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Copping R, Tai E, Shlomovitz E. Abstract No. 61 STS Sclerotherapy is Effective and Durable for Liver Cyst Volume Reduction in Autosomal Dominant Polycystic Kidney Disease. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Copping R, Shlomovitz E, Tai E. Abstract No. 62 STS Sclerotherapy for Renal Cyst Volume Reduction in Autosomal Dominant Polycystic Kidney Disease. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Syed F, Stogios N, Sockalingam S, Maunder R, Cobain M, Tai E, Nolan R, Peiris R, Huszti E. AN ASSESSMENT OF GOAL-DIRECTED BEHAVIOURS THAT PROMOTE HEALTH-RELATED QUALITY OF LIFE: A PROOF-OF-CONCEPT STUDY. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.103] [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] Open
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Shlomovitz E, Barragan C, Alshehri H, Tai E, Swanstrom L. Abstract No. 98 Early human experience with magnetic compression anastomosis for recanalization of complete esophageal occlusion in adults. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Tai E, Kennedy S, Farrell A, Jaberi A, Kachura J, Beecroft R. Comparison of transarterial bland and chemoembolization for neuroendocrine tumours: a systematic review and meta-analysis. Curr Oncol 2020; 27:e537-e546. [PMID: 33380868 PMCID: PMC7755439 DOI: 10.3747/co.27.6205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 12/17/2022] Open
Abstract
Background Treatment of hepatic metastases from neuroendocrine tumours improves survival and symptom relief. Hepatic arterial embolotherapy techniques include transarterial chemoembolization (tace) and bland embolization (tae). The relative efficacy of the techniques is controversial. The purpose of the present study was to use a meta-analysis and systematic review to compare tace with tae in the treatment of hepatic metastases. Methods A literature search identified studies comparing tace and tae for treatment of hepatic metastases. Outcomes of interest included overall survival (os), progression-free survival (pfs), radiographic response, complications, and symptom control. The hazard ratios (hrs) and odds ratios (ors) were estimated and pooled. Results Eight studies and 504 patients were included. No statistically significant differences between tace and tae were observed for os at 1, 2, and 5 years or for hrs [1-year or: 0.72; 95% confidence interval (ci): 0.27 to 1.94; p < 0.52; 2-year or: 0.69; 95% ci: 0.43 to 1.11; p < 0.12; 5-year or: 0.91; 95% ci: 0.37 to 2.24; p < 0.85; hr: 0.96; 95% ci: 0.73 to 1.24; p < 0.74]. No statistically significant differences between tace and tae were observed for pfs at 1, 2, and 5 years or for hrs (1-year or: 0.71; 95% ci: 0.38 to 1.55; p < 0.30; 2-year or: 0.83; 95% ci: 0.33 to 2.06; p < 0.69; 5-year or: 0. 91; 95% ci: 0.37 to 2.24; p < 0.85; hr: 0.99-1.74; 95% ci: 0.74 to 1.73; p < 0.97). Both techniques are safe and effective for symptom control. Conclusions No statistically significant differences between tace and tae were observed for os and pfs.
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Affiliation(s)
- E Tai
- Division of Interventional Radiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON
| | - S Kennedy
- Division of Interventional Radiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON
| | - A Farrell
- Library and Information Services, Toronto General Hospital, Toronto, ON
| | - A Jaberi
- Division of Interventional Radiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON
| | - J Kachura
- Division of Interventional Radiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON
| | - R Beecroft
- Division of Interventional Radiology, Joint Department of Medical Imaging, University Health Network, Toronto, ON
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Lamagna C, Chan M, Bagos A, Tai E, Young C, Chen Y, Chou L, Park G, Masuda E, Taylor V. OP0046 TARGETING IRAK1 AND 4 SIGNALING WITH R835, A NOVEL ORAL SMALL MOLECULE INHIBITOR: A POTENTIAL NEW TREATMENT FOR SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background:Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by loss of immunological tolerance, hyperactivation of immune cells, proinflammatory cytokine production and, ultimately, end organ damage due to immune complex deposition. Toll-like receptors (TLRs), which are essential to the innate immune response to microbes and other danger signals, play a key role in the pathogenesis of SLE by recognition of self-molecules (1). Interleukin receptor associated kinases (IRAK)1 and 4 are responsible for initiating MyD88-dependent signaling from most TLRs and Interleukin-1 Receptors (IL-1R) and represent attractive targets for the therapeutic treatment of SLE (2). We have identified a potent and selective IRAK1/4 inhibitor, R835, that substantially suppressed the elevation of LPS (TLR4 agonist)-induced serum cytokines in healthy human volunteers in a recently completed phase 1 study.Objectives:The aim of our study was to investigate the effect of IRAK1/4 selective inhibition as potential therapeutic approach for SLE. We evaluated the effect of our clinical candidate R835 on TLR7 signaling and in a mouse model of lupus-like disease.Methods:Human primary dendritic cells and whole blood were stimulated with gardiquimod (TLR7 agonist) to evaluate the effect of R835 on Interferon-alpha (IFN-α) production. R835 was further evaluated for its efficacy on survival and disease progression in lupus-prone NZB/W F1 mice with early or active signs of disease.Results:R835 inhibited TLR7-induced cytokine production in human dendritic cells and whole blood. Given orally to mice, R835 dose-dependently decreased serum IFN-α in response to administration of a TLR7 agonist. Furthermore, treatment of NZB/W F1 lupus-prone mice with R835 reversed the progression of lupus-like disease and the establishment of a pro-inflammatory environment, as demonstrated by decreased levels of proteinuria, blood urea nitrogen and autoantibodies, and reversal of renal pathology.Conclusion:To our knowledge, R835 is the first dual IRAK1/4 inhibitor to enter clinical development and provides an attractive approach to treat a range of autoimmune and rheumatic diseases, including lupus.References:[1]Signals via the Adaptor MyD88 in B cells and DCs Make Distinct and Synergistic Contributions to Immune Activation and Tissue Damage in Lupus. Lino L. Teichmann, Dominik Schenten, Ruslan Medzhitov, Michael Kashgarian, and Mark J. Shlomchik. Immunity. 2013 March 21; 38(3): 528–540.[2]Suppression of IRAK1 or IRAK4 Catalytic Activity, but Not Type 1 IFN Signaling, Prevents Lupus Nephritis in Mice Expressing a Ubiquitin Binding-Defective Mutant of ABIN1. Nanda SK, Lopez-Pelaez M, Arthur JS, Marchesi F, Cohen P. J Immunol. 2016 Dec 1;197(11):4266-4273.Disclosure of Interests:Chrystelle Lamagna Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Meagan Chan Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Art Bagos Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Ernest Tai Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Chi Young Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Yan Chen Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Lu Chou Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Gary Park Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Esteban Masuda Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vanessa Taylor Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals
