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Brown TR, Amir H, Hirsch D, Jansen MO. Designing a Novel Digitally Delivered Antiracism Intervention for Mental Health Clinicians: Exploratory Analysis of Acceptability. JMIR Hum Factors 2024; 11:e52561. [PMID: 38568730 PMCID: PMC11024743 DOI: 10.2196/52561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND There is a great need for evidence-based antiracism interventions targeting mental health clinicians to help mitigate mental health disparities in racially and ethnically minoritized groups. OBJECTIVE This study provides an exploratory analysis of mental health clinicians' perspectives on the acceptability of a web-based antiracism intervention. METHODS Mental health clinicians were recruited from a single academic medical center through outreach emails. Data were collected through individual 30-minute semistructured remote video interviews with participants, then recorded, transcribed, and analyzed using content analysis. RESULTS A total of 12 mental health clinicians completed the study; 10 out of 12 (83%) were female candidates. Over half (7/12, 58%) of the respondents desired more robust antiracism training in mental health care. Regarding the web-based antiracism intervention, (8/12, 67%) enjoyed the digitally delivered demo module, (7/12, 58%) of respondents suggested web-based content would be further enhanced with the addition of in-person or online group components. CONCLUSIONS Our results suggest a strong need for additional antiracist training for mental health clinicians. Overall, participants responded favorably to novel web-based delivery methods for an antiracism intervention. These findings provide important support for future development and pilot testing of a large-scale digitally enhanced antiracist curriculum targeting mental health clinicians.
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Affiliation(s)
- Tashalee Rushell Brown
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Habiba Amir
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Drew Hirsch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Madeline Owens Jansen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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Slutzky-Shraga I, Hirsch D, Gorshtein A, Masri-Iraqi H, Shochat T, Robenshtok E, Shimon I, Tsvetov G. Features of patients and fracture risk in hypoparathyroidism; a single center study. J Endocrinol Invest 2024; 47:593-601. [PMID: 37610611 DOI: 10.1007/s40618-023-02177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/16/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE Patients with hypoparathyroidism (hypoPT) have low bone turnover and high bone mineral density (BMD). However, data on fracture risk are conflicting. The objectives of this study were: 1. To describe clinical/biochemical characteristics of hypoPT patients followed at a single medical center. 2. To identify postsurgical hypoPT patients and investigate their fracture rate compared with gender/age-matched post-surgical normocalcemic patients. METHODS Retrospective analysis of patient's medical records treated at the tertiary medical center in 2010-2021 identified by computerized medical database search. RESULTS The cohort included 133 patients (91% women, mean age 64 ± 13 years) of whom 105 (79%) had post-thyroidectomy hypoparathyroidism and the remainder had an autoimmune/idiopathic/other etiology. Mean follow-up time was 21 ± 12 and 27 ± 12 years, respectively. The control group included 142 post-thyroidectomy patients without hypoparathyroidism. Patients in the postsurgical hypoparathyroidism group were older and had higher calcium and PTH levels at diagnosis than the non-surgical hypoPT patients. Comparing the postsurgical hypoPT and postsurgical normocalcemic control patients revealed a significantly higher BMD in the hypoPT group. Yet, fracture rates were 31% in the postsurgical hypoparathyroidism group and 21% in the control group (P = 0.1) over a similar median follow-up period (17 and 18.4 years, respectively). In both groups the most common fracture site was the spine (50% and 70%, respectively; p = 0.33), mainly nonclinical morphometric fractures. Higher phosphorus blood level was associated with increased fracture risk. CONCLUSIONS The relatively high BMD in patients with postsurgical hypoparathyroidism is not associated with lower fracture risk. Silent morphometric fractures are quite common in this group of patients.
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Affiliation(s)
- I Slutzky-Shraga
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
- Clalit Healthcare Services, Yaffo District, Tel Aviv, Israel.
- Department of Endocrinology, Diabetes & Metabolism, Rabin Medical Center - Beilinson Hospital, 39 Jabotinski St., 4941492, Petach Tikva, Israel.
| | - D Hirsch
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Gorshtein
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Masri-Iraqi
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T Shochat
- Statistical Consulting Unit, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - E Robenshtok
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I Shimon
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Tsvetov
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Hirsch D. [Colorectal tumor evolution in inflammatory bowel disease : Dynamics of genomic alterations and potential molecular markers to predict malignant progression]. Pathologe 2019; 40:232-238. [PMID: 31811372 DOI: 10.1007/s00292-019-00709-3] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Inflammatory bowel diseases (IBDs) increase the risk for colorectal cancer (CRC). In IBD, the evolution of potential tumor clones occurs long before neoplastic lesions become evident and these clones can be undetectable by endoscopy and histology at early stages. The spectrum of genomic alterations in IBD-associated colorectal carcinogenesis is distinct from the changes observed in the sporadic adenoma-carcinoma sequence. Predominant alterations include aneuploidies and mutations of TP53, which both occur early in IBD-related tumorigenesis. In some IBD patients, genomic alterations can already be detected in colonic mucosa without any histologic signs of dysplasia. Genomic analysis of multiregional samples from colectomy specimens of IBD patients revealed distinct tumor evolutionary patterns. This suggests an increased genomic instability in the chronically inflamed bowel that enables the emergence of multiple, phylogenetically unrelated neoplastic lesions within the colorectum of a single IBD patient. This article summarizes the genomic alterations underlying IBD-associated colorectal tumorigenesis and the evolutionary patterns from inflamed, not yet dysplastic epithelium to CRC. Furthermore, it is discussed how this knowledge can eventually be exploited for early detection of malignant progression of IBD and thus help to improve the clinical management and surveillance schedule of IBD patients.
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Affiliation(s)
- D Hirsch
- Institut für Pathologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland. .,Genetics Branch, National Cancer Institute, National Institutes of Health, 50 South Drive, 20892, Bethesda, MD, USA.
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Abstract
Background: Bipolar sealing devices are routinely used to seal blood vessels. The aim of the study is to evaluate the feasibility and safety of colonic sealing with the use of the bipolar energy devices in rats as model for experimental appendectomy. Methods: Seventy-five male Wistar rats underwent a cecal resection with four different bipolar sealing devices or a linear stapler. The harvesting procedure was performed immediately or at postoperative day (POD) 7. The sealing front bursting pressure (BP) was measured in both groups. At POD7, the resection line was clinically examined and the hydroxyproline (HDP) levels were determined. Hematoxylin and Eosin (H&E) staining was used for histopathological evaluation of the sealing front as well. Results: There was no mortality and no insufficiency. The BPs between the bipolar sealing devices showed no statistical differences. The early phase of the seal (POD 0) provides a low BP with an 30.8% increase until POD 7. The BPs in the stapler group showed significant better values. The hydroxyproline levels did not differ statistically between the groups. Histopathologically, there were more signs of ischemic necrosis in the stapler group than in the sealing devices groups. Conclusion: The resection and sealing of the cecum as an experimental appendectomy model with the use of bipolar energy devices proved feasible and safe in rats. The different energy devices in this study produce comparable results. To justify clinical practice in humans, several studies on the underlying mechanisms of early stage wound healing are needed.
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Affiliation(s)
- E Tagkalos
- Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg University Hospital Mainz, Mainz, Germany
| | - A Heimann
- Institute for Neurosurgical Pathophysiology, Johannes Gutenberg University Hospital Mainz, Mainz, Germany
| | - T Gaiser
- Department of Pathology, University Hospital Mannheim, Mannheim, Germany
| | - D Hirsch
- Department of Pathology, University Hospital Mannheim, Mannheim, Germany
| | - I Gockel
- Department of Visceral, Transplant-, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - H Lang
- Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg University Hospital Mainz, Mainz, Germany
| | - B Jansen-Winkeln
- Department of Visceral, Transplant-, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
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Kraus TM, Imhoff FB, Reinert J, Wexel G, Wolf A, Hirsch D, Hofmann A, Stöckle U, Buchmann S, Tischer T, Imhoff AB, Milz S, Anton M, Vogt S. Stem cells and bFGF in tendon healing: Effects of lentiviral gene transfer and long-term follow-up in a rat Achilles tendon defect model. BMC Musculoskelet Disord 2016; 17:148. [PMID: 27048602 PMCID: PMC4822291 DOI: 10.1186/s12891-016-0999-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 03/25/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The influence of stem cells and lentiviral expression of basic fibroblastic growth factor (bFGF) on tendon healing and remodelling was investigated in an in-vivo long-term (12 weeks) rat Achilles tendon defect model. METHODS In sixty male Lewis rats, complete tendon defects (2.4 mm) were created and either left untreated (PBS) or treated by injection of stem cells lentivirally expressing the enhanced green fluorescence marker gene eGFP (MSC-LV-eGFP) or basic fibroblast growth factor bFGF (MSC-LV-bFGF). Tendons were harvested after 12 weeks and underwent biomechanical and (immuno)-histological analysis. RESULTS After 12 weeks the mean ultimate load to failure ratio (treated side to contralateral side) in biomechanical testing reached 97 % in the bFGF-group, 103 % in the eGFP-group and 112 % in the PBS-group. Also in the stiffness testing both MSC groups did not reach the results of the PBS group. Histologically, the MSC groups did not show better results than the control group. There were clusters of ossifications found in all groups. In immunohistology, only the staining collagen-type-I was strongly increased in both MSC groups in comparison to PBS control group. However, there were no significant differences in the (immuno)-histological results between both stem cell groups. CONCLUSION The biomechanical and (immuno)-histological results did not show positive effects of the MSC groups on tendon remodelling in a long-term follow-up. Interestingly, in later stages stem cells had hardly any effects on biomechanical results. This study inspires a critical and reflected use of stem cells in tendon healing.
