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Partridge E, Brooks M, Curd C, Davis V, Oates C, McGeeney D. The effects of centralisation of vascular surgical services in the Bath, Bristol and Weston area on the carotid endarterectomy pathway. Ann R Coll Surg Engl 2017; 99:617-623. [PMID: 28682128 PMCID: PMC5696921 DOI: 10.1308/rcsann.2017.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Accepted: 04/03/2017] [Indexed: 12/14/2022] Open
Abstract
Introduction Patients who experience a transient ischaemic attack are at the highest risk of having a subsequent stroke immediately after their symptoms. A carotid endarterectomy should be performed on symptomatic, surgically suitable patients who present with a greater than 50% North American Symptomatic Carotid Endarterectomy Trial stenosis of the internal carotid artery within 2 weeks of their symptoms. This study aimed to determine whether the effectiveness of the carotid endarterectomy pathway has been impacted by the centralisation of vascular surgical services in the Bath, Bristol and Weston area. Materials and Methods From October 2013 to October 2015, critical steps in the patient carotid endarterectomy pathway that vascular surgeons from the Royal United Hospital Bath, Bristol Royal Infirmary and North Bristol NHS Trust input into the Royal College of Surgeons National Vascular Registry were collected. The dates of patient's symptoms, referral, first scan, surgical team review and surgery were analysed. Results Carotid endarterectomy data was collected for 261 patients. Overall, no significant difference in median time (days) from symptom to surgery from precentralisation data compared with post-centralisation data was seen (P = .175), with 65% patients meeting the national target of symptom to surgery in less than 14days. Discussion and Conclusion Centralisation has not significantly impacted the overall efficiency of the carotid endarterectomy pathway. This study highlights areas where improvement across the vascular network is required. This includes addressing the 35% patients that are not currently meeting the 14-day target and standardising the provision of care to outlying communities. Further follow-up is required to assess the longer term effects of centralisation.
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Affiliation(s)
- E Partridge
- Imperial College Healthcare Trust, Charing Cross Hospital , London , UK
| | - M Brooks
- North Bristol NHS Trust, Vascular Surgery, Southmead Hospital , Bristol , UK
| | - C Curd
- Royal United Hospital Bath Foundation Trust , Bath , UK
| | - V Davis
- Royal United Hospital Bath Foundation Trust , Bath , UK
| | - C Oates
- Newcastle University, Newcastle upon Tyne , UK
| | - D McGeeney
- Newcastle University, Newcastle upon Tyne , UK
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Wallace A, Keene K, Kvale E, Williams C, Pisu M, Partridge E, Fiveash J, Rocque G. Palliating Bone Mets at the End of Life: Are We Choosing Wisely? Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.541] [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: 11/17/2022]
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Skates SJ, Greene MH, Buys SS, Mai PL, Brown P, Piedmonte M, Rodriguez G, Schorge JO, Sherman M, Daly MB, Rutherford T, Brewster WR, O'Malley DM, Partridge E, Boggess J, Drescher CW, Isaacs C, Berchuck A, Domchek S, Davidson SA, Edwards R, Elg SA, Wakeley K, Phillips KA, Armstrong D, Horowitz I, Fabian CJ, Walker J, Sluss PM, Welch W, Minasian L, Horick NK, Kasten CH, Nayfield S, Alberts D, Finkelstein DM, Lu KH. Early Detection of Ovarian Cancer using the Risk of Ovarian Cancer Algorithm with Frequent CA125 Testing in Women at Increased Familial Risk - Combined Results from Two Screening Trials. Clin Cancer Res 2017; 23:3628-3637. [PMID: 28143870 DOI: 10.1158/1078-0432.ccr-15-2750] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/18/2017] [Accepted: 01/25/2017] [Indexed: 01/15/2023]
Abstract
Purpose: Women at familial/genetic ovarian cancer risk often undergo screening despite unproven efficacy. Research suggests each woman has her own CA125 baseline; significant increases above this level may identify cancers earlier than standard 6- to 12-monthly CA125 > 35 U/mL.Experimental Design: Data from prospective Cancer Genetics Network and Gynecologic Oncology Group trials, which screened 3,692 women (13,080 woman-screening years) with a strong breast/ovarian cancer family history or BRCA1/2 mutations, were combined to assess a novel screening strategy. Specifically, serum CA125 q3 months, evaluated using a risk of ovarian cancer algorithm (ROCA), detected significant increases above each subject's baseline, which triggered transvaginal ultrasound. Specificity and positive predictive value (PPV) were compared with levels derived from general population screening (specificity 90%, PPV 10%), and stage-at-detection was compared with historical high-risk controls.Results: Specificity for ultrasound referral was 92% versus 90% (P = 0.0001), and PPV was 4.6% versus 10% (P > 0.10). Eighteen of 19 malignant ovarian neoplasms [prevalent = 4, incident = 6, risk-reducing salpingo-oophorectomy (RRSO) = 9] were detected via screening or RRSO. Among incident cases (which best reflect long-term screening performance), three of six invasive cancers were early-stage (I/II; 50% vs. 10% historical BRCA1 controls; P = 0.016). Six of nine RRSO-related cases were stage I. ROCA flagged three of six (50%) incident cases before CA125 exceeded 35 U/mL. Eight of nine patients with stages 0/I/II ovarian cancer were alive at last follow-up (median 6 years).Conclusions: For screened women at familial/genetic ovarian cancer risk, ROCA q3 months had better early-stage sensitivity at high specificity, and low yet possibly acceptable PPV compared with CA125 > 35 U/mL q6/q12 months, warranting further larger cohort evaluation. Clin Cancer Res; 23(14); 3628-37. ©2017 AACR.
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Affiliation(s)
| | | | - Saundra S Buys
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | | | | | | | | | - Mary B Daly
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | | | | | - David M O'Malley
- Ohio State University and the James Cancer Center, Columbus, Ohio
| | - Edward Partridge
- University of Alabama at Birmingham, Comprehensive Cancer Center, Birmingham, Alabama
| | | | | | - Claudine Isaacs
- Georgetown University Medical Center, Lombardi Cancer Center, Washington, District of Columbia
| | - Andrew Berchuck
- Duke University Medical Center, Division of Gynecologic Oncology, Durham, North Carolina
| | - Susan Domchek
- University of Pennsylvania, Abramson Cancer Center, Philadelphia, Pennsylvania
| | | | | | - Steven A Elg
- The Iowa Clinic, Gynecologic Oncology, Des Moines, Iowa
| | - Katie Wakeley
- Dana-Farber Cancer Center in Clinical Affiliation with South Shore Hospital, South Weymouth, Massachusetts
| | - Kelly-Anne Phillips
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | | | - Ira Horowitz
- Emory University School of Medicine, Atlanta, Georgia
| | - Carol J Fabian
- The University of Kansas Cancer Center, Westwood, Kansas
| | - Joan Walker
- Stephenson Cancer Center, University of Oklahoma HSC, Oklahoma City, Oklahoma
| | | | | | | | - Nora K Horick
- Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - David Alberts
- University of Arizona Cancer Center, Tucson, Arizona
| | | | - Karen H Lu
- MD Anderson Cancer Center, Houston, Texas
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Pinsky PF, Yu K, Kramer BS, Black A, Buys SS, Partridge E, Gohagan J, Berg CD, Prorok PC. Extended mortality results for ovarian cancer screening in the PLCO trial with median 15years follow-up. Gynecol Oncol 2016; 143:270-275. [PMID: 27615399 PMCID: PMC5077651 DOI: 10.1016/j.ygyno.2016.08.334] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [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] [Received: 07/14/2016] [Revised: 08/24/2016] [Accepted: 08/28/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial originally reported no mortality benefit of ovarian cancer screening after a median of 12.4years of follow-up. The UKCTOCS screening trial failed to show a statistically significant mortality reduction in the primary analysis but reported an apparent increased mortality benefit in trial years 7-14 compared to 0-7. Here we report an updated analysis of PLCO with extended mortality follow-up. METHODS Participants were randomized from 1993 to 2001 at ten U.S. centers to an intervention or usual care arm. Intervention arm women were screened for ovarian cancer with annual trans-vaginal ultrasound (TVU) (4years) and CA-125 (6years), with a fixed cutoff at 35U/mL for CA-125. The original follow-up period was for up to 13years (median follow-up 12.4years); in this analysis follow-up for mortality was extended by up to 6years. RESULTS 39,105 (intervention) and 39,111 (usual care) women were randomized, of which 34,253 and 34,304, respectively, had at least one ovary at baseline. Median follow-up was 14.7years in each arm and maximum follow-up 19.2years in each arm. A total of 187 (intervention) and 176 (usual care) deaths from ovarian cancer were observed, for a risk-ratio of 1.06 (95% CI: 0.87-1.30). Risk-ratios were similar for study years 0-7 (RR=1.04), 7-14 (RR=1.06) and 14+ (RR=1.09). The risk ratio for all-cause mortality was 1.01 (95% CI: 0.97-1.05). Ovarian cancer specific survival was not significantly different across trial arms (p=0.16). CONCLUSION Extended follow-up of PLCO indicated no mortality benefit from screening for ovarian cancer with CA-125 and TVU.