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Braselmann S, Tai E, Frances R, Young C, Markovtsov V, Masuda E, Taylor V. AB0058 CELL-TYPE SPECIFIC REGULATION OF IL-1R SIGNALING BY R835, A DUAL IRAK1/4 INHIBITOR. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Interleukin-1 beta (IL-1b) is a key mediator of the inflammatory response and is known to exacerbate damage during chronic disease and acute tissue injury. Through association with the adaptor protein Myd88, interleukin receptor associated kinases (IRAK)1 and 4 initiate signaling downstream of IL-1Rs resulting in the activation of the NFkB and MAPK pathways and the production of proinflammatory cytokines (1). IL-1Rs are broadly expressed across cell types and little is known about differences in signaling between cell types and the role of IRAK1 and IRAK4 kinase activity.Objectives:We have identified a potent and selective IRAK1/4 inhibitor, R835, that substantially suppressed the elevation of LPS (TLR4 agonist)-induced serum cytokines in healthy human volunteers in a recent phase 1 study. The aim of this study was to evaluate the effect of R835 on IL-1R signaling in primary human fibroblasts and endothelial cells.Methods:Human dermal fibroblasts, lung fibroblasts or endothelial cells were stimulated with IL-1b and the effect of R835 on the signaling pathway was evaluated by western blotting. Human dermal fibroblasts were stimulated with different amounts of IL-1b to evaluate both the signaling pathways activated and the cytokines produced. The ability of R835 to inhibit cytokine production induced by high or low amounts of IL-1b in dermal fibroblasts was assessed.Results:In human endothelial cells, inhibition of IRAK1/4 kinases with R835 resulted in a block of IL-1b-induced IRAK4 phosphorylation, IRAK1 degradation and downstream NFkB, p38 and JNK activation. In contrast, in both human primary dermal and lung fibroblasts stimulated with IL-1b, we observed potent inhibition of IRAK4 phosphorylation, IRAK1 degradation, and downstream JNK phosphorylation, but no inhibition of NFkB pathway proteins and only weak inhibition of p38. Upon titration of IL-1b we observed that dermal fibroblasts produced IL-8 and GRO in response to low levels of IL-1b (20pg/ml), and produced additional cytokines including G-CSF and GM-CSF with higher levels of IL-1b (400pg/ml). In the presence of low levels of IL-1b (20pg/ml), we observed a weak activation of NFkB pathway proteins and p38, compared to a very robust NFkB, p38 and additional JNK activation in the presence of higher levels of IL-1b (400pg/ml). Consistent with these results, in dermal fibroblasts, R835 showed little to no inhibition of IL-8 and GRO induced by low levels of IL-1b, but potently inhibited G-CSF and GM-CSF induced by high levels of IL-1b where JNK was activated.Conclusion:This study has elucidated signaling differences between cell types downstream of the IL-1R. In endothelial cells, as in myeloid cells, the kinase activity of IRAK1 and IRAK4 is required for the activation of all downstream signaling. Unexpectedly, in human fibroblasts, IRAK1/4 kinase activity appears to primarily regulate the JNK pathway, and not the NFkB pathway. Concomitant with that, only the cytokines induced by the additional activation of JNK in fibroblasts are regulated by a dual IRAK1/4 inhibitor. Clinically, an IRAK1/4 inhibitor may show select inhibition of IL-1b-induced cytokines depending on the tissue and cell type involved in inflammation.References:[1]Flannery S, Bowie A G. The interleukin-1 receptor-associated kinases: Critical regulators of innate immune signaling. Biochemical Pharmacology, Volume 80, Issue 12, 15 December 2010, Pages 1981-1991.Disclosure of Interests:Sylvia Braselmann Shareholder of: Shareholder of Rigel Pharmaceuticals, Employee of: Employee of Rigel Pharmaceuticals, Ernest Tai Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Roy Frances Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Chi Young Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vadim Markovtsov Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Esteban Masuda Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vanessa Taylor Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals
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Lamagna C, Chan M, Tai E, Siu S, Frances R, Yi S, Young C, Markovtsov V, Chen Y, Chou L, Park G, Masuda E, Taylor V. OP0133 PRECLINICAL EFFICACY OF R835, A NOVEL IRAK1/4 DUAL INHIBITOR, IN RODENT MODELS OF JOINT INFLAMMATION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Interleukin receptor associated kinases (IRAK) 1 and 4 are kinases involved in Toll-Like Receptor (TLR) and Interleukin-1 Receptor (IL-1R) signaling pathways, which regulate innate immunity and inflammation. Dysregulation of IRAK1/4 signaling can lead to a variety of inflammatory conditions including rheumatoid and gouty arthritis. As a result, IRAK1/4 are promising therapeutic targets for rheumatic diseases (1). We have identified a potent and selective IRAK1/4 inhibitor, R835, that substantially suppressed the elevation of LPS (TLR4 agonist)-induced serum cytokines in healthy human volunteers in a recently completed phase 1 study.Objectives:The aim of our study was to investigate the effect of IRAK1/4 selective inhibition as a potential therapeutic approach for rheumatological diseases. We evaluated the inhibition by our clinical candidate, R835, on TLR-, IL-1R- and NLRP3 inflammasome-induced cytokine production, as well as in preclinical models of arthritis.Methods:The effect of R835 on TLR- or IL-1R-induced cytokine production was evaluated in vitro using THP-1, human primary endothelial cells and human primary dendritic cells. The activity of R835 on the NLRP3 inflammasome was also tested in vitro using THP-1 cells. The pharmacokinetic-pharmacodynamic relationship of R835 was evaluated in a mouse model of IL-1b-induced cytokine release. Mice were pre-treated orally with vehicle or R835 prior to challenge; serum cytokine and plasma compound levels were determined. The efficacy of IRAK1/4 inhibition by R835 in rodent models of joint inflammation was evaluated in a mouse model monosodium (MSU)-induced peritonitis, in rat model of MSU-induced gouty arthritis and in a rat model of collagen-induced arthritis (CIA).Results:In human cells, R835 blocked proinflammatory cytokine production in response to TLR, IL-1R and NLRP3 inflammasome activation. In mice, R835 dose-dependently decreased serum cytokines in response to administration of IL-1b. Mice pre-treated with R835 demonstrated dose-dependent reductions in MSU crystal-induced serum and peritoneal cytokine levels, as well as neutrophil influx in the peritoneal cavity. Prophylactic and therapeutic treatment with R835 also resulted in significant inhibition of MSU crystal-induced knee edema and pain in a rat model of human gouty arthritis. In the rat model of CIA, R835 blocked both onset and progression of disease, by reducing inflammation, cartilage degeneration and synovial inflammation.Conclusion:R835 is a promising clinical candidate for the treatment of a range of cytokine-driven rheumatological diseases. R835 has proven to have desirable pharmacokinetic properties, was well tolerated and suppressed LPS-induced serum cytokines in healthy volunteers in a recent phase 1 study.References:[1]Bahia M S, Kaur M, Silakari P, Silakari O. Interleukin-1 receptor associated kinase inhibitors: Potential therapeutic agents for inflammatory- and immune-related disorders. Cellular Signalling 27 (2015) 1039–1055.Disclosure of Interests:Chrystelle Lamagna Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Meagan Chan Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Ernest Tai Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Stacey Siu Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Roy Frances Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Sothy Yi Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Chi Young Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vadim Markovtsov Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Yan Chen Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Lu Chou Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Gary Park Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Esteban Masuda Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals, Vanessa Taylor Shareholder of: Rigel Pharmaceuticals, Employee of: Rigel Pharmaceuticals