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Affiliation(s)
- T M Kraus
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany. .,BG Trauma Center, Eberhard Karls University Tübingen, Tübingen, Germany.
| | - F B Imhoff
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - J Reinert
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - G Wexel
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - A Wolf
- Institute of Molecular Immunology/Experimental Oncology and Therapy Research, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - D Hirsch
- Institute of Molecular Immunology/Experimental Oncology and Therapy Research, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - A Hofmann
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - U Stöckle
- BG Trauma Center, Eberhard Karls University Tübingen, Tübingen, Germany
| | - S Buchmann
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - T Tischer
- Department of Orthopaedic Surgery, University of Rostock, Rostock, Germany
| | - A B Imhoff
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - S Milz
- Anatomische Anstalt, Ludwig Maximillians Universität, Munich, Germany
| | - M Anton
- Institute of Molecular Immunology/Experimental Oncology and Therapy Research, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - S Vogt
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.,Department of Sports Orthopaedics, Hessing Stiftung, Augsburg, Germany
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Ben-Shachar S, Ayalon I, Reznik-Wolf H, Tenenbaum-Rakover Y, Zuckerman-Levin N, Cohen O, Lifshitz A, Fraenkel M, Toledano Y, Rouach V, Koren I, Modan-Moses D, Hirsch D, Schachter-Davidov A, Israel S, Eyal O, Weintrob N. Correction: Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency. Horm Metab Res 2015; 47:e6. [PMID: 29566405 DOI: 10.1055/a-0594-0327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S Ben-Shachar
- Genetic Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Ayalon
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H Reznik-Wolf
- Genetic Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Y Tenenbaum-Rakover
- Pediatric Endocrine Unit, Ha'Emek Medical Center, Afula, Israel
- The Technion Faculty of Medicine, Haifa, Israel
| | - N Zuckerman-Levin
- The Technion Faculty of Medicine, Haifa, Israel
- Pediatric Diabetes Unit, Meyer Children's Hospital, Haifa, Israel
| | - O Cohen
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Lifshitz
- Endocrinology, Kupat-Holim Clalit, Israel
| | - M Fraenkel
- Endocrine Unit, Soroka Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y Toledano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - V Rouach
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Koren
- Pediatric Endocrinology Clinic, Armon Child Center, Clalit HMO, Haifa, Israel
| | - D Modan-Moses
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - D Hirsch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute for Endocrinology and Diabetes, Rabin Medical Center, Petah Tikva, Israel
| | - A Schachter-Davidov
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Israel
- Tissue Typing Unit, Hadassah University Hospital, Jerusalem, Israel
| | - O Eyal
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - N Weintrob
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ben-Shachar S, Ayalon I, Reznik-Wolf H, Tenenbaum-Rakover Y, Zuckerman-Levin N, Cohen O, Lifshitz A, Fraenkel M, Toledano Y, Roash V, Koren I, Modan-Moses D, Hirsch D, Schachter-Davidov A, Israel S, Eyal O, Weintrob N. Androgen Receptor CAG Repeat Length in Relation to Phenotype Among Females with Nonclassical 21-Hydroxylase Deficiency. Horm Metab Res 2015; 47:491-6. [PMID: 25230321 DOI: 10.1055/s-0034-1389901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Nonclassical 21-hydroxylase deficiency (NC21OHD) manifests with various degrees of post natal virilization. The length of CAG repeats of the androgen receptor gene (AR) is inversely correlated to activity of the human androgen receptor (AR) and affects phenotype of several androgen-dependent disorders. The aim of the study was to investigate the associations between CAG repeat length and the phenotype of females with NC21OHD. CAG repeat length and AR inactivation were assessed in females with NC21OHD, and related to their clinical presentation. CAG repeat length and AR inactivation were assessed in 119 females with NC21OHD. Biallelic mean (BAM) of the CAG repeat length and the weighted BAM (WBAM) were related to various clinical parameters. Age at diagnosis and age of menarche positively correlated with BAM (r=0.22, p=0.02, and r=0.23, p=0.01, respectively). A shorter (<25) BAM was associated with younger age at diagnosis (14.8 vs. 21.4 years, p<0.01), at adrenarche (8.1 vs. 10.2 years, p<0.01) and gonadarche (9.9 vs. 11.2 years, p<0.01), and higher corrected height standard deviation score at diagnosis (0.77 vs. 0.15, p=0.01). Precocious pubarche and precocious puberty were more frequent in these with the shorter BAM. Results of WBAM were similar. The CAG repeat length of the AR gene contributes to the clinical diversity of the phenotype in females with NC21OHD.
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Affiliation(s)
- S Ben-Shachar
- Genetic Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Ayalon
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - H Reznik-Wolf
- Genetic Institute, Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - O Cohen
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - A Lifshitz
- Endocrinology, Kupat-Holim Clalit, Israel
| | - M Fraenkel
- Endocrine Unit, Soroka Medical Center, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Y Toledano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
| | - V Roash
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - I Koren
- Pediatric Endocrinology Clinic, Armon Child Center, Clalit HMO, Haifa, Israel
| | - D Modan-Moses
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Hirsch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Schachter-Davidov
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - S Israel
- Tissue Typing Unit, Hadassah University Hospital, Jerusalem, Israel
| | - O Eyal
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - N Weintrob
- Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Alogna VK, Attaya MK, Aucoin P, Bahník Š, Birch S, Birt AR, Bornstein BH, Bouwmeester S, Brandimonte MA, Brown C, Buswell K, Carlson C, Carlson M, Chu S, Cislak A, Colarusso M, Colloff MF, Dellapaolera KS, Delvenne JF, Di Domenico A, Drummond A, Echterhoff G, Edlund JE, Eggleston CM, Fairfield B, Franco G, Gabbert F, Gamblin BW, Garry M, Gentry R, Gilbert EA, Greenberg DL, Halberstadt J, Hall L, Hancock PJB, Hirsch D, Holt G, Jackson JC, Jong J, Kehn A, Koch C, Kopietz R, Körner U, Kunar MA, Lai CK, Langton SRH, Leite FP, Mammarella N, Marsh JE, McConnaughy KA, McCoy S, McIntyre AH, Meissner CA, Michael RB, Mitchell AA, Mugayar-Baldocchi M, Musselman R, Ng C, Nichols AL, Nunez NL, Palmer MA, Pappagianopoulos JE, Petro MS, Poirier CR, Portch E, Rainsford M, Rancourt A, Romig C, Rubínová E, Sanson M, Satchell L, Sauer JD, Schweitzer K, Shaheed J, Skelton F, Sullivan GA, Susa KJ, Swanner JK, Thompson WB, Todaro R, Ulatowska J, Valentine T, Verkoeijen PPJL, Vranka M, Wade KA, Was CA, Weatherford D, Wiseman K, Zaksaite T, Zuj DV, Zwaan RA. Registered Replication Report: Schooler and Engstler-Schooler (1990). Perspect Psychol Sci 2014; 9:556-78. [PMID: 26186758 DOI: 10.1177/1745691614545653] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Trying to remember something now typically improves your ability to remember it later. However, after watching a video of a simulated bank robbery, participants who verbally described the robber were 25% worse at identifying the robber in a lineup than were participants who instead listed U.S. states and capitals-this has been termed the "verbal overshadowing" effect (Schooler & Engstler-Schooler, 1990). More recent studies suggested that this effect might be substantially smaller than first reported. Given uncertainty about the effect size, the influence of this finding in the memory literature, and its practical importance for police procedures, we conducted two collections of preregistered direct replications (RRR1 and RRR2) that differed only in the order of the description task and a filler task. In RRR1, when the description task immediately followed the robbery, participants who provided a description were 4% less likely to select the robber than were those in the control condition. In RRR2, when the description was delayed by 20 min, they were 16% less likely to select the robber. These findings reveal a robust verbal overshadowing effect that is strongly influenced by the relative timing of the tasks. The discussion considers further implications of these replications for our understanding of verbal overshadowing.
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Kraus TM, Imhoff FB, Wexel G, Wolf A, Hirsch D, Lenz L, Stöckle U, Buchmann S, Tischer T, Imhoff AB, Milz S, Anton M, Vogt S. Stem cells and basic fibroblast growth factor failed to improve tendon healing: an in vivo study using lentiviral gene transfer in a rat model. J Bone Joint Surg Am 2014; 96:761-9. [PMID: 24806013 DOI: 10.2106/jbjs.l.01794] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 02/01/2023]
Abstract
BACKGROUND The aim of this controlled study was to investigate the influence of mesenchymal stem cells (MSCs) and lentiviral (LV) expression of basic fibroblast growth factor (bFGF) on tendon remodeling in an in vivo rat model of an Achilles tendon defect. METHODS In eighty-four male Lewis rats, complete 2.4-mm tendon defects were created and were either left untreated (the phosphate-buffered saline solution [PBS] group) or were treated with mesenchymal stem cells expressing enhanced green fluorescent protein (the MSC-LV-eGFP group) or with mesenchymal stem cells expressing basic fibroblast growth factor lentivirally (the MSC-LV-bFGF group). After fourteen and twenty-eight days, the tendons were harvested and analyzed biomechanically and immunohistologically. RESULTS After fourteen days, both mesenchymal stem cell groups were slightly superior in biomechanical testing. However, only the PBS control group showed a significant increase in biomechanical results over time (fourteen versus twenty-eight days; p = 0.012). Biomechanical results were better after twenty-eight days for the control group than for both MSC groups. However, the difference was significant only with regard to the stiffness results in the comparison of the PBS control and the eGFP stem cell group (p = 0.024). Histologically, the MSC groups had no better results than the control group after fourteen and twenty-eight days. In immunohistology, only labeling for type-I procollagen was strongly increased in both MSC groups in comparison with the PBS control group (p = 0.0009 for the MSC-LV-bFGF group and p = 0.0041 for the MSC-LV-eGFP group at fourteen days, and p = 0.004 and p = 0.132, respectively, at twenty-eight days). There were no significant differences in the immunohistological results between the stem cell groups. CONCLUSIONS The biomechanical and immunohistological results showed that mesenchymal stem cells in both groups had only partially positive effects on tendon remodeling in the initial stages; however, in later stages, stem cells had potentially negative effects on biomechanical results. The additional expression of bFGF in stem cells had negligible effects on tendon remodeling. CLINICAL RELEVANCE Preliminary studies using stem cells are partially promising; however, there are no relevant clinical data showing that stem cells are of significant benefit. The present study should lead to a more critical evaluation and thoughtful use of stem cells in humans until more clinical data are available.