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Affiliation(s)
- Paul F Pinsky
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, United States.
| | - Kelly Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, United States
| | - Barnett S Kramer
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, United States
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, United States
| | | | - Edward Partridge
- University of Alabama at Birmingham School of Medicine, United States
| | - John Gohagan
- Office of Disease Prevention, National Institutes of Health, United States
| | - Christine D Berg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, United States
| | - Philip C Prorok
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, United States
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Taylor R, Acemgil A, Meneses K, Rocque G, Pisu M, Wang X, Demark-Wahnefried W, Partridge E. Abstract PR04: Functional mobility disparities in older African American women with cancer in a multisite lay navigation program in the Deep South. Cancer Epidemiol Biomarkers Prev 2015. [DOI: 10.1158/1538-7755.disp14-pr04] [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: 11/16/2022] Open
Abstract
Abstract
The purpose of this abstract is to (1) describe the incidence of functional mobility impairments among African American (AA) females enrolled in the Patient Care Connect Program (PCCP); (2) report the impact of a lay navigation program (LNP) on identifying and resolving problems with functional mobility in the PCCP population; and (3) explore the future potential of a LNP in oncogeriatrics (65 years of age or older with cancer).
Background: The geriatric (65 years of age or older) population in the United States (US) is estimated to increase from 16% in 2013 to 20% by 2030, when 70% of all cancers are expected to be diagnosed in this population. By 2050, 14% of the US geriatric population is predicted to be AA. The PCCP is a Centers for Medicare & Medicaid Services (CMS) LNP located in twelve cancer programs across five states in the Deep South (AL, MS, TN, FL, GA). The LNP is used to identify and intervene early in patient's self-reported distress and barriers to care.
Methods: Thirty-nine lay navigators (LNs) were educated about the fundamentals of oncogeriatrics, communication, and use of the Distress Thermometer (DT) to guide patient conversations. The National Comprehensive Cancer Network (NCCN) DT was modified with a focus on collecting patients' self-reported global distress level on a thermometer image and distress items in 7 domains (i.e., practical, family problems, information, cognitive, physical, emotional, and spiritual/religious problems or concerns). Based on the items identified from the DT tool, the LN identifies resources to address these items and empowers the patient to access the resources. For each patient, the LN also records all associated high-risk diseases (i.e., congestive heart failure, diabetes mellitus, stroke, chronic obstructive pulmonary disease, emphysema, interstitial lung disease, renal disease).
Findings: Interim data from 3,500 participants completing the DT tool in the PCCP indicates that mobility is the third highest ranked distress item after pain and fatigue. Of females, 18 % of the AAs report mobility problems compared to the 12% in the Caucasian population. Of these females, 40% of the AAs have at least one or more high risk disease compared to 37% of the Caucasian population. Of the females with mobility problems, 2.6% of the AAs have 3 or more high-risk diseases compared to 1.4 % of the Caucasians. In the females reporting mobility problems, 27.4% of them requested assistance from the LN to address this problem and 86% of the time the patient reported back that the LN's assistance resolved the problem.
Conclusions: AA oncogeriatric females have a greater number of high risk diseases and functional mobility limitations that affect their health, compared to Caucasians. By identifying functional mobility limitations early, proactive interventions can be implemented, monitored, and adjusted to modify or resolve mobility problems that can lead to disability and health disparities in oncogeriatric females. LNs can effectively use the DT to identify functional mobility problems and empower female oncogeriatrics to resolve them; improving health and decreasing health disparities. Data will be used to continue expanding the knowledge base in the area of oncogeriatrics and lay navigation, refine the oncogeriatric conceptual model within the PCCP, and translate the findings into clinical practice; improving health and decreasing health disparities.
This publication was made possible by Grant Number 1C1CMS331023 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
This abstract was also presented as Poster A9.
Citation Format: Richard Taylor, Aras Acemgil, Karen Meneses, Gabrielle Rocque, Maria Pisu, Xin Wang, Wendy Demark-Wahnefried, Edward Partridge. Functional mobility disparities in older African American women with cancer in a multisite lay navigation program in the Deep South. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr PR04.
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Affiliation(s)
| | - Aras Acemgil
- University of Alabama at Birmingham, Birmingham, AL
| | | | | | - Maria Pisu
- University of Alabama at Birmingham, Birmingham, AL
| | - Xin Wang
- University of Alabama at Birmingham, Birmingham, AL
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Halilova KI, Rocque GB, Kvale EA, Bevis KS, Taylor RA, Acemgil A, Martin M, Demark-Wahnefried W, Li Y, Meneses K, Fouad M, Partridge E, Pisu M. Identifying sources of distress in patients with breast cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e17707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Karina I. Halilova
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | | | - Elizabeth Ann Kvale
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Kerri S. Bevis
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Richard A. Taylor
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Aras Acemgil
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Michelle Martin
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | | | - Yufeng Li
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Karen Meneses
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Mona Fouad
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Edward Partridge
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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Jackson BE, Rocque GB, Kvale EA, Kenzik K, Acemgil A, Taylor RA, Martin M, Demark-Wahnefried W, Lisovicz N, Li Y, Meneses K, Fouad M, Partridge E, Pisu M. Disparities in hospice use among patients with cancer in the Deep South. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.6561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Bradford E. Jackson
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | | | - Elizabeth Ann Kvale
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Kelly Kenzik
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Aras Acemgil
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Richard A. Taylor
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Michelle Martin
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | | | - Nedra Lisovicz
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Yufeng Li
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Karen Meneses
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Mona Fouad
- Minority Health and Health Disparities Research Center, Birmingham, AL
| | - Edward Partridge
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Maria Pisu
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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9
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Wells KJ, Lima DS, Meade CD, Muñoz-Antonia T, Scarinci I, McGuire A, Gwede CK, Pledger WJ, Partridge E, Lipscomb J, Matthews R, Matta J, Flores I, Weiner R, Turner T, Miele L, Wiese TE, Fouad M, Moreno CS, Lacey M, Christie DW, Price-Haywood EG, Quinn GP, Coppola D, Sodeke SO, Green BL, Lichtveld MY. Assessing needs and assets for building a regional network infrastructure to reduce cancer related health disparities. Eval Program Plann 2014; 44:14-25. [PMID: 24486917 PMCID: PMC4360072 DOI: 10.1016/j.evalprogplan.2013.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 10/12/2013] [Accepted: 12/19/2013] [Indexed: 05/09/2023]
Abstract
Significant cancer health disparities exist in the United States and Puerto Rico. While numerous initiatives have been implemented to reduce cancer disparities, regional coordination of these efforts between institutions is often limited. To address cancer health disparities nation-wide, a series of regional transdisciplinary networks through the Geographic Management Program (GMaP) and the Minority Biospecimen/Biobanking Geographic Management Program (BMaP) were established in six regions across the country. This paper describes the development of the Region 3 GMaP/BMaP network composed of over 100 investigators from nine institutions in five Southeastern states and Puerto Rico to develop a state-of-the-art network for cancer health disparities research and training. We describe a series of partnership activities that led to the formation of the infrastructure for this network, recount the participatory processes utilized to develop and implement a needs and assets assessment and implementation plan, and describe our approach to data collection. Completion, by all nine institutions, of the needs and assets assessment resulted in several beneficial outcomes for Region 3 GMaP/BMaP. This network entails ongoing commitment from the institutions and institutional leaders, continuous participatory and engagement activities, and effective coordination and communication centered on team science goals.
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Affiliation(s)
- Kristen J Wells
- University of South Florida, 4202 East Fowler Avenue, Tampa, FL 33620, USA
| | - Diana S Lima
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA.