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Patel N, Tai E, Bailey S, Mirrahimi A, Mafeld S, Beecroft J, Tan K, Annamalai G. 3:36 PM Abstract No. 222 Percutaneous radiologic gastrostomy with and without gastropexy: a prospective comparison. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.264] [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] Open
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Patel N, Frosi Stella S, Hsiao R, Gurevich A, Kostrzewa M, Iliuta I, Tai E, Jaberi A, Pei Y, Shlomovitz E. 4:12 PM Abstract No. 116 Safety of high-dose 3% sodium tetradecyl sulfate for sclerotherapy treatment of renal cysts in autosomal dominant polycystic kidney disease: a five-year study. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.146] [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: 10/25/2022] Open
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Tai E, Min A, Itkin M, Rajan D. Abstract No. 613 Interventional radiology management of chylous ascites. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.674] [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: 10/25/2022] Open
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Stover AM, Urick BY, Deal AM, Teal R, Vu MB, Carda-Auten J, Jansen J, Chung AE, Bennett AV, Chiang A, Cleeland C, Deutsch Y, Tai E, Zylla D, Williams LA, Pitzen C, Snyder C, Reeve B, Smith T, McNiff K, Cella D, Neuss MN, Miller R, Atkinson TM, Spears PA, Smith ML, Geoghegan C, Basch EM. Performance Measures Based on How Adults With Cancer Feel and Function: Stakeholder Recommendations and Feasibility Testing in Six Cancer Centers. JCO Oncol Pract 2020; 16:e234-e250. [PMID: 32074014 PMCID: PMC7069703 DOI: 10.1200/jop.19.00784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Patient-reported outcome measures (PROMs) that assess how patients feel and function have potential for evaluating quality of care. Stakeholder recommendations for PRO-based performance measures (PMs) were elicited, and feasibility testing was conducted at six cancer centers. METHODS Interviews were conducted with 124 stakeholders to determine priority symptoms and risk adjustment variables for PRO-PMs and perceived acceptability. Stakeholders included patients and advocates, caregivers, clinicians, administrators, and thought leaders. Feasibility testing was conducted in six cancer centers. Patients completed PROMs at home 5-15 days into a chemotherapy cycle. Feasibility was operationalized as ≥ 75% completed PROMs and ≥ 75% patient acceptability. RESULTS Stakeholder priority PRO-PMs for systemic therapy were GI symptoms (diarrhea, constipation, nausea, vomiting), depression/anxiety, pain, insomnia, fatigue, dyspnea, physical function, and neuropathy. Recommended risk adjusters included demographics, insurance type, cancer type, comorbidities, emetic risk, and difficulty paying bills. In feasibility testing, 653 patients enrolled (approximately 110 per site), and 607 (93%) completed PROMs, which indicated high feasibility for home collection. The majority of patients (470 of 607; 77%) completed PROMs without a reminder call, and 137 (23%) of 607 completed them after a reminder call. Most patients (72%) completed PROMs through web, 17% paper, or 2% interactive voice response (automated call that verbally asked patient questions). For acceptability, > 95% of patients found PROM items to be easy to understand and complete. CONCLUSION Clinicians, patients, and other stakeholders agree that PMs that are based on how patients feel and function would be an important addition to quality measurement. This study also shows that PRO-PMs can be feasibly captured at home during systemic therapy and are acceptable to patients. PRO-PMs may add value to the portfolio of PMs as oncology transitions from fee-for-service payment models to performance-based care that emphasizes outcome measures.
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Affiliation(s)
- Angela M. Stover
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Benjamin Y. Urick
- Department of Pharmacy, Center for Medication Optimization in the Division of Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Randall Teal
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
- Connected Health Applications and Interventions (CHAI-Core), University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Maihan B. Vu
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
- Connected Health Applications and Interventions (CHAI-Core), University of North Carolina at Chapel Hill, Chapel Hill, NC
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jessica Carda-Auten
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
- Connected Health Applications and Interventions (CHAI-Core), University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Arlene E. Chung
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
- Departments of Medicine and Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Antonia V. Bennett
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Anne Chiang
- Yale University and Smilow Cancer Center, Hartford, CT
| | | | | | - Edmund Tai
- Palo Alto Medical Foundation, Palo Alto, CA
| | - Dylan Zylla
- Park Nicollet Oncology Research, Frauenshuh Cancer Center, HealthPartners Institute, Minneapolis, MN
| | | | | | | | | | | | | | | | | | - Robert Miller
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | - Mary Lou Smith
- Patient Advocate
- Research Advocacy Network, Naperville, IL
| | | | - Ethan M. Basch
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Siegel D, Richardson L, Henley S, Wilson R, Dowling N, Weir H, Tai E, Lunsford NB. Trends in pediatric cancer mortality and survival in the United States. Ann Epidemiol 2019. [DOI: 10.1016/j.annepidem.2019.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tai E, Qazi A, Chan T, Zener R, Iliuta I, Barua M, Khalili K, Jaberi A, Pei Y, Shlomovitz E. 04:12 PM Abstract No. 419 3% STS foam sclerotherapy of liver cysts is effective and durable for cyst volume reduction in autosomal dominant polycystic kidney disease patients. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Tai E, Kwan J, Qazi A, Fischer S, Shlomovitz E. Abstract No. 543 Long-term recanalization of complete biliary enteric occlusion by magnetic compression anastomosis in living donor related liver transplant patients: radiologic, endoscopic and pathologic correlation. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.624] [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: 10/27/2022] Open
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Kwan J, Chan T, Tai E, Tan K, Kwan J. 03:27 PM Abstract No. 26 Embolization of type II endoleaks via a percutaneous trans-abdominal direct sac puncture approach: a comparison of outcomes of embolizing the aneurysm sac only versus the aneurysm sac and branch vessels. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.064] [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: 10/27/2022] Open
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Morozkin M, Denisov G, Tai E, Soluyanova E, Sedov A, Fokin A, Kuftin A, Tsvetkov A, Bakulin M, Sokolov E, Malygin V, Proyavin M, Zapevalov V, Mocheneva O, Glyavin M. Development of the Prototype of High Power Sub-THz Gyrotron for Advanced Fusion Power Plant (DEMO). EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201819501008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kwong A, Shin VY, Ma ES, Chan CT, Ford JM, Kurian AW, Tai E. Screening for founder and recurrent BRCA mutations in Hong Kong and US Chinese populations. Hong Kong Med J 2018; 24 Suppl 3:4-6. [PMID: 29937436] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- A Kwong
- Department of Surgery, The University of Hong Kong
| | - V Y Shin
- Department of Surgery, The University of Hong Kong
| | - E Sk Ma
- Department of Surgery, The University of Hong Kong
| | - C Tl Chan
- Department of Surgery, The University of Hong Kong
| | - J M Ford