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Affiliation(s)
- T M Kraus
- BG Trauma Clinic Tübingen, University Hospital Tübingen, Schnarrenbergstr. 95, 72076 Tübingen, Germany. E-mail address for T.M. Kraus:
| | - F B Imhoff
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - G Wexel
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - A Wolf
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - D Hirsch
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - L Lenz
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - U Stöckle
- BG Trauma Clinic Tübingen, University Hospital Tübingen, Schnarrenbergstr. 95, 72076 Tübingen, Germany. E-mail address for T.M. Kraus:
| | - S Buchmann
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - T Tischer
- Department of Orthopaedic Surgery, University of Rostock, Doberaner Str. 142, 18057 Rostock, Germany
| | - A B Imhoff
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - S Milz
- Anatomische Anstalt, Ludwig Maximilians Universität, Pettenkoferstr. 11, D-80336 Munich, Germany
| | - M Anton
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
| | - S Vogt
- Departments of Sports Orthopaedics (G.W., L.L., S.B., A.B.I., and S.V.) and Traumatology (F.B.I.), and the Institute of Experimental Oncology and Therapy Research (A.W., D.H., and M.A.), Klinikum rechts der Isar der Technischen Universität München, Ismani
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Hirsch D, Odorico J, Danobeitia JS, Alejandro R, Rickels MR, Hanson M, Radke N, Baidal D, Hullett D, Naji A, Ricordi C, Kaufman D, Fernandez L. Early metabolic markers that anticipate loss of insulin independence in type 1 diabetic islet allograft recipients. Am J Transplant 2012; 12:1275-89. [PMID: 22300172 PMCID: PMC4569145 DOI: 10.1111/j.1600-6143.2011.03947.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The objective of this study was to identify predictors of insulin independence and to establish the best clinical tools to follow patients after pancreatic islet transplantation (PIT). Sequential metabolic responses to intravenous (I.V.) glucose (I.V. glucose tolerance test [IVGTT]), arginine and glucose-potentiated arginine (glucose-potentiated arginine-induced insulin secretion [GPAIS]) were obtained from 30 patients. We determined the correlation between transplanted islet mass and islet engraftment and tested the ability of each assay to predict return to exogenous insulin therapy. We found transplanted islet mass within an average of 16 709 islet equivalents per kg body weight (IEQ/kg BW; range between 6602 and 29 614 IEQ/kg BW) to be a poor predictor of insulin independence at 1 year, having a poor correlation between transplanted islet mass and islet engraftment. Acute insulin response to IVGTT (AIR(GLU) ) and GPAIS (AIR(max) ) were the most accurate methods to determine suboptimal islet mass engraftment. AIR(GLU) performed 3 months after transplant also proved to be a robust early metabolic marker to predict return to insulin therapy and its value was positively correlated with duration of insulin independence. In conclusion, AIR(GLU) is an early metabolic assay capable of anticipating loss of insulin independence at 1 year in T1D patients undergoing PIT and constitutes a valuable, simple and reliable method to follow patients after transplant.
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Affiliation(s)
- D. Hirsch
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - J. Odorico
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - J. S. Danobeitia
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - R. Alejandro
- Department of Medicine, Division of Endocrinology, University of Miami School of Medicine, Miami, FL
| | - M. R. Rickels
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - M. Hanson
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - N. Radke
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - D. Baidal
- Department of Medicine, Division of Endocrinology, University of Miami School of Medicine, Miami, FL
| | - D. Hullett
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - A. Naji
- Department of Surgery, Division of Transplantation, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - C. Ricordi
- Department of Surgery, Microbiology and Immunology, University of Miami, Miami, FL
| | - D. Kaufman
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI
| | - L. Fernandez
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI,Corresponding author: Luis A. Fernandez,
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11
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Gershinsky M, Barnett-Griness O, Stein N, Hirsch D, Tzvetov G, Bardicef O, Pauker J, Grozinsky-Glasberg S, Ish-Shalom S, Slutski I, Shimon I, Benbassat C. Total versus hemithyroidectomy for microscopic papillary thyroid cancer. J Endocrinol Invest 2012; 35:464-8. [PMID: 21952495 DOI: 10.3275/7963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND No increased mortality has been reported in patients with thyroid papillary microcarcinoma (PMC); however, neck recurrences and distant metastases have been described. In this study, we compare patients' outcomes after total thyroidectomy vs hemithyroidectomy for treatment of thyroid PMC. METHODS Two hundred and ninety-three patients from two major medical centers in Israel were included. The mean follow-up period was 7.2±6.8 yr. RESULTS Total thyroidectomy was performed in 214 patients and hemithyroidectomy in 79 patients. Mean tumor size was 6.3±3 mm. Lymph-node (LN) metastases and extraglandular extension were more frequent in the total thyroidectomy group than in the hemithyroidectomy group, 24.8% vs 1.3% (p<0.001) and 11.7% vs 3.8% (p=0.042), respectively. The cumulative incidence of recurrence at the end of follow-up was 13.2% in the total thyroidectomy group and 14.3% in the hemithyroidectomy group (p=ns). The incidence of recurrence was higher in patients with LN involvement in both groups. Considering low risk patients only (monofocal tumors, no LN involvement, no extraglandular extension; no.=63 in the total thyroidectomy group vs no.=60 in the hemithyroidectomy group) neck recurrence was found in 10% of patients in the hemithyroidectomy group but none in the total thyroidectomy group. In the hemithyroidectomy group, all locoregional recurrences were diagnosed using ultrasonography, compared to 47.6% in the total thyroidectomy group. CONCLUSION For patients with monofocal disease within the thyroid gland and no LN involvement, hemithyroidectomy can be considered an option, bearing in mind a higher risk for recurrence. For all other patients with PMC, we propose total thyroidectomy as initial treatment.
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Affiliation(s)
- M Gershinsky
- Department of Endocrinology, Linn Medical Center, General Health Services, 35 Rotchild st. Haifa, 35152, Israel.
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12
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Polachek A, Hirsch D, Tzvetov G, Grozinsky-Glasberg S, Slutski I, Singer J, Weinstein R, Shimon I, Benbassat CA. Prognostic value of post-thyroidectomy thyroglobulin levels in patients with differentiated thyroid cancer. J Endocrinol Invest 2011; 34:855-60. [PMID: 21646855 DOI: 10.3275/7768] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Thyroglobulin is an excellent biological marker of persistent or recurrent thyroid cancer during long-term follow-up. Most studies investigated its diagnostic value but not its prognostic value over time. We aim to study the prognostic value of thyroglobulin levels early after total thyroidectomy, before iodine ablation. METHODS The study was based on the Rabin Medical Center registry of patients with non-medullary thyroid carcinoma. Data were collected on the clinical, laboratory, and outcome characteristics of 420 consecutive patients followed at our institution for whom early post-operative pre-ablation thyroglobulin values (baseline thyroglobulin) were available. RESULTS Patients were classified into 4 groups by baseline thyroglobulin level: 0-2, 2-10, 10-100, and >100 ng/ml. Higher levels were associated with a shift toward male gender (p=0.01), larger tumor size (p=0.02), and a more extensive disease (p<0.0001). They were also related to disease persistence and evidence of disease at last follow-up (p<0.0001). The 10 ng/ml cut-off level identified patients with persistent disease with a sensitivity and specificity of 73%, positive predictive value of 43%, and negative predictive value of 89%. On multivariate analysis, the following variables were predictive of persistent disease: baseline thyroglobulin level, male gender, lymph-node involvement, distant metastases, higher tumor invasiveness, and larger tumor size. However, the predictive power of baseline thyroglobulin level was relatively weak (odds ratio 1.002, 95% confidence interval 1.00-1.04). CONCLUSIONS In patients with well-differentiated thyroid cancer, a post-thyroidectomy thyroglobulin level <10 ng/ml is associated with a low probability of having persistent disease and can be used combined with other disease characteristics for decisions regarding treatment and follow-up.