| | - Cathy D Meade
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Teresita Muñoz-Antonia
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Isabel Scarinci
- University of Alabama at Birmingham Comprehensive Cancer Center, 1824 6th Avenue South, Birmingham, AL 35210, USA
| | - Allison McGuire
- University of Alabama at Birmingham Comprehensive Cancer Center, 1824 6th Avenue South, Birmingham, AL 35210, USA
| | - Clement K Gwede
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - W Jack Pledger
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Edward Partridge
- University of Alabama at Birmingham Comprehensive Cancer Center, 1824 6th Avenue South, Birmingham, AL 35210, USA
| | - Joseph Lipscomb
- Emory University, 615 Michael Street, Atlanta, GA 30322, USA
| | - Roland Matthews
- Morehouse School of Medicine, 720 Westview Drive Southwest, Atlanta, GA 30310, USA
| | - Jaime Matta
- Ponce School of Medicine, 388 Zona Ind Reparada 2, Ponce, PR 00716-2347, USA
| | - Idhaliz Flores
- Ponce School of Medicine, 388 Zona Ind Reparada 2, Ponce, PR 00716-2347, USA
| | - Roy Weiner
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - Timothy Turner
- Tuskegee University, 1200 West Montgomery Road, Tuskegee Institute, AL 36088, USA
| | - Lucio Miele
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| | - Thomas E Wiese
- Xavier University of Louisiana College of Pharmacy, 1 Drexel Drive, New Orleans, LA 70125, USA
| | - Mona Fouad
- University of Alabama at Birmingham Comprehensive Cancer Center, 1824 6th Avenue South, Birmingham, AL 35210, USA
| | - Carlos S Moreno
- Emory University, 615 Michael Street, Atlanta, GA 30322, USA
| | - Michelle Lacey
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - Debra W Christie
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
| | - Eboni G Price-Haywood
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
| | - Gwendolyn P Quinn
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Domenico Coppola
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Stephen O Sodeke
- Tuskegee University, 1200 West Montgomery Road, Tuskegee Institute, AL 36088, USA
| | - B Lee Green
- H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
| | - Maureen Y Lichtveld
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112, USA
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Singh KP, Jackson BE, Ojha RP, Wang C, Uhm M, Fouad M, Partridge E, Bae S. The potential impact of the Deep South Network for Cancer Control on cervical cancer mortality among black females in historically underserved areas of Alabama. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.6559] [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
6559 Background: Racial disparities in cervical cancer mortality are well-documented. The Deep South Network for Cancer Control (DSNCC) was implemented in 2000 to address this disparity by targeting blacks for cervical cancer screening in historically underserved areas of Alabama and Mississippi. We aimed to assess whether the implementation of the DSNCC has improved cervical cancer mortality among black females in Alabama. Methods: We used data from the University of Alabama-Birmingham (UAB) Comprehensive Cancer Center Tumor Registry, which comprises all cancer cases treated in the UAB Health system. We selected all black females diagnosed with cervical cancer in the pre-DSNCC (January 1995-December 1999) and post-DSNCC (January 2001-December 2005) periods. Person time was calculated for up to five years post diagnosis. We estimated hazard ratios (HRs) and corresponding 95% confidence limits (CLs) using Cox proportional hazards models. The cervical cancer mortality rate of black females who resided in DSNCC-targeted Alabama counties was compared to non-DSNCC-targeted Alabama counties before and after implementation of the DSNCC. Results: The study population comprised 129 black females diagnosed with cervical cancer pre-DSNCC and 175 diagnosed post-DSNCC. During the pre-intervention period, black females in DSNCC-targeted counties had a two-fold higher cervical cancer mortality rate than black females in non-DSNCC-targeted counties (HR=2.0; 95%CL: 1.10, 3.72). During the post-intervention period, black females in DSNCC-targeted counties had nearly a two-fold lower cervical cancer mortality rate than black females in non-DSNCC-targeted counties (HR=0.54; 95%CL: 0.35, 0.87). Conclusions: Our results suggest that the DSNCC interventions are improving cervical cancer outcomes among black females in historically underserved areas of Alabama. The current analysis was only able to examine the initial 5 years after implementation of the DSNCC; continued assessment of outcomes would be useful for assessing the long-term impact of the DSNCC.
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Affiliation(s)
| | | | - Rohit P Ojha
- St. Jude Children's Research Hospital, Memphis, TN
| | | | - Minyong Uhm
- University of Alabama at Birmingham, Birmingham, AL
| | - Mona Fouad
- Minority Health and Health Disparities Research Center, Birmingham, AL
| | - Edward Partridge
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
| | - Sejong Bae
- University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL
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11
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Pinsky PF, Zhu C, Skates SJ, Black A, Partridge E, Buys SS, Berg CD. Potential effect of the risk of ovarian cancer algorithm (ROCA) on the mortality outcome of the Prostate, Lung, Colorectal and Ovarian (PLCO) trial. Int J Cancer 2012; 132:2127-33. [PMID: 23065684 DOI: 10.1002/ijc.27909] [Citation(s) in RCA: 29] [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] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 09/10/2012] [Indexed: 12/13/2022]
Abstract
Recently, the Prostate, Lung, Colorectal and Ovarian (PLCO) Trial reported no mortality benefit for annual screening with CA-125 and transvaginal ultrasound (TVU). Currently ongoing is the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), which utilizes the risk of ovarian cancer algorithm (ROCA), a statistical tool that considers current and past CA125 values to determine ovarian cancer risk. In contrast, PLCO used a single cutoff for CA125, based on current levels alone. We investigated whether having had used ROCA in PLCO could have, under optimal assumptions, resulted in a significant mortality benefit by applying ROCA to PLCO CA125 screening values. A best-case scenario assumed that all cancers showing a positive screen result earlier with ROCA than under the PLCO protocol would have avoided mortality; under a stage-shift scenario, such women were assigned survival equivalent to Stage I/II screen-detected cases. Updated PLCO data show 132 intervention arm ovarian cancer deaths versus 119 in usual care (relative risk, RR = 1.11). Forty-three ovarian cancer cases, 25 fatal, would have been detected earlier with ROCA, with a median (minimum) advance time for fatal cases of 344 (147) days. Best-case and stage-shift scenarios gave 25 and 19 deaths prevented with ROCA, for RRs of 0.90 (95% CI: 0.69-1.17) and 0.95 (95% CI: 0.74-1.23), respectively. Having utilized ROCA in PLCO would not have led to a significant mortality benefit of screening. However, ROCA could still show a significant effect in other screening trials, including UKCTOCS.
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Affiliation(s)
- Paul F Pinsky
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Fayez R, AlMuntashery A, Bodie G, Almamar A, Gill R, Raîche I, Mueller C, AlMuntashery A, Fayez R, AlMuntashery A, Moustarah F, Khokhotva M, Anvari M, Kwong J, Elkassem S, Bonrath E, Zevin B, Sockalingam S, Smith C, Smith C, Whitlock K, Gill R, Suri M, Palter V, Wakeam E, Khan R, Martelli V, Malik A, Young P, Daigle C, McCreery G, Seth R, Paskar D, Sudarshan M, Richardson D, Haggar F, Davis V, Rivard J, Agzarian J, Racz J, Winocour J, Zilbert N, Decker C, Neumann K, Gosney J, Wissanji H, Chadi S, Alhabboubi M, Partridge E, Alhabboubi M, Olszewski M, Chan R, Nadler A, Hameed U, Brotherhood H, Menezes A, MacDonald B, Rakovich G, Hilsden R, Merani S, Davis P, Davis P, Cools-Lartigue J, Ojah J, Julien F, Carter D, Pitt D, Banks B, Rudovics A, Ravichandran P, Anantha R, Aad I, Kholdebarin R, Aird L, Wong S, Payne J, Hallet J, Farries L, Raiche I, Botkin C, Morency D, Berger-Richardson D, Isa A, Dupuis I, Schweigert M, Koubi S, Ernjakovic M, Grant K, Cools-Lartigue J, Carrott P, Stafford T, Malthaner R, Sudarshan M, Hanna W, Lee L, Markar S, Razzak R, Bharadwaj S, Ashrafi A, Ouellette D, Fergusson D, Forster A, Boushey R, Porter G, Johnson P, Gomes T, Chan B, Auer R, Moloo H, Mamdani M, Markar S, Al-Omran M, Al-Obaid O, Boushey R, Lim DR, Min BS, Baik SH, Gordon P, Kim NK, Lo A, Pinsk I, Bottoni D, Brown C, Raval M, Cheng H, Wong C, Johnston N, Farrokhyar F, Stephen W, Kelly