- Department of Surgery, The University of Hong Kong
| | - A W Kurian
- Department of Surgery, The University of Hong Kong
| | - E Tai
- Department of Surgery, The University of Hong Kong
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Popov L, Agapova M, Belov Y, Chirkov A, Denisov G, Eremeev A, Gnedenkov A, Ilin V, Kuzmin A, Litvak A, Lyubimov A, Malygin V, Miasnikov V, Nichiporenko V, Sokolov E, Soluyanova E, Tai E, Usachev S, Usov V, Zapevalov V. Status of the gyrotron complex for ITER: composition of the complex, manufacturing, obtained parameters, delivery conditions. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201818701016] [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: 11/14/2022] Open
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Denisov G, Fokin A, Glyavin M, Kuftin A, Morozkin M, Malygin V, Proyavin M, Sedov A, Soluyanova E, Sokolov E, Tsvetkov A, Tai E, Zapevalov V. Design and Experimental Test Of 250 GHz/300 kW/CW Gyrotron. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201818701006] [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: 11/14/2022] Open
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Fichadiya A, Kotha V, Gregory A, Herget E, Tai E, Holloway D, Appoo J. WHAT IS THE LONG-TERM AORTIC REMODELING OUTCOME AFTER HEMI-ARCH REPAIR FOR ACUTE TYPE A DISSECTION? AN 11-YEAR STUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.079] [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: 11/15/2022] Open
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Leuterer F, MÜnich M, Brandl F, Brinkschulte H, GrÜnwald G, Manini A, Monaco F, Ryter F, SchÜtz H, Stober J, Wagner D, Kasparek W, Gantenbein G, Empacher L, Lechte C, Kumric H, SchÜller P, Litvak A, Chirkov A, Denisov G, Fix A, Illin V, Malygin S, Miasnikov V, Nichiporenko V, Popov L, Tai E, Zapevalov V. Operation Experience with the ASDEX Upgrade ECRH System. Fusion Science and Technology 2017. [DOI: 10.13182/fst09-a4051] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- F. Leuterer
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - M. MÜnich
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - F. Brandl
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - H. Brinkschulte
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - G. GrÜnwald
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - A. Manini
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - F. Monaco
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - F. Ryter
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - H. SchÜtz
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - J. Stober
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - D. Wagner
- Max-Planck-Institut für Plasmaphysik, Association Euratom-IPP, D-85748 Garching, Germany
| | - W. Kasparek
- Institut für Plasmaforschung, Universität Stuttgart, D-70569 Stuttgart, Germany
| | - G. Gantenbein
- Institut für Plasmaforschung, Universität Stuttgart, D-70569 Stuttgart, Germany
| | - L. Empacher
- Institut für Plasmaforschung, Universität Stuttgart, D-70569 Stuttgart, Germany
| | - C. Lechte
- Institut für Plasmaforschung, Universität Stuttgart, D-70569 Stuttgart, Germany
| | - H. Kumric
- Institut für Plasmaforschung, Universität Stuttgart, D-70569 Stuttgart, Germany
| | - P. SchÜller
- Institut für Plasmaforschung, Universität Stuttgart, D-70569 Stuttgart, Germany
| | - A. Litvak
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - A. Chirkov
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - G. Denisov
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - A. Fix
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - V. Illin
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - S. Malygin
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - V. Miasnikov
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - V. Nichiporenko
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - L. Popov
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - E. Tai
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
| | - V. Zapevalov
- Institute of Applied Physics, RAS, 603950 Nizhny Novgorod, Russia
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Ke T, Dorajoo R, Han Y, Khor C, Van Dam R, Yuan J, Koh W, Liu J, Teo Y, Goh D, Tai E, Wong T, Friedlander Y, Heng C. Associations of snps in peroxisome proliferator activated receptors with high density lipoprotein, and gene-gene interactions in singaporean chinese. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ahmed I, Biswas A, Krishnamurthy S, Julka P, Rath G, Back M, Huang D, Gzell C, Chen J, Kastelan M, Gaur P, Wheeler H, Badiyan SN, Robinson CG, Simpson JR, Tran DD, Rich KM, Dowling JL, Chicoine MR, Leuthardt EC, Kim AH, Huang J, Michaelsen SR, Christensen IJ, Grunnet K, Stockhausen MT, Broholm H, Kosteljanetz M, Poulsen HS, Tieu M, Lovblom E, Macnamara M, Mason W, Rodin D, Tai E, Ubhi K, Laperriere N, Millar BA, Menard C, Perkins B, Chung C, Clarke J, Molinaro A, Phillips J, Butowski N, Chang S, Perry A, Costello J, DeSilva A, Rabbitt J, Prados M, Cohen AL, Anker C, Shrieve D, Hall B, Salzman K, Jensen R, Colman H, Farber O, Weinberg U, Palti Y, Fisher B, Chen H, Macdonald D, Lesser G, Coons S, Brachman D, Ryu S, Werner-Wasik M, Bahary JP, Chakravarti A, Mehta M, Gupta T, Nair V, Epari S, Godasastri J, Moiyadi A, Shetty P, Juvekar S, Jalali R, Herrlinger U, Schafer N, Steinbach J, Weyerbrock A, Hau P, Goldbrunner R, Kohnen R, Urbach H, Stummer W, Glas M, Houillier C, Ghesquieres H, Chabrot C, Soussain C, Ahle G, Choquet S, Faurie P, Bay JO, Vargaftig J, Gaultier C, Nicolas-Virelizier E, Hoang-Xuan K, Iskanderani O, Izar F, Benouaich-Amiel A, Filleron T, Moyal E, Iweha C, Jain S, Melian E, Sethi A, Albain K, Shafer D, Emami B, Kong XT, Green S, Filka E, Green R, Yong W, Nghiemphu P, Cloughesy T, Lai A, Mallick S, Biswas A, Roy S, Purkait S, Gupta S, Julka PK, Rath GK, Marosi C, Thaler J, Ay C, Kaider A, Reitter EM, Haselbock J, Preusser M, Flechl B, Zielinski C, Pabinger I, Miyatake SI, Furuse M, Miyata T, Yoritsune E, Kawabata S, Kuroiwa T, Muragaki Y, Maruyama T, Iseki H, Akimoto J, Ikuta S, Nitta M, Maebayashi K, Saito T, Okada Y, Kaneko S, Matsumura A, Kuroiwa T, Karasawa K, Nakazato Y, Kayama T, Nabors LB, Fink KL, Mikkelsen T, Grujicic D, Tarnawski R, Nam DH, Mazurkiewicz M, Salacz M, Ashby L, Thurzo L, Zagonel V, Depenni R, Perry JR, Henslee-Downey J, Picard M, Reardon DA, Nambudiri N, Nayak L, LaFrankie D, Wen P, Ney D, Carlson J, Damek D, Blatchford P, Gaspar L, Kavanagh B, Waziri A, Lillehei K, Reddy K, Chen C, Rashed I, Melian E, Sethi A, Barton K, Anderson D, Prabhu V, Rusch R, Belongia M, Maheshwari M, Firat S, Schiff D, Desjardins A, Cloughesy T, Mikkelsen T, Glantz M, Chamberlain M, Reardon DA, Wen P, Shapiro W, Gopal S, Judy K, Patel S, Mahapatra A, Shan J, Gupta D, Shih K, Bacha JA, Brown D, Garner WJ, Steino A, Schwart R, Kanekal S, Li M, Lopez L, Burris HA, Soderberg-Naucler C, Rahbar A, Stragliotto G, Song AJ, Kumar AMS, Murphy ES, Tekautz T, Suh JH, Recinos V, Chao ST, Spoor J, Korami K, Kloezeman J, Balvers R, Dirven C, Lamfers M, Leenstra S, Sumrall A, Haggstrom D, Crimaldi A, Symanowski J, Giglio P, Asher A, Burri S, Sunkersett G, Khatib Z, Prajapati CM, Magalona EE, Mariano M, Sih IM, Torcuator R, Taal W, Oosterkamp H, Walenkamp A, Beerenpoot L, Hanse M, Buter J, Honkoop A, Boerman D, de Vos F, Jansen R, van der Berkmortel F, Brandsma D, Enting R, Kros J, Bromberg J, van Heuvel I, Smits M, van der Holt R, Vernhout R, van den Bent M, Weinberg U, Farber O, Palti Y, Wick W, Suarez C, Rodon J, Desjardins A, Forsyth P, Gueorguieva I, Cleverly A, Burkholder T, Desaiah D, Lahn M, Zach L, Guez D, Last D, Daniels D, Nissim O, Grober Y, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Mardor Y. MEDICAL RADIATION THERAPIES. Neuro Oncol 2013; 15:iii75-iii84. [PMCID: PMC3823894 DOI: 10.1093/neuonc/not179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