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Affiliation(s)
- A Polachek
- Endocrine Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva 49100, Israel
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13
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Hirsch D, Bae J, Bae J. Risk Factors and Aggressiveness of Oral Cavity Carcinomas in Young Patients. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Hirsch D, Franco P, Levine J. Poster 13: Treatment and Reconstruction of Ameloblastoma in an Urban Hospital Setting. J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.joms.2011.06.113] [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: 11/13/2022]
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15
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Lai DW, Buckley SA, Schmidt BL, Viet C, Muggia F, Belitskaya-Levy I, Cohen RF, DeLacure MD, Sanfilippo N, Myssiorek D, Hirsch D, Seetharamu N. Exploring factors in diagnostic delays of head and neck cancer at a public hospital. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5544] [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: 11/20/2022] Open
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16
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Cannon TL, Muggia F, Hirsch D, Andreopoulou EA, Kerr AR, DeLacure MD. Multiple cases of squamous cell carcinoma of the tongue and oral cavity in patients treated with long-term pegylated liposomal doxorubicin (PLD) for ovarian cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Bousquet J, Anto J, Auffray C, Akdis M, Cambon-Thomsen A, Keil T, Haahtela T, Lambrecht BN, Postma DS, Sunyer J, Valenta R, Akdis CA, Annesi-Maesano I, Arno A, Bachert C, Ballester F, Basagana X, Baumgartner U, Bindslev-Jensen C, Brunekreef B, Carlsen KH, Chatzi L, Crameri R, Eveno E, Forastiere F, Garcia-Aymerich J, Guerra S, Hammad H, Heinrich J, Hirsch D, Jacquemin B, Kauffmann F, Kerkhof M, Kogevinas M, Koppelman GH, Kowalski ML, Lau S, Lodrup-Carlsen KC, Lopez-Botet M, Lotvall J, Lupinek C, Maier D, Makela MJ, Martinez FD, Mestres J, Momas I, Nawijn MC, Neubauer A, Oddie S, Palkonen S, Pin I, Pison C, Rancé F, Reitamo S, Rial-Sebbag E, Salapatas M, Siroux V, Smagghe D, Torrent M, Toskala E, van Cauwenberge P, van Oosterhout AJM, Varraso R, von Hertzen L, Wickman M, Wijmenga C, Worm M, Wright J, Zuberbier T. MeDALL (Mechanisms of the Development of ALLergy): an integrated approach from phenotypes to systems medicine. Allergy 2011; 66:596-604. [PMID: 21261657 DOI: 10.1111/j.1398-9995.2010.02534.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [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: 12/17/2022]
Abstract
The origin of the epidemic of IgE-associated (allergic) diseases is unclear. MeDALL (Mechanisms of the Development of ALLergy), an FP7 European Union project (No. 264357), aims to generate novel knowledge on the mechanisms of initiation of allergy and to propose early diagnosis, prevention, and targets for therapy. A novel phenotype definition and an integrative translational approach are needed to understand how a network of molecular and environmental factors can lead to complex allergic diseases. A novel, stepwise, large-scale, and integrative approach will be led by a network of complementary experts in allergy, epidemiology, allergen biochemistry, immunology, molecular biology, epigenetics, functional genomics, bioinformatics, computational and systems biology. The following steps are proposed: (i) Identification of 'classical' and 'novel' phenotypes in existing birth cohorts; (ii) Building discovery of the relevant mechanisms in IgE-associated allergic diseases in existing longitudinal birth cohorts and Karelian children; (iii) Validation and redefinition of classical and novel phenotypes of IgE-associated allergic diseases; and (iv) Translational integration of systems biology outcomes into health care, including societal aspects. MeDALL will lead to: (i) A better understanding of allergic phenotypes, thus expanding current knowledge of the genomic and environmental determinants of allergic diseases in an integrative way; (ii) Novel diagnostic tools for the early diagnosis of allergy, targets for the development of novel treatment modalities, and prevention of allergic diseases; (iii) Improving the health of European citizens as well as increasing the competitiveness and boosting the innovative capacity of Europe, while addressing global health issues and ethical issues.
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Affiliation(s)
- J Bousquet
- University Hospital, Department of Respiratory Diseases, Hôpital Arnaud de Villeneuve, Montpellier, France.
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18
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Hirsch D, Odorico J, Radke N, Hanson M, Danobeitia JS, Hullett D, Alejandro R, Ricordi C, Fernandez LA. Correction of insulin sensitivity and glucose disposal after pancreatic islet transplantation: preliminary results. Diabetes Obes Metab 2010; 12:994-1003. [PMID: 20880346 PMCID: PMC6419521 DOI: 10.1111/j.1463-1326.2010.01290.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Pancreatic islet transplantation (PIT) represents a potential curative treatment for patients with type 1 diabetes, but only 10-15% of patients remain insulin independent 5 years post-transplant. It is not known whether intrinsic insulin resistance exacerbated by immunosuppression plays a pivotal role in low graft survival. The study objective was to understand the changes in insulin resistance, glucose effectiveness (S(g)) and free fatty acid dynamics (FFAd) before and after PIT. METHODS Insulin sensitivity index (S(i)), S(g) and FFAd were measured before and after PIT in 10 lean patients, 8 of whom reached insulin independence. Modified Bergman minimal model of frequently sampled intravenous glucose tolerance tests were performed pretransplant and at 12 months post-transplant. Nine non-diabetic control (NDC) subjects matched by age, gender and BMI were used. RESULTS Pretransplant S(i) and S(g) were 3.5 ± 0.8 × 10(-5)/min/(pmol/l) and 0.74 ± 0.24 × 10(-2)/min, respectively. S(i) was significantly lower than matched NDCs [10.8 ± 0.6 × 10(-5)/min/(pmol/l), p < 0.004]; S(g) did not reach statistical significance (1.27 ± 0.22 × 10(-2)/min, p = 0.25). Compared to pretransplant values, mean post-transplant S(i) and S(g) were 9.6 ± 1.3 × 10(-5)/min/(pmol/l)and 1.28 ± 0.22 ×10(-2)/min, respectively, indicating significant improvement for S(i) but not S(g) (p = 0.008 and p = 0.06). Twelve-month post-PIT compared to NDC values were not significantly different (p = 0.58 and 0.97, respectively). In addition, fractional disposal rate for FFA which directly depends on the endogenous insulin release (10-20 min) nearly normalized after PIT (p = 0.06). CONCLUSION These preliminary findings demonstrate that PIT can restore glucose disposal and insulin sensitivity and partially correct glucose effectiveness and FFAd.
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Affiliation(s)
- D Hirsch
- Department of Surgery, Division of Transplantation, University of Wisconsin, Madison, WI 53792-7375, USA
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19
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Grozinsky-Glasberg S, Szalat A, Benbassat CA, Gorshtein A, Weinstein R, Hirsch D, Shraga-Slutzky I, Tsvetov G, Gross DJ, Shimon I. Clinically silent chromaffin-cell tumors: Tumor characteristics and long-term prognosis in patients with incidentally discovered pheochromocytomas. J Endocrinol Invest 2010; 33:739-44. [PMID: 20479567 DOI: 10.1007/bf03346680] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chromaffin-cell tumors (CCT), a rare group of catecholamine producing endocrine neoplasms, are traditionally suspected and diagnosed in patients presenting with episodic hypertension, together with the classic triad of headache, sweating, and tachycardia. Asymptomatic CCT are increasingly diagnosed, frequently as "incidentalomas". We have conducted a multicenter retrospective study, to assess the characteristics of a group of patients with clinically silent CCT, compared with a group of patients with typical CCT. METHODS Forty-three consecutive patients with CCT (24 with silent and 19 with typical tumors) have been retrospectively studied for a period of up to 20 yr (between 1989 and 2009); clinical picture, biochemical tests, as well as topographic and functional assessment were analyzed at diagnosis and periodically following treatment. Surgical samples were reviewed for neuroendocrine markers and for signs of invasiveness. RESULTS Patients with clinically silent CCT were significantly older than the typical ones (56.3±3.4 vs 48.0±4.8 yr; p<0.05); 15 of them (63%) were completely asymptomatic, and 9 patients (37%) complained of non-specific abdominal symptoms. Hypertension was present in only 6 silent CCT patients (25%), it was well controlled [mean blood pressure (BP) 134/84 mmHg], and persisted after surgery in only 2 patients. Fourteen out of twenty-four silent CCT patients (58%) were managed pre-operatively with prophylactic combination of α and β blockade, despite normal BP values. Clinically silent CCT were larger than typical CCT (mean diameter of 5.2±2.3 cm vs 4.6±1.5 cm, p<0.05) and secreted higher a mounts of normeta neph rines. All clinically silent CCT patients were defined as "cured" after surgery. CONCLUSION Clinically silent CCT are more prevalent than previously reported. With an adequate pre-surgical diagnosis and patient preparation, the prognosis of silent tumors is usually excellent.
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Affiliation(s)
- S Grozinsky-Glasberg
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva 49100, Israel.
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20
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Hirsch D. Recurrence Patterns in Oral Squamous Cell Carcinoma From an Urban Hospital Setting. J Oral Maxillofac Surg 2010. [DOI: 10.1016/j.joms.2010.06.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Caldroney S, Delacure M, Wang B, Hirsch D. Poster Board Number: 19: Ameloblastic Carcinoma: An Underdiagnosed Entity? J Oral Maxillofac Surg 2010. [DOI: 10.1016/j.joms.2010.06.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Hirsch D. Poster Board Number: 77: Computer Aided Surgical Simulation (CASS) Following High Velocity, Multisegmental Panfacial Trauma: A Novel Technique in Facial Reconstruction. J Oral Maxillofac Surg 2010. [DOI: 10.1016/j.joms.2010.06.160] [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: 11/27/2022]
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23
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Giordano R, Liersch S, Vurro M, Hirsch D. Integrating local and technical knowledge to support soil salinity monitoring in the Amudarya river basin. J Environ Manage 2010; 91:1718-1729. [PMID: 20417023 DOI: 10.1016/j.jenvman.2010.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 12/21/2009] [Accepted: 03/23/2010] [Indexed: 05/29/2023]
Abstract
The role of monitoring is changing due to the increasing awareness of complexity and uncertainty in environmental resources management. Monitoring systems are required to support critical reflection about the effectiveness of actions toward the achievement of management objectives. To this aim, monitoring should be based on a strong integrated and multi-scale approach. Monitoring costs could be prohibitive if the monitoring is only based on traditional scientific methods of measurements. To deal with these issues, the design of an innovative monitoring system should be based on the integration between different sources of knowledge and information. In this work the usability of local knowledge to support environmental monitoring is investigated. A multi-step participatory monitoring design process has been implemented aiming to design a program for soil salinity monitoring in the lower Amudarya river basin in Uzbekistan. Although there is an increasing awareness of the importance of stakeholders being involved in decision processes, the current socio-cultural and institutional context is not favourable to the participatory approach. The choice of method to be implemented in this work was influenced by such conditions. The analysis of the lessons learned from the experiences gained in this project revealed some important clues concerning the development of a locally-based monitoring program. These lessons can be subdivided according to three fundamental issues: the long term involvement of local community members in monitoring activities, the acceptance of locally-based monitoring systems by decision makers, and the reliability of monitoring information.
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Affiliation(s)
- R Giordano
- National Research Council - Water Research Institute, via De Blasio, 5, 70123 Bari, Italy.
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24
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Scholz S, Bauer J, Leibiger G, Herrnberger H, Hirsch D, Gottschalch V. MOVPE growth of GaAs on Ge substrates by inserting a thin low temperature buffer layer. Cryst Res Technol 2006. [DOI: 10.1002/crat.200510541] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Pituitary metastases account for about 1% of operated pituitary lesions. Most derive from primaries in the breast or lung. Pituitary metastases from hepatocellular carcinoma (HCC) have rarely been reported. We describe a patient in whom headache and left external ophthalmoplegia were the only presenting signs of a clinically silent and radiographically undetectable HCC, that had metastasized to the pituitary and both adrenal glands. Pituitary histology and adrenal needle biopsy failed to establish the final diagnosis, which was reached only after surgical exploration of the abdomen. This case illustrates the difficulties encountered in the histopathological diagnosis of pituitary metastasis and the need for good clinical judgment when confronting pituitary tumors with atypical features.