S, Lindsay L, Forbes S, Knickle C, Bouchard A, Parry N, Leslie K, Ott M, Coughlin S, Gazala S, Gazala S, Donahoe L, Walker K, Li C, Alnasser S, Schweigert M, Schweigert M, Zhuruk A, Hanouf A, Vanounou T, Karanicolas P, Aubin JM, Yeung J, Dumitra S, Simoneau E, Vanounou T, Howe B, Hawel J, Jang JH, Bertens K, Rekman J, Wei A, Dumitra S, Koubi S, Ouellet JF, Wei A, Covelli A, Maniar R, Sun S, Davis V, Brackstone M, Boissonneault R, Kim S, Baliski C, Gazala S, Hameed U, Sudarshan M, Arnaout A, Wedman D, Nostedt M, Hebbard P, Shetty S, Dixon M, Wei A, Dixon M, Kazazian K, Lemke M, Wells B, Musselman R, Zih FSW, Menezes A, Nassif M, Leon-Carlyle M, Wei A, Krotneva S, Bradley N, Trabulsi N, Trabulsi N, Chin-Lenn L, Cheng H, Petrucci A, Sandhu L, Neville A, Lee L, Li C, Yang I, Prabhu KL, Melich G, Knowles S, Richardson D, Borowiec A, Hallet J, Boissonneault R, Kolozsvari N, Hallet J, Tuttle P, VanHouwelingen L, Haggar F, Boulanger-Gobeil C, Chan B, Chan B, Richardson D, Musselman R, Melich G, Phang P, Goldstein L, Wen C, Lebrun A, Chadi S, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, Fayez R, Demyttenaere S, Christou N, Court O, Bonrath E, Hagen J, Okrainec A, Sullivan P, Grantcharov T, Sharma A, Karmali S, Birch D, Majumdar S, Wang X, Tuepah R, Klarenbach S, Birch D, Karmali S, Sharma A, Padwal R, Smith C, Haggar F, Moloo H, Poulin E, Martel G, Yelle JD, Mamazza J, Jackson T, Penner T, Pitzul K, Urbach D, Okrainec A, Villeneuve S, Roy M, Fayez R, Demyttenaere S, Christou N, Court O, Roy M, Villeneuve S, AlMuntashery A, Demyttenaere S, Christou N, Court O, Fayez R, Demyttenaere S, Court O, Christou N, Biertho L, Hould FS, Lebel S, Lescelleur O, Marceau S, Marceau P, Biron S, Grantcharov T, Sharma A, Yusuf S, Okrainec A, Pitzul K, Urbach D, Jackson T, Lindsay D, Sullivan P, Smith L, Zevin B, Dedy N, Grantcharov T, Bonrath E, Aggarwal R, Grantcharov T, Cassin S, Crawford S, Pitzul K, Khan A, Hawa R, Jackson T, Okrainec A, Brar B, Mamazza J, Raîche I, Yelle JD, Haggar F, Moloo H, Brar B, Haggar F, Dent R, Mamazza J, Raîche I, Moloo H, Gill R, Ali T, Shi X, Birch D, Karmali S, Whitlock K, Shi X, Sarkhosh K, Birch D, Karmali S, Turner J, Nation P, Wizzard P, Brubaker P, Gisalet D, Wales P, Grantcharov T, Tien H, Spencer F, Brenneman F, Kowal J, Wiseman S, Fraser S, Vedel I, Deban M, Holcroft C, Monette M, Monette J, Bergman S, Bell C, Stukel T, Urbach D, Mueller T, Lucykx V, Lukowski C, Compston C, Churchill T, Khadaroo R, Grantcharov T, Vogt K, Dubois L, Gray D, Ananth A, Tai LH, Lam T, Falls T, Souza C, Bell J, Auer R, Crawford S, Parry N, Leslie K, Alhabboubi M, St-Louis E, Deckelbaum D, Razek T, Feldman L, Khwaja K, Porter G, Johnson P, Boushey R, Moloo H, Raiche I, Mamazza J, Schiller D, Eurich D, Sawyer M, Vergis A, Unger B, Hardy K, Andrew C, Gillman L, Park J, Prodger J, Kelly W, Kelly S, Prodger D, Ewara E, Martin J, Sarma S, Chu M, Schlachta C, Zaric G, Al-Ali K, Briggs K, George R, Murnaghan M, Leung A, Regehr G, Moulton CA, Mahmud S, Metcalfe J, McKay A, Park J, Hochman D, Burkle F, Redmond A, McQueen K, Desrosiers E, Gilbert A, Leslie K, Ott M, Sudarshan M, Jessula S, Alburakan A, Deckelbaum D, Razek T, Iqbal S, Khwaja K, Aikins C, Sudarshan M, Deckelbaum D, Iqbal S, Khwaja K, Razek T, Roberts N, Moulton CA, Murnaghan M, Cil T, Marshall J, Pederson K, Erichsen S, White J, Aarts MA, Okrainec A, Victor J, Pearsall E, McLeod R, Jackson T, Okrainec A, Penner T, Urbach D, Karimuddin A, Hall C, Bawan S, Malik S, Hayashi A, Gill R, McAlister C, Zhang N, DesRosiers E, Mills A, Crozier M, Lee L, Maxwell J, Partridge E, Chad S, Steigerwald S, Mapiour D, Roberts D, MacPherson C, Donahoe L, Mercer D, Hopman W, Latulippe JF, Knowles S, Moffat B, Parry N, Leslie K, Switzer N, Khadaroo R, Tul Y, Widder S, Molinari M, Levy A, Johnson P, Bailey J, Molinari M, Hayden J, Johnson P, Benlolo S, Marcus V, Ferri L, Finley R, Anderson D, Gagné JP, Chan S, Wong S, Li J, Michael A, Choi D, Liu E, Hoogenes J, Dath D, Aubin JM, Mew D, McConnell Y, Classen D, Kanthan S, Croome K, Kovacs M, Lazo-Langner A, Hernandez-Alejandro R, Vogt K, Crawford S, Parry N, Leslie K, Khoshgoo N, Iwasiow B, Keijzer R, Brown C, Isa D, Pace D, Widder S, Tul Y, Primrose M, Hudson D, Khadaroo R, Lauzier F, Mailloux O, Trottier V, ARchambault P, Zarychanski R, Turgeon A, Mailloux O, Hardy P, Muirhead R, Masters J, Haggar F, Poulin HME, Martel G, Mamazza J, Milbrandt C, Keijzer R, Sideris L, Grenier-Vallée P, Latulippe JF, Dubé P, Kurashima Y, Kaneva P, Feldman L, Fried G, Vassiliou M, Kwan AL, Fraser S, Solymosi N, Rauh N, Dubecz A, Renz M, Ofner D, Stein H, Borgaonkar M, Crystal P, Easson A, Escallon J, Reedijk M, Cil T, Leong W, McCready D, Clifton J, Mayo J, Finley R, Noreau-Nguyen M, Mulder D, Ferri L, Markar S, Hong J, Low D, Maslow A, Davignon K, Ng T, Tan L, Aruranian J, Kosa S, Ferri L, Murphy G, Allison F, Moshonov H, Darling G, Waddell T, De Perrot M, Cypel M, Yasufuku K, Keshavjee S, Paul N, Pierre A, Darling G, Pedneault C, Marcus V, Mulder D, Ferri L, Low D, Roa W, Löbenberg R, McEwan S, Bédard E, Louie B, Farivar A, McHugh S, Aye R, Tan-Tam C, De Vera M, Bond R, Ong S, Johal B, Schellenberg D, Po M, Nissar S, Lund C, Ahmadi S, Wakil N, Rakovich G, Beauchamps G, Preston S, Baker C, Low D, Campbell G, Malthaner R, Bethune D, Henteleff H, Johnston M, Buduhan G, Coughlin HE, Roth L, Bhandari M, Malthaner R, Johnson J, Kutsogiannis J, Bédard E, Rammohan K, Stewart K, Bédard E, Buduhan G, Gruchy J, Xu Z, Buduhan G, Ferri L, Mulder D, Ncuti A, Neville A, Kaneva P, Watson D, Vassiliou M, Carli F, Feldman L, Av R, Mayrand S, Franco E, Ferri L, Dubecz A, Renz M, Stadlhuber R, Ofner D, Stein H, Renz M, Dubecz A, Solymosi N, Thumfart L, Ofner D, Stein H, Croome K, Leeper R, Hernandez R, Livingstone S, Sapp J, Woodhall D, Alwayn I, Bergman S, Lam-McCulloch J, Balaa F, Jayaraman S, Quan D, Wei A, Guyatt G, Rekman J, Fairfull-Smith R, Mimeault R, Balaa F, Martel G, Boehnert M, Bazerbachi F, Knaak J, Selzner N, McGilvray I, Rotstein O, Adeyi O, Levy G, Keshavjee S, Grant D, Selzner M, Khalil JA, Jamal M, Chaudhury P, Zogopoulos G, Petrakos P, Tchervenkov J, Barkun J, Jamal M, Hassanain M, Chaudhury P, Wong S, Salman A, Tran T, Metrakos P, Groeschl R, Geller D, Marsh J, Gamblin T, Croome K, Croome K, Quan D, Hernandez R, Kim P, Greig PD, Gallinger S, Moulton CA, Wei A, Fischer S, Cleary S, Vogt K, Hernandez-Alejandro R, Gray D, Aubin J, Fairfull-Smith J, Mimeault R, Balaa F, Martel G, Devitt K, Ramjaun A, Gallingher S, Alabbad S, Constantinos D, Hassanein M, Barkun J, Metrakos P, Paraskevas S, Chaudhury P, Tchervenkov J, Borgaonkar M, Tanyingoh D, Dixon E, Kaplan G, Myers R, Howard T, Sutherland F, Zyromski N, Ball C, Coburn N, Moulton CA, Cleary S, Law C, Greig P, Steven G, Baxter N, Fitch M, Wright F, Hochman D, Wirtzfeld D, McKay A, Yaffe C, Yip B, Silverman R, Park J, McConnell Y, Temple W, Mack L, Schiller D, Bathe O, Sawyer M, Scott L, Vandenberg T, Perera F, Potvin K, Chambers A, Loungnarath R, DeBroux É, Lavertu S, Donath D, Ayoub JP, Tehfé M, Richard C, Cornacchi S, Heller B, Farrokhyar F, Babra M, Lovrics P, Liberto C, Ghosh S, McLean R, Schiller D, Jackson T, Okrainec A, Penner T, Urbach D, Dumitra S, Duplisea J, Wexler S, Seely J, Smylie J, Knight K, Robertson S, Watters J, Zhang T, Arneout A, Hochman D, Wirtzfeld D, McKay A, Yip B, Yaffe C, Silverman R, Park J, Baxter N, Yun L, Rakovitch E, Wright F, Warner E, McCready D, Hodgson N, Quan M, Natarajan B, Govindarajan V, Thomas P, Loggie B, Brar S, Mahar A, Law C, Coburn N, Devitt K, Wiebe M, Bathe O, McLeod R, Baxter N, Gagliardi A, Kennedy E, Urbach D, Brar S, Mahar A, Law C, Coburn N, Zih F, Rosario C, Dennis J, Gingras AC, Swallow C, Ko YJ, Rowsell C, Law C, Saskin R, Quan ML, Xie M, McLaughlin K, Marginean C, Moyana T, Moloo H, Boushey R, Auer R, Razik R, Haase E, Mathieson A, Smith A, Swallow C, Barnes A, Scheer A, Moloo H, Boushey R, Sabri E, Auer R, Reidel K, Trabulsi N, Meterissian S, Tamblyn R, Mayo N, Meguerditchian A, Brown J, Hamm J, Phang P, Raval M, Brown C, Devitt K, Wiebe M, Bathe O, McLeod R, Taylor B, Urbach D, Reidel K, Mayo N, Tamblyn R, Meguerditchian A, Hamm J, Wiseman S, Patakfalvi L, Nassif M, Turcotte R, Nichols A, Meguerditchian A, Riedel K, Winslade N, Grégoire JP, Meterissian S, Abrahamovicz M, Megueerditchian A, Pasieka J, McMillan C, Lipa J, Snell L, Sudarshan M, Dumitra S, Duplisea J, Wexler S, Meterissian S, Tomlinson G, Kennedy E, Wei A, Baxter N, Urbach D, Liberman A, Charlebois P, Stein B, Ncuti A, Vassiliou M, Fried G, Feldman L, Capretti G, Power A, Liberman A, Charlebois P, Stein B, Kaneva P, Carli F, Fried G, Feldman L, Carli F, Charlebois P, Stein B, Liberman A, Kaneva P, Augustin B, Gamsa A, Kim DJ, Vassiliou M, Feldman L, Boushey R, Moloo H, Vu L, Chan S, Phang P, Gown A, Jones S, Wiseman S, Jeong DH, Hur H, Baik SH, Kim NK, Faria J, Min BS, Lumb K, Colquhoun P, Porter G, Johnson P, Baxter N, Schmocker