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Underwood JM, Rim SH, Tai E, Fairley T. The risk of subsequent malignancies in cervical cancer survivors as compared with breast and colorectal cancer survivors: United States 1992-2007. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9043] [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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Li J, German R, King J, Joseph D, Thompson T, Wu X, Tai E, Ajani U. Prostate cancer screening and incidence among men younger than age 50. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
183 Background: Prostate cancer has long been considered as a disease of older men. However, age at diagnosis with prostate cancer has continued to decline. Since the introduction of prostate-specific antigen (PSA) test in 1986, the prostate cancer incidence rate has steadily and dramatically increased in men under age 50. This study aims to better understand demographic variations in prostate cancer screening and incidence, and clinical characteristics of prostate cancers in men under age 50. Methods: We examined prostate cancer testing data from the Behavioral Risk Factor Surveillance System (2002, 2004, 2006, and 2008) and prostate cancer incidence data from the CDC's National Program of Cancer Registries and the NCI's Surveillance, Epidemiology, and End Results programs (2001-2006). We estimated the weighted percentage of self-reported cancer testing using SUDAAN and age-adjusted cancer incidence rates and trends using SEER-STAT. Statistical significance for trends was determined by the annual percentage change (APC) differing form zero. Results: A total of 29,176 prostate cancer cases were identified from 2001-2006 among men under age 50. Of these, 551 (1.9%) were among men under age 40. Incidence rates remained stable from 2001-2006; however the incidence of well-differentiated tumors decreased significantly (APC=−24.7) during this time period. About 44% of men aged 40-49 years old reported having a prostate cancer test in the past two years. Prostate cancer testing and incidence rates were highest among men who were black, non-Hispanic, or lived in the northeast. Black men had more than a 2-fold increase in cancer incidence than white men. Conclusions: The magnitude of prostate cancer testing and incidence in men under age 50 reveals significant health/public health problems in this younger population. This study demonstrates substantial regional differences in prostate cancer testing and incidence in men under age 50. It also confirms that prostate cancer testing and incidence varies by race and ethnicity. We observed a large disparity in prostate cancer incidence between blacks and whites. The incidence rate remained stable over time; the dramatic decrease occurred in well-differentiated cancers. No significant financial relationships to disclose.
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Affiliation(s)
- J. Li
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - R. German
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - J. King
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - D. Joseph
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - T. Thompson
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - X. Wu
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - E. Tai
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
| | - U. Ajani
- Centers for Disease Control, Atlanta, GA; Louisiana State University, Baton Rouge, LA
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Tai E, Richardson L, Townsend J, Steele B. Differences in length of stay among hospitalized children with acute lymphoblastic leukemia. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10044 Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy among children in the United States. While age, race, and clinical complications have been associated with longer length of stay (LOS) among children with cancer, it is unknown what factors are related to LOS among children with ALL. We examined differences in LOS among hospitalized children with ALL. Methods: We used 2000, 2003, and 2006 data from the Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Database (KID) which contains pediatric discharges from community, non-rehabilitation hospitals. We used negative binomial regression to determine factors related to LOS. Results: We found the following factors related to greater LOS among hospitalized children with ALL: Non-Hispanic blacks vs. non-Hispanic whites (Rate Ratio (RR) = 1.06, CI:1.03–1.10), Hispanics vs. non-Hispanic whites (RR = 1.07, CI:1.04–1.10), age < 1 year vs. age 1–5 years (RR = 1.93, CI:1.83–2.04), female vs. male (RR = 1.05, CI:1.03–1.07), lowest quartile of household income in patient's zip code vs. highest quartile (RR = 1.09, CI:1.06–1.12), Medicaid vs. private insurance (RR = 1.11, CI:1.09–1.14), children's hospital vs. non-children's (RR = 1.11, CI:1.08–1.14), Western region of United States vs. Northeast region (RR = 1.14, CI:1.11–1.17), emergency room admission vs. routine admission (RR = 1.23, CI:1.20–1.26), blood transfusion (RR = 1.64, CI:1.61–1.67), bone marrow transplant (RR = 7.64, CI:7.11–8.20), and neutropenia (RR = 1.22, CI:1.19–1.24). Conclusions: Race/ethnicity, age, sex, household income, insurance status, admission source, hospital type and region, transfusion, bone marrow transplant, and neutropenia were significantly associated with longer LOS. These factors may help identify children with ALL at risk for complications. Prophylactic treatment for clinical complications may reduce LOS. No significant financial relationships to disclose.
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Affiliation(s)
- E. Tai
- Centers for Disease Control and Prevention, Atlanta, GA
| | - L. Richardson
- Centers for Disease Control and Prevention, Atlanta, GA
| | - J. Townsend
- Centers for Disease Control and Prevention, Atlanta, GA
| | - B. Steele
- Centers for Disease Control and Prevention, Atlanta, GA
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Tai E, Sanchez T, Lansky A, Mahle K, Heffelfinger J, Workowski K. Self-reported syphilis and gonorrhoea testing among men who have sex with men: national HIV behavioural surveillance system, 2003-5. Sex Transm Infect 2009; 84:478-82. [PMID: 19028951 DOI: 10.1136/sti.2008.030973] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The Centers for Disease Control and Prevention provides guidance on sexually transmitted disease (STD) testing specifically for men who have sex with men (MSM) in STD treatment guidelines to address increasing rates of gonorrhoea and syphilis among MSM in the USA. The guidelines recommend at least annual syphilis, gonorrhoea and chlamydia testing for sexually active MSM. The implementation of these guidelines was evaluated. METHODS Data from the 2003-5 MSM cycle of the National HIV Behavioural Surveillance System were used. The proportion of sexually active HIV-negative MSM reporting syphilis and gonorrhoea testing during the previous year was determined and multivariate logistic regression was used to identify factors associated with testing. RESULTS Of 10 030 MSM, 39% and 36% reported having been tested for syphilis and gonorrhoea in the previous year, respectively. Four factors were associated with syphilis and gonorrhoea testing, respectively: age 18-24 years versus > or =45 years (odds ratio (OR) 2.2, 95% CI 1.8 to 2.5; OR 2.7, 95% CI 2.3 to 3.2), black versus white race (OR 1.3, 95% CI 1.1 to 1.4; OR 1.4, 95% CI 1.2 to 1.6), private insurance versus no insurance (OR 1.3, 95% CI 1.1 to 1.4; OR 1.3, 95% CI 1.1 to 1.4) and disclosing male-male sex to a healthcare provider (OR 2.2, 95% CI 2.0 to 2.5; OR 2.1, 95% CI 1.9 to 2.3). CONCLUSIONS Syphilis and gonorrhoea testing among MSM was low, despite specific testing recommendations in the STD treatment guidelines. To increase STD testing among MSM, healthcare providers should assess the risks of STD for male patients through routine enquiries about sexual activity.