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Affiliation(s)
- D Hirsch
- Institute of Endocrinology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
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26
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Gat-Yablonski G, Klar A, Hirsch D, Eliakim A, Lazar L, Hurvitz H, Phillip M. Three novel mutations in POU1F1 in Israeli patients with combined pituitary hormone deficiency. J Pediatr Endocrinol Metab 2005; 18:385-93. [PMID: 15844473 DOI: 10.1515/jpem.2005.18.4.385] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND POU1F1, a pituitary-specific transcription factor of the class 1 POU family, is crucial for the development and differentiation of the anterior pituitary gland. Mutations in the POU1F1 gene have been shown to be responsible for a syndrome of combined pituitary hormone deficiency (CPHD), including prolactin, growth hormone and thyroid-stimulating hormone deficiencies. METHODS Five patients with CPHD from three families were evaluated. The clinical and biochemical data were taken from the medical records. DNA was analyzed by polymerase chain reaction (PCR), denaturing gradient gel electrophoresis (DGGE), and sequencing. RESULTS Molecular analysis yielded three novel mutations in POU1F1: W193X, Q242R (-2 bp), and F262L. CONCLUSIONS Three novel POU1F1 mutations were detected in Israeli patients with CPHD. Two of them, a W193X missense mutation and a deletion of two adenine bases at position 242Q, may lead to the production of a truncated protein that lacks the entire POU homeodomain or part of it, respectively. The third mutation, F262L, resides in the POU homeodomain and hence might change the activity of the protein.
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Affiliation(s)
- G Gat-Yablonski
- Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children 's Medical Center of Israel, Petah Tiqva, Israel
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Grundmann JU, Wiswedel I, Hirsch D, Gollnick HPM. Detection of monohydroxyeicosatetraenoic acids and F2-isoprostanes in microdialysis samples of human UV-irradiated skin by gas chromatography-mass spectrometry. Skin Pharmacol Physiol 2004; 17:37-41. [PMID: 14755126 DOI: 10.1159/000074061] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2002] [Accepted: 05/23/2003] [Indexed: 01/22/2023]
Abstract
UV irradiation of the human skin leads to induction of oxidative stress and inflammation mediated by reactive oxygen radicals, lipid peroxidation, liberation of arachidonic acid from membrane phospholipids and formation of prostaglandins and leucotrienes. We investigated "lipid mediators", such as F(2)-isoprostanes (8-iso-PGF(2alpha), 9alpha,11alpha-PGF(2alpha)) and monohydroxyeicosatetraenoic acids (HETEs) in the dermal interstitial fluid obtained by a cutaneous microdialysis technique. Defined areas on the volar forearm of 10 healthy volunteers were exposed to UVB irradiation (20-60 mJ/cm(2)). Microdialysis membranes were cutaneously inserted beneath the irradiated area. The probes were perfused with isotonic saline solution, and microdialysate samples were collected at 20-min intervals up to 4-5 h. Oxidized arachidonic acid derivatives (2-, 3-, 5-, 8-12- and 15-HETEs, 8-iso-PGF(2alpha) and 9alpha,11alpha-PGF(2alpha)) could be detected and quantified in microdialysates of normal skin in the picomole (HETEs) and femtomole (isoprostanes) range and after UVB irradiation using sensitive gas chromatography-mass spectrometry/negative ion chemical ionization. UVB irradiation enhanced the levels of 8-iso-PGF(2alpha) after 24 h significantly, whereas the HETE levels were slightly increased within shorter time intervals (3 h after UVB irradiation). Further investigations have to show whether these new findings are relevant to validate therapeutic strategies for topical and systemic UV prevention agents or for monitoring of specific therapeutic strategies in inflammatory skin disorders.
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Affiliation(s)
- J-U Grundmann
- Department of Dermatology and Venereology, Otto von Guericke University, Leipziger Strasse 44, DE-39120 Magdeburg, Germany
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Wiswedel I, Grundmann JU, Hirsch D, Gollnick H. Detection of Enhanced Monohydroxyeicosatetraenoic Acid and F 2-Isoprostane Levels in Human Plasma Samples after Extracorporeal Photoimmunotherapy. Skin Pharmacol Physiol 2003; 16:372-8. [PMID: 14528061 DOI: 10.1159/000072932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2002] [Accepted: 05/08/2003] [Indexed: 11/19/2022]
Abstract
To investigate the involvement of reactive oxygen species in extracorporeal photoimmunotherapy (photopheresis), we have introduced two highly sensitive and specific techniques for the detection and quantitative measurement of oxygenated nonenzymatically formed arachidonic acid isomers [mono-hydroxyeicosatetraenoic acids (HETEs) and F2-isoprostanes] by gas chromatography-mass spectrometry/negative ion chemical ionization (GC-MS/NICI) in plasma samples of patients suffering from cutaneous T-cell lymphoma and progressive systemic scleroderma II. The analysis of HETEs involved hydrogenation, solid phase extraction on a C18 cartridge, formation of pentafluorobenzyl bromide and trimethylsilyl ether derivatives. In the case of F2-isoprostanes, the analytical procedure was similar to that of HETEs except that the hydrogenation step was omitted. In the plasma of healthy volunteers picomole amounts of 2-, 5-, 8-12-, 15-HETEs, 8-iso-PGF(2alpha) and 9alpha,11alpha-PGF(2alpha) were quantified by using 12-hydroxy-heptadecatrienoic acid and PGF(2alpha)-d4 as internal standards of HETEs and isoprostanes, respectively. Analysis of plasma samples obtained from patients before and after extracorporeal photoimmunotherapy revealed characteristic increases in both, HETE and isoprostane levels. The enhancement of indicators of lipid peroxidation is in correspondence with a moderate loss of alpha-tocopherol, the most important lipid-soluble antioxidant in human plasma. Thus, our data confirm the involvement of lipid peroxidation in extracorporeal photoimmunotherapy.
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Affiliation(s)
- I Wiswedel
- Department of Pathological Biochemistry, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.
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Siems W, Quast S, Carluccio F, Wiswedel I, Hirsch D, Augustin W, Kraemer K, Hampl H, Sommerburg O. Oxidative stress in cardio renal anemia syndrome: correlations and therapeutic possibilities. Clin Nephrol 2003; 60 Suppl 1:S22-30. [PMID: 12940531] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Cardiovascular injury has been shown to be the most critical factor affecting quality of life and mortality in patients suffering from chronic renal failure. Oxidative stress has been thought to be an important risk factor for cardiovascular disorders. As oxidative stress parameters with high cardiovascular risk factor 4-hydroxynonenal and other aldehydic lipid peroxidation products, F2-isoprostanes, homocysteine, and cholesterol oxidation products were measured in chronic renal failure patients. 4-Hydroxynonenal and some cholesterol oxidation products correlated well with the degree of renal anemia. F2-isoprostane levels were related to inflammation, whereas homocysteine was increased due to malnutrition. Further, cholesterol oxidation products correlated well with the consumption of lipophilic antioxidants such as alpha-tocopherol. There was an almost linear correlation between the left ventricular mass index and 4-hydroxynonenal. Both parameters furthermore showed an inverse relationship to hemoglobin concentration. The correction of renal anemia by means of erythropoietin therapy led to an efficient strengthening of the antioxidative defence system. The improvement of the antioxidative capacity is of complex nature comprising both enzymatic pathways and low molecular antioxidants. The correction of renal anemia with its well documented reduction of the cardiovascular risk can be regarded as an antioxidative therapy, demonstrating the clinical efficiency of antioxidative protection in patients with chronic renal failure.
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Affiliation(s)
- W Siems
- Herzog-Julius Hospital for Rheumatology and Orthopedics, Bad Harzburg, Germany.
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Assumpção E, Piccoli-Valle R, Hirsch D, Abreu L. Fontes de contaminação por Staphylococcus aureus na linha de processamento de queijo prato. ARQ BRAS MED VET ZOO 2003. [DOI: 10.1590/s0102-09352003000300019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Com o objetivo de identificar as principais fontes de contaminação por Staphylococcus aureus e Staphylococcus produtores de coagulase (SC+), avaliou-se o processo de fabricação de queijo prato em um laticínio de Lavras, MG, durante os meses de outubro de 2000 a abril de 2001. As análises microbiológicas foram feitas no leite cru, no leite pasteurizado resfriado, nas mãos e antebraços dos funcionários, na salmoura, na água de imersão das fôrmas e no queijo embalado. Contagens elevadas de SC+ e de S. aureus (4x10³ a 4,8x10(6) UFC/ml e 4x10³ a 3,3x10(5) UFC/ml, respectivamente) foram encontradas em quatro avaliações no leite cru. Após a pasteurização, as contagens foram reduzidas a <1 UFC/ml. Em três das cinco avaliações, o queijo prato apresentou contagens de SC+ (10(4), 10(5) e 2,3x10(5) UFC/g) superiores às permitidas pela legislação vigente. A água de imersão das fôrmas e a salmoura apresentaram contagens de SC+ e S. aureus inferiores a 1 UFC/ml não se constituindo em importantes fontes de contaminação. As mãos e os antebraços dos funcionários foram possivelmente as fontes de contaminação do queijo, isto é, alta contagem nos queijos estava associada à contagem elevada nas mãos (4x10² UFC/cm²) ou nos antebraços (4,7x10² e 3,3x10³ UFC/cm²) dos manipuladores.