S, Huang H, Victor J, Krzyzanowska MK, Brierley J, McLeod R, Kennedy E, Milot H, Desrosiers E, Lebrun A, Drolet S, Bouchard A, Grégoire R, Vuong T, Loungnarath R, DeBroux E, Liberman A, Charlebois P, Stein B, Richard C, Capretti G, Kaneva P, Neville A, Carli F, Liberman S, Charlebois P, Stein B, Vassiliou M, Fried G, Feldman L, Milot H, Drolet S, Bouchard A, Grégoire R, Powell R, Fowler A, Mathieson A, Martin K, Vogt K, Ott M, Pereira G, Einarsdottir K, Moloo H, Boushey R, Mamazza J, Bouchard A, Gagné J, Grégoire R, Thibault C, Bouchard P, Gomes T, Musselman R, Auer R, Moloo H, Mamdani M, Al-Omran M, Boushey R, AlObeed O, Armstrong J. Canadian Surgery Forum1 Is laparoscopic sleeve gastrectomy a reasonable stand-alone procedure for super morbidly obese patients?2 Postoperative monitoring requirements of patients with obstructive sleep apnea undergoing bariatric surgery3 Role of relaparoscopy in the diagnosis and treatment of bariatric complications in the early postoperative period4 Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding5 Prioritization and willingness to pay for bariatric surgery: the patient perspective6 Ventral hernia at the time of laparoscopic gastric bypass surgery: Should it be repaired?7 Linear stapled gastrojejunostomy with transverse handsewn enterotomy closure significantly reduces strictures for laparoscopic Roux-en-Y bypass8 Laparoscopic biliopancreatic diversion with duodenal switch as second stage for super super morbidly obese patients. Do all patients benefit?9 Sleeve gastrectomy in the super super morbidly obese (BMI > 60 kg/m2): a Canadian experience10 Laparoscopic gastric bypass for the treatment of refractory idiopathic gastroparesis: a report of 2 cases11 Duodeno-ileal switch as a primary bariatric and metabolic surgical option for the severely obese patient with comorbidities: review of a single-institution case series of duodeno-ileal intestinal bypass12 Management of large paraesophageal hernias in morbidly obese patients with laparoscopic sleeve gastrectomy: a case series13 Early results of the Ontario bariatric surgical program: using the bariatric registry14 Improving access to bariatric surgical care: Is universal health care the answer?15 Early and liberal postoperative exploration can reduce morbidity and mortality in patients undergoing bariatric surgery16 Withdrawn17 Identification and assessment of technical errors in laparoscopic Roux-en-Y gastric bypass18 A valid and reliable tool for assessment of surgical skill in laparoscopic Roux-en-Y gastric bypass19 Psychiatric predictors of presurgery drop-out following suitability assessment for bariatric surgery20 Predictors of outcomes following Roux-en-Y gastric bypass surgery at The Ottawa Hospital21 Prophylactic management of cholelithiasis in bariatric patients: Is routine cholecystectomy warranted?22 Early outcomes of Roux-en-Y gastric bypass in a publicly funded obesity program23 Similar incidence of gastrojejunal anastomotic stricture formation with hand-sewn and 21 mm circular stapler techniques during Roux-en-Y gastric bypass24 (CAGS Basic Science Award) Exogenous glucagon-like peptide-1 improves clinical, morphological and histological outcomes of intestinal adaptation in a distal-intestinal resection piglet model of short bowel syndrome25 (CAGS Clinical Research Award) Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial26 Negative-pressure wound therapy (iVAC) on closed, high-risk incisions following abdominal wall reconstruction27 The impact of seed granting on research in the University of British Columbia Department of Surgery28 Quality of surgical care is inadequate for elderly patients29 Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada30 Oncostatin M receptor deficiency results in increased mortality in an intestinal ischemia reperfusion model in mice31 Laparoscopic repair of large paraesophageal hernias with anterior gastropexy: a multicentre trial32 Response to preoperative medical therapy predicts success of laparoscopic splenectomy for immune thrombocytopenic purpura33 Perioperative sepsis, but not hemorrhagic shock, promotes the development of cancer metastases in a murine model34 Measuring the impact of implementing an acute care surgery service on the management of acute biliary disease35 Patient flow and efficiency in an acute care surgery service36 The relationship between treatment factors and postoperative complications after radical surgery for rectal cancer37 Risk of ventral hernia after laparoscopic colon surgery38 Urinary metabolomics as a tool for early detection of Barrett’s and esophageal cancer39 Construct validity of individual and summary performance metrics associated with a computer-based laparo-scopic simulator40 Impact of a city-wide health system reorganization on emergency department visits in hospitals in surrounding communities41 Transcatheter aortic valve implantation for the nonoperative management of aortic stenosis: a cost-effectiveness analysis42 Breast cancer: racial differences in age of onset. A potential confounder in Canadian screening recommendations43 Risk taking in surgery: in and out of the comfort zone44 A tumour board in the office: Track those cancer patients!45 Increased patient BMI is not associated with advanced colon cancer stage or grade on presentation: a retrospective chart review46 Consensus statements regarding the multidisciplinary care of limb amputation patients in disasters or humanitarian emergencies. Report of the 2011 Humanitarian Action Summit Surgical Working Group on amputations following disasters or conflict47 Learning the CanMEDS role of professional: a pilot project of supervised discussion groups addressing the hidden curriculum48 Assessing the changing scope of training in Canadian general surgery programs: expected versus actual experience49 Predicting need for surgical management for massive gastrointestinal hemorrhage50 International health care experience: using CanMEDS to evaluate learning outcomes following a surgical mission in Mampong, Ghana51 The open abdomen: risk factors for mortality and rates of closure52 How surgeons think: an exploration of mental practice in surgical preparation53 The surgery wiki: a novel method for delivery of under-graduate surgical education54 Understanding surgical residents’ postoperative practices before implementing an enhanced recovery after surgery (ERAS) guideline at the University of Toronto55 From laparoscopic transabdominal to posterior retroperitoneal adrenalectomy: a paradigm shift in operative approach56 A retrospective audit of outcomes in patients over the age of 80 undergoing acute care abdominal surgery57 Canadian general surgery residents’ perspectives on work-hour regulations58 Timing of surgical intervention and its outcomes in acute appendicitis59 Preparing surgical trainees to deal with adverse events. An outline of learning issues60 Acute care surgical service: surgeon agreement at the time of handover61 Predicting discharge of elderly patients to prehospitalization residence following emergency general surgery62 Morbidity and mortality after emergency abdominal surgery in octo- and nonagenarians63 The impact of acute abdominal illness and urgent admission to hospital on the living situation of elderly patients64 A comparison of laparoscopic versus open subtotal gastrectomy for antral gastric adenocarcinoma: a North American perspective65 Minimally invasive excision of ectopic mediastinal parathyroid adenomas66 Perioperative outcomes of laparoscopic hernia repair in a tertiary care centre: a single institution’s experience67 Evaluation of a student-run, practical and didactic curriculum for preclerkship medical students68 Joseph Lister: Father of Modern Surgery69 Comparisons of melanoma sentinel lymph node biopsy prediction nomograms in a cohort of Canadian patients70 Local experience with myocutaneous flaps after extensive pelvic surgery71 The treatment of noncirrhotic splanchnic vein thrombosis: Is anticoagulation enough?72 Implementation of an acute care surgery service does not affect wait-times for elective cancer surgeries: an institutional experience73 Use of human collagen mesh for closure of a large abdominal wall defect, after colon cancer surgery, a case report74 The role of miR-200b in pulmonary hypoplasia associated with congenital diaphragmatic hernia75 Systematic review and meta-analysis of electrocautery versus scalpel for incising epidermis and dermis76 Accuracy of sentinel lymph node biopsy for early breast cancer in the community setting in St. John’s, New-foundland: results of a retrospective review77 Acute surgical outcomes in the 80 plus population78 The liberal use of platelets transfusions in the acute phase of trauma resuscitation: a systematic review79 Implementation of an acute care surgical on call program in a Canadian community hospital80 Short-term outcomes following