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Affiliation(s)
- E Tai
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA.
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Luo DYW, Tai E, Lim TS, Stokes B, McMenamin P. SE20 THE ANATOMY OF COMPLICATIONS IN THE UPPER LIMB. ANZ J Surg 2007. [DOI: 10.1111/j.1445-2197.2007.04129_20.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tan W, Gou DM, Tai E, Zhao YZ, Chow LMC. Functional reconstitution of purified chloroquine resistance membrane transporter expressed in yeast. Arch Biochem Biophys 2006; 452:119-28. [PMID: 16884678 DOI: 10.1016/j.abb.2006.06.017] [Citation(s) in RCA: 21] [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] [Received: 05/16/2006] [Revised: 06/10/2006] [Accepted: 06/12/2006] [Indexed: 11/18/2022]
Abstract
Malaria is one of the major parasitic diseases. Current treatment of malaria is seriously hampered by the emergence of drug resistant cases. A once-effective drug chloroquine (CQ) has been rendered almost useless. The mechanism of CQ resistance is complicated and largely unknown. Recently, a novel transmembrane protein, Plasmodium falciparum chloroquine resistance transporter (PfCRT), has fulfilled all the requirements of being the CQ resistance gene. In order to elucidate the mechanism how PfCRT mediates CQ resistance, we have cloned the cDNA from a CQ sensitive parasite (3D7) and tried to express it in Pichia pastoris (P. pastoris) but with unsuccessful results due to AT-rich sequences in the malaria genome. We have therefore, based on the codon usage in P. pastoris, chemically synthesized a codon-modified pfcrt with an overall 55% AT content. This codon-modified pfcrt has now been successfully expressed in P. pastoris. The expressed PfCRT has been purified with immuno metal affinity chromatography (IMAC) and then reconstituted into proteoliposome. It was found that proteoliposomes have a saturable, concentration and time-dependent CQ transport activity. In addition, we found that proteoliposomes with resistant PfCRT(r) (K76T or K76I) showed an increased CQ transport activity compared to liposomes with lipid alone, or proteoliposomes reconstituted with sensitive PfCRT(s) (K76) protein. This activity could be inhibited by nigericin and decreased with the removal of Cl(-). This work suggests that PfCRT is mediating CQR in P. falciparum by virtue of its changes in CQ transport activity depending on pH gradient and chloride ion in the food vacuole.
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Affiliation(s)
- W Tan
- Department of Applied Biology and Chemical Technology, Central Laboratory of the Institute of Molecular Technology for Drug Discovery and Synthesis, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, PR China.
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Bora D, Sathyanarayana K, Shukla BK, Chattopadhyay P, Srinivas YSS, Khilar PL, Kushwah M, Rajnish K, Sugandhi R, Singh M, Babu R, P J, G A, Biswas P, D P, Kadia BR, V C, Patel H, P D, Kirit P, Parmar KG, Makwana AR, Harsha M, Soni J, Yadav V, Shmelev M, Belousov V, Kurbatov V, Belov Y, Tai E. Test and Commissioning of 82.6 GHz ECRH system on SST-1. ACTA ACUST UNITED AC 2005. [DOI: 10.1088/1742-6596/25/1/013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Olsen DR, Leigh SD, Chang R, McMullin H, Ong W, Tai E, Chisholm G, Birk DE, Berg RA, Hitzeman RA, Toman PD. Production of human type I collagen in yeast reveals unexpected new insights into the molecular assembly of collagen trimers. J Biol Chem 2001; 276:24038-43. [PMID: 11279215 DOI: 10.1074/jbc.m101613200] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Substantial evidence supports the role of the procollagen C-propeptide in the initial association of procollagen polypeptides and for triple helix formation. To evaluate the role of the propeptide domains on triple helix formation, human recombinant type I procollagen, pN-collagen (procollagen without the C-propeptides), pC-collagen (procollagen without the N-propeptides), and collagen (minus both propeptide domains) heterotrimers were expressed in Saccharomyces cerevisiae. Deletion of the N- or C-propeptide, or both propeptide domains, from both proalpha-chains resulted in correctly aligned triple helical type I collagen. Protease digestion assays demonstrated folding of the triple helix in the absence of the N- and C-propeptides from both proalpha-chains. This result suggests that sequences required for folding of the triple helix are located in the helical/telopeptide domains of the collagen molecule. Using a strain that does not contain prolyl hydroxylase, the same folding mechanism was shown to be operative in the absence of prolyl hydroxylase. Normal collagen fibrils were generated showing the characteristic banding pattern using this recombinant collagen. This system offers new opportunities for the study of collagen expression and maturation.
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Affiliation(s)
- D R Olsen
- Cohesion Technologies Inc., Palo Alto, California 94303, USA
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Affiliation(s)
- E Tai
- Lipid Unit, Department of Endocrinology, Singapore General Hospital, Outram Road, 169608, Singapore, Singapore
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Lambert JR, Tai E, Strauss B, Blackwell L, Manolitsas N, Marks S, Bainbridge R, Stroud D, Wahlqvist ML. Nutritional and pulmonary function assessment in chronic obstructive pulmonary disease: Effects of nutritional supplementation. Asia Pac J Clin Nutr 1998; 7:88-93. [PMID: 24394903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We found that with oral supplementation by a liquid soy-based protein hydrolysate in malnourished COPD patients (BMI <= 20), it possible to increase weight over a 6-week period, and body water and an index of muscle mass (MAMC), but not total body nitrogen (TBN judged by Nitrogen Index) which identifies a particular challenge for nutrition support in COPD patients. There was no associated improvement in pulmonary function but we found that better nourished COPD patients (BMI > 20) had some pulmonary function advantage; it is suggested that TBN may need to improve with nutrition support for pulmonary function to improve.
