biopsy revealed a mixed glioma in continuity with the scar resulting from the trauma.
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Affiliation(s)
- G Di Trapani
- Istituto di Neurologia, Università Cattolica, Roma, Italy
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Mei D. Evidence for the involvement of the ATP-sensitive potassium channel in a novel model of hypoxic preconditioning in dogs. Cardiovasc Res 1995. [DOI: 10.1016/0008-6363(95)00023-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abstract
Based on numerical simulation it is found that three-dimensional periodic patterns with micrometer or submicrometer lattice constants, such as those with simple cubic, face-centered cubic, body-centered cubic, or body-centered tetragonal symmetry, can be formed by use of multiple laser beam interference. Changes in the number and angle of the incident beams result in different spatial patterns, whereas variation of the incident wavelength affects only the lattice constant of the patterns. Face-centered cubic and body-centered tetragonal patterns have been observed experimentally. Our results, combined with the optical trapping of dielectric particles, might provide a promising approach to the realization of a new kind of material-a photonic crystal.
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