paraesophageal hernia repair in the elderly patient81 First experience with single incision surgery: feasibility in the pediatric population and cost evaluation82 The impact of the establishment of an acute care surgery unit on the outcomes of appendectomies and cholecystectomies83 Description and preliminary evaluation of a low-cost simulator for training and evaluation of flexible endoscopic skills84 Tumour lysis syndrome in metastatic colon cancer: a case report85 Acute care surgery service model implementation study at a single institution86 Colonic disasters approached by emergent subtotal and total colectomy: lessons learned from 120 consecutive cases87 Acellular collagen matrix stent to protect bowel anastomoses88 Lessons we learned from preoperative MRI-guided wire localization of breast lesions: the University Health Network (UHN) experience89 Interim cost comparison for the use of platinum micro-coils in the operative localization of small peripheral lung nodules90 Routine barium esophagram has minimal impact on the postoperative management of patients undergoing esophagectomy for esophageal cancer91 Iron deficiency anemia is a common presenting issue with giant paraesophageal hernia and resolves following repair92 A randomized comparison of different ventilation strategies during thoracotomy and lung resection93 The Canadian Lung Volume Reduction Surgery study: an 8-year follow-up94 A comparison of minimally invasive versus open Ivor-Lewis esophagectomy95 A new paradigm in the follow-up after curative resection for lung cancer: minimal-dose CT scan allows for early detection of asymptomatic cancer activity96 Predictors of lymph node metastasis in early esophageal adenocarcinoma: Is endoscopic resection worth the risk?97 How well can thoracic surgery residents operate? Comparing resident and program director opinions98 The impact of extremes of age on short- and long-term outcomes following surgical resection of esophageal malignancy99 Epidermal growth factor receptor targeted gold nanoparticles for the enhanced radiation treatment of non–small cell lung cancer100 Laparoscopic Heller myotomy results in excellent outcomes in all subtypes of achalasia as defined by the Chicago classification101 Neoadjuvant chemoradiation versus surgery in managing esophageal cancer102 Quality of life postesophagectomy for cancer!103 The implementation, evolution and translocation of standardized clinical pathways can improve perioperative outcomes following surgical treatment of esophageal cancer104 A tissue-mimicking phantom for applications in thoracic surgical simulation105 Sublobar resection compared with lobectomy for early stage non–small cell lung cancer: a single institution study106 Not all reviews are equal: the quality of systematic reviews and meta-analyses in thoracic surgery107 Do postoperative complications affect health-related quality of life after video-assisted thoracoscopic lobectomy for patients with lung cancer? A cohort study108 Thoracoscopic plication for palliation of dyspnea secondary to unilateral diaphragmatic paralysis: A worthwhile venture?109 Thoracic surgery experience in Canadian general surgery residency programs110 Perioperative morbidity and pathologic response rates following neoadjuvant chemotherapy and chemoradiation for locally advanced esophageal carcinoma111 An enhanced recovery pathway reduces length of stay after esophagectomy112 Predictors of dysplastic and neoplastic progression of Barrett’s esophagus113 Recurrent esophageal cancer complicated by tracheoesophageal fistula: management by means of palliative airway stenting114 Pancreaticopleural fistula-induced empyema thoracis: principles and results of surgical management115 Prognostic factors of early postoperative mortality following right extended hepatectomy116 Optimizing steatotic livers for transplantation using a cell-penetrating peptide CPP-fused heme oxygenase117 Video outlining the technical steps for a robot-assisted laparoscopic pancreaticoduodenectomy118 Establishment of a collaborative group to conduct innovative clinical trials in Canada119 Hepatic resection for metastatic malignant melanoma: a systematic review and meta-analysis120 Acellular normothermic ex vivo liver perfusion for donor liver preservation121 Pancreatic cancer and predictors of survival: comparing the CA 19–9/bilirubin ratio with the McGill Brisbane Scoring System122 Staged liver resections for bilobar hepatic colorectal metastases: a single centre experience123 Economic model of observation versus immediate resection of hepatic adenomas124 Resection of colorectal liver metastasis in the elderly125 Acceptable long-term survival in patients undergoing liver resection for metastases from noncolorectal, non-neuroendocrine, nonsarcoma malignancies126 Patient and clinicopathological features and prognosis of CK19+ hepatocellular carcinomas: a case–control study127 The management of blunt hepatic trauma in the age of angioembolization: a single centre experience128 Liver resections for noncolorectal and non-neuroendocrine metastases: an evaluation of oncologic outcomes129 Developing an evidence-based clinical pathway for patients undergoing pancreaticoduodenectomy130 Hepatitis C infection and hepatocellular carcinoma in liver transplant: a 20 year experience131 The effect of medication on the risk of post-ERCP pancreatitis132 Temporal trends in the use of diagnostic imaging for patients with hepato-pancreato-biliary (HPB) conditions: How much ionizing radiation are we really using?196 A phase II study of aggressive metastasectomy for intra-and extrahepatic metastases from colorectal cancer133 Why do women choose mastectomy for breast cancer treatment? A conceptual framework for understanding surgical decision-making in early-stage breast cancer134 Synoptic operative reporting: documentation of quality of care data for rectal cancer surgery135 Learning curve analysis for cytoreductive surgery: a useful application of the cumulative sum (CUSUM) method136 Pancreatic cancer is strongly associated with a unique urinary metabolomic signature137 Concurrent neoadjuvant chemo/radiation in locally advanced breast cancer138 Impact of positron emission tomography on clinical staging of newly diagnosed rectal cancer: a specialized single centre retrospective study139 An evaluation of intraoperative Faxitron microradiography versus conventional specimen radiography for the excision of nonpalpable breast lesions140 Comparison of breast cancer treatment wait-times in the Southern Interior of British Columbia in 2006 and 2010141 Factors affecting lymph nodes harvest in colorectal carcinoma142 Laparoscopic adrenalectomy for metastases143 You have a message! Social networking as a motivator for fundamentals of laparoscopic surgery (FLS) training144 The evaluation and validation of a rapid diagnostic and support clinic for women assessment for breast cancer145 Oncoplastic breast surgery: oncologic benefits and limitations146 A qualitative study on rectal cancer patients’ preferences for location of surgical care147 The effect of surgery on local recurrence in young women with breast cancer148 Elevated IL-6 and IL-8 levels in tumour microenvironment is not associated with increased serum levels in humans with Pseudomyxoma peritonei and peritoneal mesothelioma149 Conversion from laparoscopic to open approach during gastrectomy: a population-based analysis150 A scoping review of surgical process improvement tools (SPITs) in cancer surgery151 Splenectomy during gastric cancer surgery: a population-based study152 Defining the polo-like kinase 4 (Plk4) interactome in cancer cell protrusions153 Neoadjuvant imatinib mesylate for locally advanced gastrointestinal stromal tumours154 Implementing results from ACOSOG Z0011: Practice-changing or practice-affirming?155 Should lymph node retrieval be a surgical quality indicator in colon cancer?156 Long-term outcomes following resection of retroperitoneal recurrence of colorectal cancer157 Clinical research in surgical oncology: an analysis of clinicaltrials.gov158 Radiation therapy after breast conserving surgery: When are we missing the mark?159 The accuracy of endorectal ultrasound in staging rectal lesions in patients undergoing transanal endoscopic microsurgery160 Quality improvement in gastrointestinal cancer surgery: expert panel recommendations for priority research areas161 Factors influencing the quality of local management of ductal carcinoma in situ: a cohort study162 Papillary thyroid microcarcinoma: Does size matter?163 Hyperthermic isolated limb perfusion for extremity soft tissue sarcomas: systematic review of clinical efficacy and quality assessment of reported trials164 Adherence to antiestrogen therapy in seniors with breast cancer: How well are we doing?165 Parathyroid carcinoma: Challenging the surgical dogma?166 A qualitative assessment of the journey to delayed