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Langlands AO, Gebski V, Hirsch D, Tattersall MHN. Delay in the clinical diagnosis of breast cancer: estimating its effect on prognosis, with particular reference to medical litigation. Breast 2002; 11:386-93. [PMID: 14965700 DOI: 10.1054/brst.2002.0456] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2002] [Revised: 06/05/2002] [Accepted: 06/13/2002] [Indexed: 02/06/2023] Open
Abstract
Medical malpractice litigation is increasing. Delay in diagnosis is the commonest basis for litigation involving the treatment of breast cancer. When delay in diagnosis has occurred, any losses for which a plaintiff seeks compensation require estimates to be made of any change in prognosis over the period of the delay relative to the extent of disease found when treatment is finally undertaken. We have examined the natural history of breast cancer and have attempted to provide evidence-based quantitative guidelines for the evaluation of the losses which may be claimed in malpractice cases.
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Affiliation(s)
- A O Langlands
- National Health and Medical Research Council Clinical Trials Centre, University of Sydney, NSW, Australia.
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Siems W, Quast S, Carluccio F, Wiswedel I, Hirsch D, Augustin W, Hampi H, Riehle M, Sommerburg O. Oxidative stress in chronic renal failure as a cardiovascular risk factor. Clin Nephrol 2002; 58 Suppl 1:S12-9. [PMID: 12227720] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Myocardial injury has been shown to be the most critical factor influencing quality of life and mortality in patients with chronic renal failure. Oxidative stress has been postulated to be an important risk factor for cardiovascular disorders. One reason for oxidative stress in patients with renal failure is the underlying disease itself. Renal toxicity, ischemia/reperfusion and immunological disorders of the kidney result in an elevated formation of reactive oxygen species active in the pathogenesis of kidney disease. However, treatment procedures were also shown to induce oxidative stress. Increased formation of free radicals leads to an accelerated lipid peroxidation (LPO). Furthermore, secondary aldehydic LPO products, e.g. malondialdehyde (MDA) and 4-hydroxynonenal (HNE), are formed which were shown to deplete antioxidants, inhibit protein syntheses, mitochondrial respiration, and enzyme functions. F2-isoprostanes, also metabolites of polyunsaturated fatty acids, represent an additional in vivo marker of oxidative stress. Both isoprostanes and aldehydic LPO products can be removed by hemodialysis, however, this suggests only in part their binding to other molecules which cause tissue damage. Protein carbonyls are end-products of such interventions. Oxysterols, another form of free-radical initiated oxidation products, were shown to initiate atherosclerosis and plaque formation increasing dramatically the risk of coronary heart disease. Today there is no doubt that the correction of the oxidant/antioxidant imbalance in patients with chronic renal failure is an important approach for the reduction of the risk of those patients to develop cardiovascular disorders. The complete correction of renal anemia represents an effective means of strengthening antioxidant capacity and, therefore, of reducting cardiovascular risk potential.
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Affiliation(s)
- W Siems
- Herzog Julius Hospital, Bad Harzburg, Germany.
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Shilo L, Hirsch D, Ellis M, Shenkman L. Pseudoascites--still a diagnostic pitfall. Isr Med Assoc J 2001; 3:770-1. [PMID: 11692555] [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: 02/22/2023]
Affiliation(s)
- L Shilo
- Department of Medicine C, Meir Hospital, Kfar Saba, Israel.
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Abstract
Thromboses are a common complication of central venous catheters in cancer patients. This study was performed to analyze retrospectively the treatment and outcome of all patients with venous thromboses related to central venous catheters at a major cancer center. From 1992 through 1995, 319 oncology patients with central venous catheters underwent radionuclide venography (RNV) at the Dana-Farber Cancer Institute for suspected catheter or venous thrombosis. The treatment and outcome of patients found to have venous thromboses were evaluated. Of the 319 patients, 112 were found to have evidence of venous thrombosis. The median age and platelet counts were not significantly different between the patients with and without thromboses. The most common indication for obtaining RNV was difficulty in aspirating or infusing material through the catheter. Patients who had pain or edema, or both, of the neck or upper extremity were more likely to have a venous thrombosis. Regardless of therapeutic intervention, including anticoagulation with heparin or coumadin, or both; line removal or replacement; or a combination thereof, no patients had a major adverse outcome such as pulmonary embolism, compromise of limb, or death. Only 4 patients did not have resolution of their presenting symptoms, all of whom were treated with line replacement. The overall survival of patients with and without thromboses was not significantly different. Either anticoagulation or removal of the central venous catheter (or both) appears to be adequate treatment for catheter-related thrombosis. A prospective trial to evaluate these approaches may be worthwhile so that the use of unnecessary procedures may be avoided in this patient population.
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Affiliation(s)
- D A Frank
- Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA.
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Hirsch T, Neumeister V, Weiland SK, von Mutius E, Hirsch D, Gräfe H, Duhme H, Leupold W. Traffic exposure and allergic sensitization against latex in children. J Allergy Clin Immunol 2000; 106:573-8. [PMID: 10984380 DOI: 10.1067/mai.2000.109430] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Latex antigens have been found in urban air samples and in debris deposited near freeways. OBJECTIVE We investigated whether exposure to road traffic in a large city is associated with allergic sensitization against latex in children. METHODS A population-based sample of 2505 children aged 5 to 11 years was examined in a cross-sectional study in the city of Dresden, Germany. Specific IgE levels against latex and a panel of common aeroallergens (timothy grass, rye, birch, mugwort, Cladosporium herbarum, Dermatophagoides pteronyssinus, cat dander, and dog dander) was determined by using a fluorescence immunoassay (CAP Pharmacia). Traffic exposure was assessed by (1) parental self-report on traffic frequency and truck traffic in the street of residence, (2) traffic counts, and (3) measurements of benzene at 182 points on a 1-km(2) grid for 1 year, which were used to estimate the children's individual exposure at the home address. RESULTS Eight hundred fifty-four (34.1%) of the children were sensitized against any of the allergens, and 150 (6.0%) had specific IgE (>0.35 kU/L) against latex. The prevalence of latex sensitization was not positively associated with self-reported traffic exposure, traffic counts in the street of residence (adjusted prevalence odds ratio for >5000 vs < or =5000 cars/d, 0.7; 95% confidence interval, 0.4-1.3), or benzene exposure (adjusted prevalence odds ratio for an increase of 1 microg/m(3) air, 0.8; 95% confidence interval, 0.7-1.05). CONCLUSION The data suggest that exposure to road traffic is not associated with allergic sensitization to latex in children.
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Affiliation(s)
- T Hirsch
- University Children's Hospital of the University of Technology, Dresden, Germany
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Wiswedel I, Bohne M, Hirsch D, Kühn H, Augustin W, Gollnick H. A sensitive gas chromatography-mass spectrometry assay reveals increased levels of monohydroxyeicosatetraenoic acid isomers in human plasma after extracorporeal photoimmunotherapy and under in vitro ultraviolet A exposure. J Invest Dermatol 2000; 115:499-503. [PMID: 10951289 DOI: 10.1046/j.1523-1747.2000.00053.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Extracorporeal photoimmunotherapy (photopheresis) is a highly effective therapy in the treatment of various disorders. Although extracorporeal photoimmunotherapy has been successfully used for more than 10 y, its mechanism of action is still unclear. The formation of reactive oxygen species have been implicated in extracorporeal photoimmunotherapy, but malonyl dialdehyde as a marker of systemic lipid peroxidation did not increase significantly during treatment. To investigate further the involvement of reactive oxygen species in extracorporeal photoimmunotherapy, we have introduced a highly sensitive negative ion gas chromatography-mass spectrometry based method for quantitating oxygenated arachidonic acid isomers (hydroxyeicosatetraenoic acids) in plasma samples of patients treated with extracorporeal photoimmunotherapy. In the plasma of healthy volunteers pmole amounts of 2-, 3-, 5-, 8-12-, and 15-hydroxyeicosatetraenoic acid were detected and we observed a dose-dependent augmentation in these metabolites when the blood was irradiated with increasing doses of ultraviolet A in the presence of the photosensitizer 8-methoxypsoralen. Analysis of plasma samples obtained from patients before and after extracorporeal photoimmunotherapy revealed a characteristic increase in total hydroxyeicosatetraenoic acid levels, particularly of 5-hydroxyeicosatetraenoic acid which contributed 80% to the sum of all hydroxyeicosatetraenoic acid isomers. Chiral phase high-performance liquid chromatography indicated almost equal amounts of 5S- and 5R-hydroxyeicosatetraenoic acid suggesting that the majority of lipid peroxidation products are formed via nonenzymatic oxidation reactions.
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Affiliation(s)
- I Wiswedel
- Department of Dermatology and Venereology, Institute of Clinical Chemistry and Pathological Biochemistry, Otto-von-Guericke-University, Magdeburg, Germany.
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Hirsch D, Orr G, Kantarovich V, Hermesh H, Stern E, Blum I. Cushing's syndrome presenting as a schizophrenia-like psychotic state. Isr J Psychiatry Relat Sci 2000; 37:46-50. [PMID: 10857272] [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: 02/16/2023]
Abstract
Neuropsychiatric abnormalities, of which depression is the most common, are frequently associated with Cushing's syndrome. The following paper describes a 58-year-old woman in whom a prolonged psychotic state--schizophrenia-like--was the presenting sign of Cushing's syndrome. The psychiatric symptoms disappeared shortly after the cortisol level has been normalized. Due to the variety of symptoms, both organic and psychiatric, which may occur with Cushing's syndrome, a high suspicion index is advisable. Suspect clinical findings should always prompt the appropriate endocrine work-up.