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Affiliation(s)
- J R Lambert
- Department of Medicine, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia
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Haubrich R, Lalezari J, Follansbee SE, Gill MJ, Hirsch M, Richman D, Mildvan D, Burger HU, Beattie D, Donatacci L, Salgo MP, Berry P, Frechette G, LeFebvre; E, Torres R, Rachlis A, Loveless M, Tai E, Jensen P, Brand D, Hauptman S, Pollard R, Collier A, Hardy WD, Johiro AK, Mitsuyasu RT, Martin M, Klimas N, Gordin F, Gilbert C, Hyslop N, RamirezRonda C, Beall G, Miller S, Thompson M, Smaill F, Henry D, Volberding P, Cohen S, Dobkin J, Pottage J, Powderly W, Spotkov J, Koletar S, Skolnik P, Marlowe S, Hammer S, Baxter J, Kaufman D, Cooper R, Fischl M, Jayaweera DT, Scerpeila E, Sargent S, Turner P, Tsoukas C, MacArthur R, Remick S, Cunniff D, Henry K, Clark R, Snyder R, Boswell S, Sax P. Improved Survival and Reduced Clinical Progression in HIV-Infected Patients with Advanced Disease Treated with Saquinavir plus Zalcitabine. Antivir Ther 1998. [DOI: 10.1177/135965359800300103] [Citation(s) in RCA: 2] [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: 11/16/2022]
Abstract
The objective of this randomized, double-blind, controlled multicentre study was to evaluate the efficacy of saquinavir alone or in combination with zalcitabine compared to zalcitabine monotherapy in reducing progression of human immunodeficiency virus (HIV) disease. Nine hundred and forty HIV-infected patients with more than 16 weeks of prior zidovudine therapy and pre-study entry CD4 cell counts between 50 and 300 cells/mm3 were randomized to saquinavir 600 mg every 8 h, zalcitabine 0.75 mg every 8 h or the combination of both drugs. In an intent-to-treat analysis, the treatment arms were balanced with respect to demographics, baseline HIV RNA (mean 5.0 log10 copies/ml) and CD4 lymphocyte count (mean 170 cells/mm3). More patients in the zalcitabine arm stopped therapy because of toxicity than in the other two arms (25% versus 16%; P=0.005). Peripheral neuropathy was the most common treatment-limiting toxicity. Fifty-one patients in the saquinavir plus zalcitabine group developed an AIDS-defining event or died compared to 84 and 88 in the saquinavir and zalcitabine monotherapy groups respectively. Combination treatment with saquinavir plus zalcitabine reduced the risk of progression to AIDS by 49% (95% confidence interval 0.36 to 0.72, P=0.0001) and reduced death by 68% (95% confidence interval 0.16 to 0.64, P=0.001) compared to zalcitabine monotherapy. The addition of saquinavir to zalcitabine resulted in a significant reduction in progression to AIDS or death compared with zalcitabine alone.
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Affiliation(s)
- Richard Haubrich
- University of California, San Diego, Department of Medicine, San Diego, California
| | - Jacob Lalezari
- University of California, San Francisco, Mt Zion Hospital, San Francisco, California
| | | | - M John Gill
- Department of Medicine, University of Calgary, Alberta, Canada
| | - Martin Hirsch
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Douglas Richman
- University of California, San Diego, Departments of Medicine and Pathology, University of California, San Diego and San Diego Veterans Affairs Medical Center, La Jolla, California
| | | | | | | | | | | | - Paul Berry
- Pacific Oaks Medical Group, Sherman Oaks California:
| | | | | | | | | | - Mark Loveless
- Oregon Health Sciences University, Portland, Oregon:
| | - Edmund Tai
- Camino Medical Group, Sunnyvale, California:
| | - Peter Jensen
- Veterans Administration, San Francisco, California:
| | | | | | | | - Ann Collier
- University of Washington, Seattle Washington:
| | - W David Hardy
- University of California, Los Angeles, CARE Center, Los Angeles, California:
| | - Anna K Johiro
- University of California, Los Angeles, CARE Center, Los Angeles, California:
| | - Ronald T Mitsuyasu
- University of California, Los Angeles, CARE Center, Los Angeles, California:
| | - Maureen Martin
- University of California, Los Angeles, CARE Center, Los Angeles, California:
| | - Nancy Klimas
- Veterans Administration Medical Center, Miami, Florida:
| | - Fred Gordin
- Veterans Administration Medical Center, Washington, DC:
| | | | | | | | - Gildon Beall
- Harbor UCLA Medical Center, Torrance, California:
| | | | | | - Fiona Smaill
- McMaster University Medical Center, Hamilton, Ontario:
| | - David Henry
- Tuttelman Cancer Center, Philadelphia, Pennsylvania:
| | | | - Stuart Cohen
- University of California, Davis, Sacramento, California:
| | | | | | | | - Jared Spotkov
- Kaiser Foundation Hospital, Harbor City, California:
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Keith Henry
- St Paul Ramsey Medical Center, St Paul Minnesota:
| | | | - Ron Snyder
- University of California, San Diego, Department of Medicine, San Diego, California:
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Abstract
BACKGROUND Alpha-1-antitrypsin is the body's major inhibitor of human neutrophil elastase, a powerful proteolytic enzyme capable of degrading the common tissue components. There are over 70 genetic variants of alpha-1-antitrypsin, with the Z allele being of greatest clinical relevance. Individuals homozygous for this allele (approximately one in 2500 in Caucasians) have low serum alpha-1-antitrypsin levels (10-20% of normal) and are predisposed to emphysema, especially if they smoke. Much rarer are mutations which result in the complete or almost complete absence of alpha-1-antitrypsin in the serum. AIM To determine the cause of complete absence of alpha-1-antitrypsin in a patient who at age 27 years had both emphysema and idiopathic cardiomyopathy. METHODS Molecular biology techniques were used to sequence the alpha-1-antitrypsin gene. Allele specific amplification was used to show the presence of the mutations in other family members. RESULTS Investigation showed that the proband was homozygous for the Pi Null Bellingham variant of alpha-1-antitrypsin due to the mutation Lys 217 (AAG) to Stop (TAG). His grandmother was heterozygous for Pi Null Bellingham and the additional rare variant P Lowell, Asp 256 (GAT) to Val (GTT), a variant that also results in alpha-1-antitrypsin deficiency. CONCLUSION Patients with complete absence of alpha-1-antitrypsin develop premature emphysema not having smoked or after only minimal exposure, and much earlier than the more common Pi Z individuals who have the usual form of alpha-1-antitrypsin deficiency.
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Affiliation(s)
- L Cook
- Department of Chemical Pathology, St Vincent's Hospital, Melbourne, Vic., Australia
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Abstract
STUDY OBJECTIVE There is considerable uncertainty about the clinical features, respiratory physiology, and optimal management of patients with asthma requiring mechanical ventilation. Furthermore, the ventilatory and pharmacologic management of asthma requiring mechanical ventilation remain controversial. We hypothesized (1) that there are clinically identifiable and pathophysiologically different subgroups presenting with asthma requiring ventilation; (2) that lower dose steroid therapy (< 400 mg/d intravenous hydrocortisone) is adequate; (3) that permissive hypercapnia is safe; (4) that prolonged paralysis is generally unnecessary; and (5) that clinical outcome would be favorable in patients treated with this approach. DESIGN Review of medical records and intensive care charts and statistical analysis of findings. SETTING ICU of tertiary institution. PATIENTS Thirty-five consecutive cases of life-threatening asthma requiring mechanic ventilation. RESULTS Three clinical subgroups of ventilation-requiring asthmatics could be identified. Those presenting with steady deterioration (10), those with unstable asthma followed by a sudden "dip" (16), and those with a sudden unexpected dip (9). Patients in the first group had a significantly lower PaCO2 (p < 0.01) at presentation, but required ventilation for longer periods. Those in the second group had a significantly higher PaCO2 (p < 0.01) and required ventilation for a shorter period. Those in the third group had an intermediate PaCO2 level before intubation and the shortest period (p < 0.01) of mechanical ventilation. Five patients experienced their sudden dip after ingesting aspirin. Ten cases received "high" dose hydrocortisone therapy (mean: 980 mg/24 h), and 25 received lower dose hydrocortisone (mean: 341 mg/24 h). No differences in illness severity at presentation or outcome could be detected between these two groups. Mean duration of ventilatory support was 36 h and mean duration of the ICU stay 52.1 h. Muscle relaxation was used in 12 patients for a mean period of 11.1 h. One patient was brain dead on arrival. All others survived. CONCLUSIONS Life threatening asthma is an endpoint for several different clinical patterns of disease. No major clinical advantage could be found in our group of patients when high-dose steroids were used. Long-term use of muscle relaxants and prolonged mechanic ventilation are rarely needed in the management of patients with life-threatening asthma and excellent results can be achieved with a relatively simple management strategy.