breast reconstruction195 The role of yoga therapy in breast cancer patients167 Outcomes reported in comparative studies of surgical interventions168 Enhanced recovery pathways decrease length of stay following colorectal surgery, but how quickly do patients actually recover?169 The impact of complications on bed utilization after elective colorectal resection170 Impact of trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study171 Complex fistula-in-ano: Should the plug be abandoned in favour of the LIFT or BioLIFT?172 Prognostic utility of cyclooxygenase-2 expression by colon and rectal cancer173 Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is complex and time-consuming: analysis of learning curves for a novice minimally invasive surgeon174 Intraoperative quality assessment following double stapled circular colorectal anastomosis175 Improving patient outcomes through quality assessment of rectal cancer care176 Are physicians willing to accept a decrease in treatment effectiveness for improved functional outcomes for low rectal cancer?177 Turnbull-Cutait delayed coloanal anastomosis for the treatment of distal rectal cancer: a prospective cohort study178 Preoperative high-dose rate brachytherapy in preparation for sphincter preservation surgery for patients with advanced cancer of the lower rectum179 Impact of an enhanced recovery program on short-term outcomes after scheduled laparoscopic colon resection180 The clinical results of the Turnbull-Cutait delayed coloanal anastomosis: a systematic review181 Is a vertical rectus abdominus flap (VRAM) necessary? An analysis of perineal wound complications182 Fistula plug versus endorectal anal advancement flap for the treatment of high transsphincteric cryptoglandular anal fistulas: a systematic review and meta-analysis183 Maternal and neonatal outcomes following colorectal cancer surgery184 Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option185 Trends in colon cancer in Ontario: 2002–2009186 Validation of electronically derived short-term outcomes in colorectal surgery187 A population-based assessment of transanal and endoscopic resection for adenocarcinoma of the rectum188 Laparoscopic colorectal surgery in the emergency setting: trends in the province of Ontario from 2002 to 2009189 Prevention of perineal hernia after laparoscopic and robotic abdominoperineal resection: review with case series of internal hernia through pelvic mesh which was placed in attempt to prevent perineal hernia190 Effect of rectal cancer treatments on quality of life191 The use of antibacterial sutures as an adjunctive preventative strategy for surgical site infection in Canada: an economic analysis192 Impact of socioeconomic status on colorectal cancer screening and stage at presentation: preliminary results of a population-based study from an urban Canadian centre193 Initial perioperative results of the first transanal endoscopic microsurgery (TEM) program in the province of Quebec194 Use of negative pressure wound therapy decreases perineal wound infections following abdominal perineal resection. Can J Surg 2012; 55:S63-S135. [DOI: 10.1503/cjs.016712] [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: 11/01/2022] Open
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Xu JL, Commins J, Partridge E, Riley TL, Prorok PC, Johnson CC, Buys SS. Longitudinal evaluation of CA-125 velocity and prediction of ovarian cancer. Gynecol Oncol 2012; 125:70-4. [PMID: 22198243 PMCID: PMC3303942 DOI: 10.1016/j.ygyno.2011.12.440] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 10/22/2011] [Accepted: 12/14/2011] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether CA-125 velocity is a statistically significant predictor of ovarian cancer and develop a classification rule to screen for ovarian cancer. METHODS In the ovarian component of the PLCO cancer screening trial, 28,038 women aged 55-74 had at least two CA-125 screening tests. Ovarian cancer was diagnosed in 72 (0.26%) women. A multiple logistic regression model was developed to evaluate CA-125 velocity and other related covariates as predictors of ovarian cancer. Predictive accuracy was assessed by the concordance index and measures of discrimination and calibration while the fit of the model was assessed by the Hosmer and Lemeshow's goodness-of-fit χ(2)test. RESULTS CA-125 velocity decreased as the number of CA-125 measurements increased but was unaffected by age at baseline screen and family history of ovarian cancer. The average velocity (19.749U/ml per month) of the cancer group was more than 500 times the average velocity (0.035U/ml per month) of the non-cancer group. CONCLUSION Among six covariates used in the model, CA-125 velocity and time intervals between baseline and second to last screening test and between last two screening tests were statistically significant predictors of ovarian cancer. The chance of having ovarian cancer increased as velocity increased, and the chance decreased when the time intervals between baseline and the second to last screening test and between last two screening tests of an individual increased.
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Affiliation(s)
- Jian-Lun Xu
- Biometry Research Group, National Cancer Institute, Bethesda, MD, USA.
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Meredith R, You Z, Alvarez R, Partridge E, Grizzle W, LoBuglio A. Predictors of long-term outcome from intraperitoneal radioimmunotherapy for ovarian cancer. Cancer Biother Radiopharm 2012; 27:36-40. [PMID: 22239432 PMCID: PMC3277922 DOI: 10.1089/cbr.2011.1111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Data was analyzed from 92 patients > 5 years after intraperitoneal (IP) radionuclide therapy (RIT) with (90)Y- or (177)Lu-CC49 to determine prognostic factors. Patients had CC49 antibody-reactive ovarian cancer confined to the abdominal cavity after primary debulking and chemotherapy. The first 27 patients received IP (177)Lu-CC49 alone; the remainder received Interferon (IFN), to increase the expression of the tumor-associated glycoprotein-72 (TAG-72) antigen, +/- IP paclitaxel (25-100 mg/m(2)) 2 days before RIT. Factors assessed by univariate (and some multivariate) analysis included age, race, body size, interval between initial diagnosis and RIT, interval between 2nd look surgery and RIT, (90)Y versus (177)Lu, MBq dose, paclitaxel dose, grade of tumor, extent of initial surgery, size of disease deposits prior to RIT, intensity of TAG reactivity, the addition of unlabeled antibody, and the development of human anti-mouse antibody and/or serum sickness after murine antibody. A statistically significant improvement in progression-free survival (p ≤ 0.05) was noted for less bulky disease and younger age. Administration of paclitaxel plus IFN, an immune response, and use of (90)Y showed a favorable nonsignificant trend. Dose escalation of radionuclide did not change risk of progression; thus, this therapy may have therapeutic efficacy at modest dose levels.
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Affiliation(s)
- Ruby Meredith
- Departments of Radiation Oncology, Medicine, Pathology and Gynecology, University of Alabama Comprehensive Cancer Center, Birmingham, Alabama, USA.
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Yu X, Wang F, Liu H, Adams G, Aikhionbare F, Liu D, Cao X, Fan L, Hu G, Chen Y, Frost A, Partridge E, Ding X, Yao X. ACAP4 protein cooperates with Grb2 protein to orchestrate epidermal growth factor-stimulated integrin β1 recycling in cell migration. J Biol Chem 2011; 286:43735-43747. [PMID: 22027826 DOI: 10.1074/jbc.m111.278770] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
ARF6 GTPase is an important regulator of membrane trafficking and actin-based cytoskeleton dynamics active at the leading edge of migrating cells. The integrin family heterodimeric transmembrane proteins serve as major receptors for extracellular matrix proteins, which play essential roles in cell adhesion and migration. Our recent proteomic analyses of ARF6 effectors have identified a novel ARF6 GTPase-activating protein, ACAP4, essential for EGF-induced cell migration. However, molecular mechanisms underlying ACAP4-mediated cell migration have remained elusive. Here, we show that ACAP4 regulates integrin β1 dynamics during EGF-stimulated cell migration by interaction with Grb2. Our biochemical study shows that EGF stimulation induces phosphorylation of tyrosine 733, which enables ACAP4 to bind Grb2. This interaction of ACAP4 with Grb2 regulates integrin β1 recycling to the plasma membrane. Importantly, knockdown of ACAP4 by siRNA or overexpression of ACAP4 decreased recycling of integrin β1 to the plasma membrane and reduced integrin-mediated cell migration. Taken together, these results suggest a novel function for ACAP4 in the regulation of cell migration through controlling integrin β1 dynamics.