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Affiliation(s)
- D Hirsch
- Endocrinology Institute, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
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Vyavahare NR, Jones PL, Hirsch D, Schoen FJ, Levy RJ. Prevention of glutaraldehyde-fixed bioprosthetic heart valve calcification by alcohol pretreatment: further mechanistic studies. J Heart Valve Dis 2000; 9:561-6. [PMID: 10947050] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Calcification is a major cause of failure of bioprosthetic heart valves derived from glutaraldehyde-crosslinked bovine pericardium or porcine aortic valve (PAV) cusps. Recently, we have shown that ethanol pretreatment of PAV cusps prevents calcification in animal models. METHODS AND RESULTS In this study we showed that ethanol pretreatment was equally effective in preventing calcification of glutaraldehyde-crosslinked bovine pericardium (control Ca2+ = 121.16+/-7.49 microg/mg tissue; ethanol-pretreated Ca2+ = 2.95+/-0.78 microg/mg). Furthermore, other low-molecular weight alcohols such as methanol and isopropanol were also effective in mitigating calcification of PAV cusps. Storage of ethanol-pretreated cusps in glutaraldehyde before implantation allowed partial return of calcification, suggesting a role for ethanol-glutaraldehyde interactions in preventing calcification. However, when ethanol-pretreated cusps were stored in ethanolic glutaraldehyde up to one month, the anti-calcification effect of ethanol persisted. The conditions whereby PAV cusps were crosslinked in pure, non-aqueous, alcoholic glutaraldehyde solutions were also examined. The crosslinking was equivalent to the standard aqueous glutaraldehyde crosslinking as indicated by thermal denaturation temperatures (Td) obtained by differential scanning calorimetry (DSC) and resistance to collagenase digestion. However, these cusps had lower water content and showed a marked decrease in spin-lattice relaxation times (T1) obtained by solid-state proton nuclear magnetic resonance (NMR). Moreover, these cusps calcified heavily in the 21-day rat subdermal implants. Thus, alcohol treatment during glutaraldehyde crosslinking was not useful. CONCLUSION Glutaraldehyde storage after ethanol pretreatment aggravates calcification; moreover, alcoholic-glutaraldehyde crosslinking solutions are not beneficial for anti-calcification. Ethanol pretreatment of glutaraldehyde-pretreated bovine pericardium prevents its calcification.
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Affiliation(s)
- N R Vyavahare
- Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, USA
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Abbasi S, Hirsch D, Davis J, Tolosa J, Stouffer N, Debbs R, Gerdes JS. Effect of single versus multiple courses of antenatal corticosteroids on maternal and neonatal outcome. Am J Obstet Gynecol 2000; 182:1243-9. [PMID: 10819866 DOI: 10.1067/mob.2000.104789] [Citation(s) in RCA: 119] [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: 11/22/2022]
Abstract
OBJECTIVE Treatment of pregnant mothers with a single course of antenatal corticosteroids significantly reduces neonatal mortality and morbidity. Multiple weekly courses are often given. However, the safety and efficacy of repeated courses of antenatal corticosteroids have not been adequately studied. STUDY DESIGN A retrospective study was performed for 609 mothers and their 713 infants who were treated with 1 to 12 courses of antenatal corticosteroids. Data for 369 singleton preterm infants born at < or =34 weeks' gestation, 210 multiple gestations, and 134 infants delivered at > or =35 weeks' gestation were analyzed separately. RESULTS The incidence of respiratory distress syndrome was 45% for single-course and 35% for multiple-course groups (P =.005; odds ratio, 0.44; 95% confidence interval, 0.25-0.79). The multiple-course group also had significantly less patent ductus arteriosus (20% vs 13%; P =.016). Incidence of death before discharge and other neonatal morbidities were similar. The multiple-course group had a reduction of 0.46 +/- 0.19 cm in head circumference at birth (P =.013) when adjusted for gestational age and preeclampsia. The 2 groups had similar birth weights. Infants born at > or =35 weeks' gestation, multiple-gestation infants, and infants who were born >7 days after the last corticosteroid dose had similar outcomes, regardless of the number of courses they received. Mothers treated with multiple courses compared with a single course had a significantly higher incidence of postpartum endometritis (P =.013), even though they had a lower incidence of prolonged rupture of membranes (24% vs 33%, P =.06) and similar cesarean delivery rates. CONCLUSION Exposure to multiple courses of antenatal corticosteroids compared with a single course resulted in a significant reduction in the incidence of respiratory distress syndrome in singleton preterm infants delivered within a week of the last corticosteroid dose. This was associated with a reduction in birth head circumference and an increased incidence of maternal endometritis. Whether the potential benefits of repeated therapy clearly outweigh the risks will ultimately be determined in randomized prospective controlled trials.
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Affiliation(s)
- S Abbasi
- Department of Pediatrics and Obstetrics and Gynecology and the Division of Biostatistics, University of Pennsylvania School of Medicine, Philadelphia 19107, USA
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Liu X, Constantinescu SN, Sun Y, Bogan JS, Hirsch D, Weinberg RA, Lodish HF. Generation of mammalian cells stably expressing multiple genes at predetermined levels. Anal Biochem 2000; 280:20-8. [PMID: 10805516 DOI: 10.1006/abio.2000.4478] [Citation(s) in RCA: 125] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Expression of cloned genes at desired levels in cultured mammalian cells is essential for studying protein function. Controlled levels of expression have been difficult to achieve, especially for cell lines with low transfection efficiency or when expression of multiple genes is required. An internal ribosomal entry site (IRES) has been incorporated into many types of expression vectors to allow simultaneous expression of two genes. However, there has been no systematic quantitative analysis of expression levels in individual cells of genes linked by an IRES, and thus the broad use of these vectors in functional analysis has been limited. We constructed a set of retroviral expression vectors containing an IRES followed by a quantitative selectable marker such as green fluorescent protein (GFP) or truncated cell surface proteins CD2 or CD4. The gene of interest is placed in a multiple cloning site 5' of the IRES sequence under the control of the retroviral long terminal repeat (LTR) promoter. These vectors exploit the approximately 100-fold differences in levels of expression of a retrovirus vector depending on its site of insertion in the host chromosome. We show that the level of expression of the gene downstream of the IRES and the expression level and functional activity of the gene cloned upstream of the IRES are highly correlated in stably infected target cells. This feature makes our vectors extremely useful for the rapid generation of stably transfected cell populations or clonal cell lines expressing specific amounts of a desired protein simply by fluorescent activated cell sorting (FACS) based on the level of expression of the gene downstream of the IRES. We show how these vectors can be used to generate cells expressing high levels of the erythropoietin receptor (EpoR) or a dominant negative Smad3 protein and to generate cells expressing two different cloned proteins, Ski and Smad4. Correlation of a biologic effect with the level of expression of the protein downstream of the IRES provides strong evidence for the function of the protein placed upstream of the IRES.
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Affiliation(s)
- X Liu
- Whitehead Institute for Biomedical Research, Nine Cambridge Center, Massachusetts 02142, USA
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Kuhnle GG, Haferburg D, Grunow M, Hirsch D, Hahn U. Nano-electrospray mass spectrometry with a modified commercial IonSpray source. Rapid Commun Mass Spectrom 2000; 14:1307-1308. [PMID: 10918385 DOI: 10.1002/1097-0231(20000730)14:14<1307::aid-rcm33>3.0.co;2-#] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Electrospray mass spectrometry is a standard tool for the investigation of biological samples. Due to the high flowrates of the standard sources, large sample amounts are required and it is almost impossible to spray physiological solutions due to their aqueous medium. The introduction of microelectrospray sources has made it possible to decrease the sample amounts needed and enabled the use of buffered solutions. In this work, a nanoES-like source based on a modification of an existing IonSpray source is introduced. In contrast to other nanoES sources available, the modification presented allows a fast change between the nanoES and the normal IonSpray modes. Copyright 2000 John Wiley & Sons, Ltd.
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Affiliation(s)
- GG Kuhnle
- Institut fur Biochemie, Fakultat fur Biowissenschaften, Pharmazie und Psychologie, Universitat Leipzig, Talstrasse 33, 04103 Leipzig, Germany
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Hirsch T, Hering M, Bürkner K, Hirsch D, Leupold W, Kerkmann ML, Kuhlisch E, Jatzwauk L. House-dust-mite allergen concentrations (Der f 1) and mold spores in apartment bedrooms before and after installation of insulated windows and central heating systems. Allergy 2000; 55:79-83. [PMID: 10696861 DOI: 10.1034/j.1398-9995.2000.00250.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [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: 11/23/2022]
Abstract
BACKGROUND It has been hypothesized that changes in heating systems and insulation of homes in developed countries have generated an indoor climate favorable to organisms that excrete allergens inducing sensitization and allergic disease. The purpose of this study was to determine the influence of the installation of highly insulated windows and central heating systems on indoor climate, and mite-allergen (Der f 1) and mold spore concentrations. METHODS The bedrooms of 98 apartments were examined before and 7 months (mean) after installation of insulated windows and central heating systems. The air-exchange rate, temperature, and humidity were measured. In settled dust on carpets and mattresses, the number of colony-forming mold spores and the Der f 1 concentration were determined. The inhabitants completed a questionnaire about their lifestyles and housing conditions. RESULTS The air-exchange rate decreased from geometric mean 0.73 to 0.52 per hour (P=0.029). Temperature (mean 13.4 vs 17.5 degrees C, P<0.001), and absolute humidity (mean 4.6 g vs 6.2 g H2O/kg air, P<0.001) increased. Relative humidity remained nearly unchanged (mean 47.6 vs 49.1%). Der f 1 concentrations on carpets (geometric mean 0.65 vs 1.28 microg/g dust, P < 0.001) and mattresses (geometric mean 1.56 vs 2.40 microg/g, P=0.002) increased. Among the fungi that were analyzed, only the thermotolerant species Aspergillus fumigatus increased (geometric mean 20 vs. 60 colony-forming units/g carpet dust, P = 0.02). CONCLUSIONS The findings of this study suggest that the installation of insulated windows and central heating systems is associated with an increase of Der f 1 concentrations in carpet and mattress dust and of A. fumigatus in carpet dust in apartment bedrooms.
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Affiliation(s)
- T Hirsch
- Kinderklinik, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Germany
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43
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Abstract
The development of glomerulonephritis as a complication of neonatal lupus or congenital toxoplasmosis is extremely rare. We report a case of membranous glomerulonephritis occurring in a neonate with toxoplasmosis and atypical congenital lupus, including high-titer antinuclear antibodies and hypocomplementemia. This case illustrates that glomerulonephritis in the neonate may be induced by passively transferred maternal antibodies.