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Affiliation(s)
- R Bellomo
- Department of Respiratory Medicine, Monash Medical Centre, Clayton, Victoria, Australia
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Abstract
AIM A prospective study was undertaken to assess the diagnostic value and therapeutic usefulness of fibreoptic bronchoscopy in the critically ill. METHOD Fifty-six bronchoscopies were performed in fifty patients. Biochemical, radiological, microbiological and clinical assessments were made before and after each procedure. RESULTS Eighteen fibreoptic bronchoscopies were performed for therapeutic indications (32.1%) of which ten (55.6%) yielded a useful outcome. Thirty-eight bronchoscopies were for diagnostic purposes (67.8%) of which 22 (57.9%) were clinically useful. Broncho-alveolar lavage was performed in twenty-eight cases (50%) and it led to a clinically useful diagnosis in 17 (60.7%). There was no major complication. A subgroup of patients was defined (persistent left lower lobe collapse or consolidation following thoracic or abdominal surgery) in whom fibreoptic bronchoscopy usually did not yield a useful outcome. CONCLUSION The use of fibreoptic bronchoscopy in the Intensive Care Unit, in combination with the technique of broncho-alveolar lavage, results in a clinically useful outcome in the majority of cases. Fibreoptic bronchoscopy is an effective and safe diagnostic and therapeutic tool in critically ill patients.
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Affiliation(s)
- R Bellomo
- Department of Respiratory Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
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Abstract
Cryptogenic organising pneumonitis (bronchiolitis obliterans organising pneumonia) is an uncommon condition that often responds to steroids. It is characterised clinically by constitutional symptoms, pathologically by intra-alveolar organising fibrosis, and radiologically by patchy pulmonary infiltrates. Its full clinical spectrum and course are only partially described and understood. Six patients are described, seen over three years, with considerably diverse clinical and radiological presentations (two had diffuse lung infiltrates, two had peripheral lung infiltrates, and two had localised lobar involvement) and with very varying severity of disease (two with a life threatening illness, three with appreciable subacute constitutional symptoms, and one with mild symptoms). It is concluded that cryptogenic organising pneumonitis can present in various ways. A set of diagnostic criteria are proposed which will help in the recognition of this syndrome, which is probably underdiagnosed.
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Affiliation(s)
- R Bellomo
- Department of Respiratory Medicine, Monash Medical Centre, Melbourne, Victoria, Australia
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Holmes P, McLaughlin P, Garfield A, Tai E. The value of bronchoalveolar lavage in the immuno-compromised host with suspected opportunistic lung infection. Panminerva Med 1986; 28:107-10. [PMID: 3774357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Veatch RM, Tai E. Talking about death: patterns of lay and professional change. Ann Am Acad Pol Soc Sci 1980; 447:29-45. [PMID: 11631409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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43
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Veatch RM, Tai E. Talking about death: patterns of lay and professional change. Ann Am Acad Pol Soc Sci 1980:29-45. [PMID: 10245666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
For the past thirty years, researchers have surveyed attitudes of providers and patients to the disclosure of the diagnosis and prognosis to the dying cancer patient. Though the lay population has expressed the wish to know over time, a change in provider attitudes is apparent: physicians are now more likely to inform their dying patients of the truth than before. This trend is viewed against a number of precipitating factors: changes in perception of the impact of disclosure and changes in the basic ethical norms related to disclosure with new cohorts of younger physicians reflecting these changes. These correlate with changes in underlying social structure brought about in part by the shift to chronic disease as the paradigm for medical care. With increasingly bureaucratized health care delivery, the physician must collaborate with others who may hold different judgments about what ought to be disclosed. Some nurses not only find it right to disclose, but also in their professional interest. In such settings, honesty may be necessary to avoid conflicting messages to the patient. These shifts may signal underlying shifts in the sick role and in the medical professional role with the patient more active and more knowledgeable in medical decisions and the physician serving as a source of information and counsel.
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Tai E. Diagnosis of asthma in the adult. Aust Fam Physician 1978; 7:201-4. [PMID: 629729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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45
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Abstract
Immunological studies of forty-three patients with cystic fibrosis showed that positive prick tests to at least one common allergen were obtained in 70%, to multiple allergens in 28% and to A. fumigatus in 50%. Specific IgE antibodies against these allergens were found in the appropriate subjects. In spite of this evidence of type 1, IgE, sensitization none of the patients had a history of infantile eczema. Intracutaneous tests with A. fumigatus extract gave types 1 and 3 reactions in sixteen patients (37%), only seven of whom were among the sixteen (37%) who gave positive precipitin tests. Raised levels of total serum IgG and IgA were found as compared with healthy controls and asthmatic subjects. No differences were found in total serum IgM and IgD levels. The high incidence of allergy to A. fumigatus in cystic fibrosis is confirmed.
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D'Souza MF, Pepys J, Wells ID, Tai E, Palmer F, Overell BG, McGrath IT, Megson M. Hyposensitization with Dermatophagoides pteronyssinus in house dust allergy: a controlled study of clinical and immunological effects. Clin Allergy 1973; 3:177-93. [PMID: 4131252 DOI: 10.1111/j.1365-2222.1973.tb01320.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Abstract
Aminophylline and isoprenaline, two drugs widely used in the management of asthma, have a pulmonary vasodilator action as well as a bronchodilator action. If regional pulmonary vasoconstriction in poorly ventilated parts of the lungs is a significant compensatory phenomenon in asthma, the effects of administration of these agents on gas exchange would depend on the relative magnitudes of bronchodilator action and pulmonary vasodilator action in the individual patient. If vasodilator action were greater than bronchodilator action in significant portions of the lungs, maldistribution of ventilation-blood flow ratios would increase and arterial oxygen tension might fall. In 40 patients with chronic asthma, arterial blood gas tensions, minute ventilation, alveolar-arterial oxygen tension gradient, physiological dead space/tidal volume ratio, and oxygen consumption were measured before and at intervals up to 20 to 40 minutes after the administration of various agents: in 13 patients, 250 mg. of aminophylline intravenously; in 16 patients, six deep inhalations of 1% isoprenaline aerosol; in 11 patients, after various control procedures. There were no significant changes following the control procedures. Administration of both aminophylline and isoprenaline was followed by increases of F.E.V.1·0 and increases of minute ventilation. Despite these changes, five patients in each group showed a fall of arterial Po2 of 5 mm. Hg or more. This was accompanied by an increase of alveolar-arterial oxygen tension gradient. It was concluded that the decreases of arterial blood Po2 resulted from reversal of pre-existing, compensatory, regional pulmonary vasoconstriction by the pulmonary vasodilator action of each drug in some subjects.
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Affiliation(s)
- E. Tai
- Department of MedicineUniversity of SydneyDepartment of AnæstheticsRoyal Prince Alfred‐HospitalSydney
| | - B. Clifton
- Department of MedicineUniversity of SydneyDepartment of AnæstheticsRoyal Prince Alfred‐HospitalSydney
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