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Affiliation(s)
- C Lam
- Department of Pathology, Columbia University College of Physicians and Surgeons, 630 West 168 Street, New York, NY 10032, USA
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44
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Abstract
A 48-year-old woman who was treated for thyrotoxicosis with methimazole developed agranulocytosis. The methimazole was stopped and treatment with subcutaneous granulocyte colony-stimulating factor (G-CSF) was initiated. Administration of the drug for 8 days did not effectively shorten the recovery period compared with the average reported in the literature without the drug, and may have triggered additional iatrogenic complications. A search of the literature yielded 15 instances of severe antithyroid-drug-induced granulocytopenia (ATDIA) (granulocyte count of less than 0.1 x 10(9)/L) treated with G-CSF. Of the 16 patients, including the 1 reported here, only 3 displayed significant shortening of the agranulocytic period after treatment. We conclude that routine therapeutic application of G-CSF in afebrile severe ATDIG is not justified, and in some cases may generate a cascade of iatrogenic adverse events.
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Affiliation(s)
- D Hirsch
- Endocrinology Institute, Rabin Medical Center, Petah-Tiqva, Israel.
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De Wit S, Cremers L, Hirsch D, Zulian C, Clumeck N, Kormoss N. Efficacy and safety of trazodone versus clorazepate in the treatment of HIV-positive subjects with adjustment disorders: a pilot study. J Int Med Res 1999; 27:223-32. [PMID: 10689628 DOI: 10.1177/030006059902700502] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [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: 11/17/2022] Open
Abstract
The efficacy of trazodone and clorazepate to relieve anxiety and depressive symptoms in 21 HIV-positive subjects with adjustment disorders was determined in a 28-day single-centre, randomized, double-blind study. Subjects were evaluated using the Hospital Anxiety and Depression Scale, the Revised Symptom Checklist, the European Organization for Research and the Treatment of Cancer Quality of Life Questionnaire, and a binary criterion based on the Clinical Global Impression. The incidence of successful treatment was 80% for trazodone compared with 64% for clorazepate; the sample number was too small to establish a significant difference. Bayesian analysis revealed the probability of making a wrong decision in prescribing trazodone rather than clorazepate reduced from 35% to 18% in this small sample. Clinical evaluations using the different scales suggest some benefit from trazodone, although this was not significant. Safety of both treatments was similar. Trazodone is devoid of the risk of abuse and dependence, and may be a valuable alternative to benzodiazepines for the treatment of HIV-related adjustment disorders.
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Affiliation(s)
- S De Wit
- Department of Infectious Diseases, Saint-Pierre University Hospital, Brussels, Belgium
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46
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Chatterton JE, Hirsch D, Schwartz JJ, Bickel PE, Rosenberg RD, Lodish HF, Krieger M. Expression cloning of LDLB, a gene essential for normal Golgi function and assembly of the ldlCp complex. Proc Natl Acad Sci U S A 1999; 96:915-20. [PMID: 9927668 PMCID: PMC15325 DOI: 10.1073/pnas.96.3.915] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/1998] [Indexed: 11/18/2022] Open
Abstract
The Chinese hamster ovary (CHO) cell mutants ldlC and ldlB, which exhibit almost identical phenotypes, define two genes required for multiple steps in the normal medial and trans Golgi-associated processing of glycoconjugates. The LDLC gene encodes ldlCp, an approximately 80-kDa protein, which in wild-type, but not ldlB, cells associates reversibly with the cytoplasmic surface of the Golgi apparatus. Here, we have used a retrovirus-based expression cloning system to clone a murine cDNA, LDLB, that corrects the pleiotropic mutant phenotypes of ldlB cells. The corresponding mRNA was not detected in ldlB mutants. LDLB encodes an approximately 110-kDa protein, ldlBp, which lacks homology to known proteins and contains no common structural motifs. Database searches identified short segments of homology to sequences from Drosophila melanogaster, Arabidopsis thaliana, and Caenorhabditis elegans, and the essentially full-length homologous human sequence (82% identity); however, as was the case for ldlCp, no homologue was identified in Saccharomyces cerevisiae. We have found that in wild-type cell cytosols, ldlCp is a component of an approximately 950-kDa "ldlCp complex," which is smaller, approximately 700 kDa, in ldlB cytosols. Normal assembly of this complex is ldlBp-dependent and may be required for Golgi association of ldlCp and for the normal activities of multiple luminal Golgi processes.
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Affiliation(s)
- J E Chatterton
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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47
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Sun J, Hirsch D, Svensson G. Spinal cord protection by papaverine and intrathecal cooling during aortic crossclamping. J Cardiovasc Surg (Torino) 1998; 39:839-42. [PMID: 9972912] [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: 02/10/2023]
Abstract
AIM To extend the safe period of aortic crossclamping in the porcine model by intrathecally dilating the spinal arteries, with cooling of the spinal cord, or using selfoteL METHODS: Experimental design and setting: prospective domestic laboratory pig study. INTERVENTIONS fifteen animals were assigned to a control group (C, N=5), intrathecal papaverine plus spinal cord cooling group (IP+C, N=5), or selfotel group (S, N=5). In the IP+C group, a lumbar laminectomy was performed and an intrathecal catheter placed for intrathecal injection of papaverine and perfusion with cold Ringer's solution (4 degrees C) prior to aortic crossclamping. In the selfotel group, 20 mg/kg of selfotel was administered 30 minutes before aortic crossclamping. In all 15 animals, the aorta was crossclamped for 60 minutes at normothermia. MEASURES immediately after the operation and 24 hours later, lower limb function was evaluated. RESULTS All five control animals were paralyzed; all 5 IP+C animals could stand or walk (p=0.004 versus control); and in the selfotel group, one had paraparesis, three had paraplegia and one died before evaluation (p=n.s.) CONCLUSIONS The combination of intrathecal papaverine to dilate spinal arteries and prevent spasm from the cold solution plus intrathecally cooling the spinal cord appears to extend the period of safe aortic crossclamping. Selfotel, in this model of extended, severe, spinal cord ischemia, was ineffective.
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Affiliation(s)
- J Sun
- Department of Thoracic and Cardiovascular Surgery Center for Aortic Surgery, Lahey Clinic, Burlington, MA 01805, USA
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48
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Abstract
Long chain fatty acids (LCFAs) are an important source of energy for most organisms. They also function as blood hormones, regulating key metabolic functions such as hepatic glucose production. Although LCFAs can diffuse through the hydrophobic core of the plasma membrane into cells, this nonspecific transport cannot account for the high affinity and specific transport of LCFAs exhibited by cells such as cardiac muscle, hepatocytes, and adipocytes. Transport of LCFAs across the plasma membrane is facilitated by fatty acid transport protein (FATP), a plasma membrane protein that increases LCFA uptake when expressed in cultured mammalian cells [Schaffer, J. E. & Lodish, H. F. (1994) Cell 79, 427-436]. Here, we report the identification of four novel murine FATPs, one of which is expressed exclusively in liver and another only in liver and kidney. Both genes increase fatty acid uptake when expressed in mammalian cells. All five murine FATPs have homologues in humans in addition to a sixth FATP gene. FATPs are found in such diverse organisms as Fugu rubripes, Caenorhabditis elegans, Drosophila melanogaster, Saccharomyces cerevisiae, and Mycobacterium tuberculosis. The function of the FATP gene family is conserved throughout evolution as the C. elegans and mycobacterial FATPs facilitate LCFA uptake when overexpressed in COS cells or Escherichia coli, respectively. The identification of this evolutionary conserved fatty acid transporter family will allow us to gain a better understanding of the mechanisms whereby LCFAs traverse the lipid bilayer as well as yield insight into the control of energy homeostasis and its dysregulation in diseases such as diabetes and obesity.
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Affiliation(s)
- D Hirsch
- Whitehead Institute for Biomedical Research, 9 Cambridge Center, Cambridge, MA 02142-1479, USA
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49
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Vyavahare NR, Hirsch D, Lerner E, Baskin JZ, Zand R, Schoen FJ, Levy RJ. Prevention of calcification of glutaraldehyde-crosslinked porcine aortic cusps by ethanol preincubation: mechanistic studies of protein structure and water-biomaterial relationships. J Biomed Mater Res 1998; 40:577-85. [PMID: 9599034 DOI: 10.1002/(sici)1097-4636(19980615)40:4<577::aid-jbm9>3.0.co;2-c] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Clinical usage of bioprosthetic heart valves (BPHVs) fabricated from glutaraldehyde-pretreated porcine aortic valves is restricted due to calcification-related failure. We previously reported a highly efficacious ethanol pretreatment of BPHVs for the prevention of cuspal calcification. The aim of the present study is to extend our understanding of the material changes brought about by ethanol and the relationship of these material effects to the ethanol pretreatment anticalcification mechanism. Glutaraldehyde-crosslinked porcine aortic valve cusps (control and ethanol-pretreated) were studied for the effects of ethanol on tissue water content and for spin-lattice relaxation times (T1) using solid state proton NMR. Cusp samples were studied for protein conformational changes due to ethanol by ATR-FTIR spectroscopy. The changes in cuspal tissue-cholesterol (in vitro) interactions also were studied. Cusp material stability was assessed in terms of residual glutaraldehyde content and collagenase degradation. Water content of the cusp samples was decreased significantly due to ethanol pretreatment. The cuspal collagen conformational changes (per infrared spectroscopy) brought about by ethanol pretreatment were persistent even after rat subdermal implantation of cusp samples for 7 days. In vitro cholesterol uptake by cusps was greatly reduced as a result of ethanol pretreatment. Ethanol pretreatment of cusps also resulted in increased resistance to collagenase digestion. Cuspal glutaraldehyde content was not changed by ethanol pretreatment. We conclude that ethanol pretreatment of bioprosthetic heart valve cusps causes multi-component effects on the tissue/material and macromolecular characteristics, which partly may explain the ethanol-pretreatment anticalcification mechanism.
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Affiliation(s)
- N R Vyavahare
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, USA
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Kartio I, Wittstock G, Laajalehto K, Hirsch D, Simola J, Laiho T, Szargan R, Suoninen E. Detection of elemental sulphur on galena oxidized in acidic solution. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0301-7516(97)00028-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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