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Affiliation(s)
- Xue Yu
- Anhui Key Laboratory of Cellular Dynamics, University of Science and Technology of China, Hefei 230027, China
| | - Fengsong Wang
- Anhui Key Laboratory of Cellular Dynamics, University of Science and Technology of China, Hefei 230027, China; Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia 30310.
| | - Hongsheng Liu
- Anhui Key Laboratory of Cellular Dynamics, University of Science and Technology of China, Hefei 230027, China
| | - Gregory Adams
- Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia 30310
| | - Felix Aikhionbare
- Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia 30310
| | - Dong Liu
- Department of Hepatobiliary Surgery, Xijing Hospital, Xi'an 710032, China
| | - Xinwang Cao
- Anhui Key Laboratory of Cellular Dynamics, University of Science and Technology of China, Hefei 230027, China; School of Life Sciences, Anhui Medical University, Hefei 230027, China
| | - Libin Fan
- School of Life Sciences, Anhui Medical University, Hefei 230027, China
| | - Guohong Hu
- Key Laboratory for Stem Cell Biology, SIBS-SJTU Institute of Health Sciences, Shanghai 200025, China
| | - Yong Chen
- Department of Hepatobiliary Surgery, Xijing Hospital, Xi'an 710032, China
| | - Andra Frost
- Comprehensive Cancer Center, University of Alabama School of Medicine, Birmingham, Alabama 35294
| | - Edward Partridge
- Comprehensive Cancer Center, University of Alabama School of Medicine, Birmingham, Alabama 35294
| | - Xia Ding
- School of Graduate Studies, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Xuebiao Yao
- Anhui Key Laboratory of Cellular Dynamics, University of Science and Technology of China, Hefei 230027, China; Department of Physiology, Morehouse School of Medicine, Atlanta, Georgia 30310.
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Buys SS, Partridge E, Black A, Johnson CC, Lamerato L, Isaacs C, Reding DJ, Greenlee RT, Yokochi LA, Kessel B, Crawford ED, Church TR, Andriole GL, Weissfeld JL, Fouad MN, Chia D, O'Brien B, Ragard LR, Clapp JD, Rathmell JM, Riley TL, Hartge P, Pinsky PF, Zhu CS, Izmirlian G, Kramer BS, Miller AB, Xu JL, Prorok PC, Gohagan JK, Berg CD. Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial. JAMA 2011; 305:2295-303. [PMID: 21642681 DOI: 10.1001/jama.2011.766] [Citation(s) in RCA: 840] [Impact Index Per Article: 64.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT Screening for ovarian cancer with cancer antigen 125 (CA-125) and transvaginal ultrasound has an unknown effect on mortality. OBJECTIVE To evaluate the effect of screening for ovarian cancer on mortality in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. DESIGN, SETTING, AND PARTICIPANTS Randomized controlled trial of 78,216 women aged 55 to 74 years assigned to undergo either annual screening (n = 39,105) or usual care (n = 39,111) at 10 screening centers across the United States between November 1993 and July 2001. Intervention The intervention group was offered annual screening with CA-125 for 6 years and transvaginal ultrasound for 4 years. Participants and their health care practitioners received the screening test results and managed evaluation of abnormal results. The usual care group was not offered annual screening with CA-125 for 6 years or transvaginal ultrasound but received their usual medical care. Participants were followed up for a maximum of 13 years (median [range], 12.4 years [10.9-13.0 years]) for cancer diagnoses and death until February 28, 2010. MAIN OUTCOME MEASURES Mortality from ovarian cancer, including primary peritoneal and fallopian tube cancers. Secondary outcomes included ovarian cancer incidence and complications associated with screening examinations and diagnostic procedures. RESULTS Ovarian cancer was diagnosed in 212 women (5.7 per 10,000 person-years) in the intervention group and 176 (4.7 per 10,000 person-years) in the usual care group (rate ratio [RR], 1.21; 95% confidence interval [CI], 0.99-1.48). There were 118 deaths caused by ovarian cancer (3.1 per 10,000 person-years) in the intervention group and 100 deaths (2.6 per 10,000 person-years) in the usual care group (mortality RR, 1.18; 95% CI, 0.82-1.71). Of 3285 women with false-positive results, 1080 underwent surgical follow-up; of whom, 163 women experienced at least 1 serious complication (15%). There were 2924 deaths due to other causes (excluding ovarian, colorectal, and lung cancer) (76.6 per 10,000 person-years) in the intervention group and 2914 deaths (76.2 per 10,000 person-years) in the usual care group (RR, 1.01; 95% CI, 0.96-1.06). CONCLUSIONS Among women in the general US population, simultaneous screening with CA-125 and transvaginal ultrasound compared with usual care did not reduce ovarian cancer mortality. Diagnostic evaluation following a false-positive screening test result was associated with complications. Trial Registration clinicaltrials.gov Identifier: NCT00002540.
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Affiliation(s)
- Saundra S Buys
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, USA
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Buys SS, Partridge E, Black A, Johnson C, Lamerato L, Isaacs C, Reding D, Greenlee R, Kessel B, Fouad M, Chia D, Ragard L, Rathmell J, Hartge P, Pinsky P, Izmirlian G, Xu J, Prorok P, Berg CD. Effect of screening on ovarian cancer mortality in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer randomized screening trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5001] [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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Piyathilake C, Badiga S, Johanning G, Alvarez R, Partridge E. Predictors and Health Consequences of Epigenetic Changes Associated with Excess Body Weight in Women of Child-bearing Age. Cancer Epidemiol Biomarkers Prev 2011. [DOI: 10.1158/1055-9965.epi-11-0094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: Epigenetic alterations occurring during pregnancy have recently emerged as important factors for developmental programming of the fetus leading to obesity-related diseases in children. However, the role of excess body weight (EBW) in the modification of epigenetic patterns or its health consequences during child-bearing age is largely unknown. Because a lower degree of DNA methylation of long interspersed nucleotide element-1 (LINE-1) in PBMCs was shown to be associated with a higher risk of developing obesity-related diseases, for example cancer, the purpose of this study was to (1) evaluate the influence of indicators of obesity (BMI, WC, and % body fat) on PBMC LINE-1 methylation, (2) determine the predictors of PBMC LINE-1 methylation, and (3) determine the influence of PBMC LINE-1 methylation on biomarkers of obesity-related diseases.
Methods: The study population consisted of 470 child-bearing age women. We quantified the degree of PBMC LINE-1 methylation by pyrosequencing. Folate concentrations were measured using a microbiological assay. The degree of LINE-1 methylation (> median vs. ≤ median) was the dependent variable in logistic models that specified BMI (>25 vs. ≤ 25), WC (>88 cm vs. ≤ 88 cm), or % body fat (>33% vs. ≤ 33%) separately as the independent predictors of primary interest, adjusting for other relevant variables. The predictors and determinants of lower LINE-1 methylation were evaluated among women with EBW.
Results: Women with higher BMI, WC, or % body fat were 2.0, 1.9, and 1.8 times more likely to have lower LINE-1 methylation, respectively (P = 0.003, 0.005, and 0.01). The predictors and determinants of lower LINE-1 methylation yielded similar patterns with all three indicators of obesity. The following results are based on models run with BMI as the indicator for EBW. Women with higher plasma folate concentrations were less likely to have lower LINE-1 methylation (OR = 0.54, P = 0.0009). Higher LINE-1 methylation was associated with lower insulin resistance as indicated by HOMA (OR = 0.50, P = 0.02).
Conclusions: EBW-associated lower LINE-1 methylation in women of child-bearing age appears to have significant, and potentially transgenerational, health consequences. Higher folate status may exert beneficial effects on obesity-related health outcomes.
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Wynn TA, Anderson-Lewis C, Johnson R, Hardy C, Hardin G, Walker S, Marron J, Fouad M, Partridge E, Scarinci I. Developing a community action plan to eliminate cancer disparities: lessons learned. Prog Community Health Partnersh 2011; 5:161-8. [PMID: 21623018 PMCID: PMC3600640 DOI: 10.1353/cpr.2011.0013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 11/11/2022]
Abstract
BACKGROUND African Americans bear an unequal burden of breast, cervical, and colorectal cancer. The Deep South Network for Cancer Control (DSN) is a community-academic partnership operating in Alabama and Mississippi that was funded by the National Cancer Institute (NCI) to address cancer disparities using community-based participatory research approaches. OBJECTIVE In addition to reporting on the plans of this work in progress, we describe the participatory process that local residents and the DSN used to identify needs and priorities, and elaborate on lessons learned from applying a participatory approach to the development of a community action plan. METHODS We conducted 24 community discussion groups involving health care professionals, government officials, faith-based leaders, and other stakeholders to identify cancer health disparity needs, community resources/assets, and county priorities to eliminate cancer health disparities. To develop a community action plan, four working groups explored the themes that emerged from the discussion groups, taking into consideration evidence-based strategies and promising community practices. RESULTS The DSN formulated a community action plan focusing on (1) increasing physical activity by implementing a campaign for individual-level focused activity; (2) increasing the consumption of fruits and vegetables by implementing NCI's Body and Soul Program in local churches; (3) increasing cancer screening by raising awareness through individual, system, and provider agents of change; and (4) training community partners to become effective advocates. CONCLUSIONS A community-academic partnership must involve trust, respect, and an appreciation of partners' strengths and differences. The DSN applied these guiding principles and learned pivotal lessons.
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Affiliation(s)
- Theresa Ann Wynn
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, USA
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Fouad MN, Partridge E, Dignan M, Holt C, Johnson R, Nagy C, Person S, Wynn T, Scarinci I. Targeted intervention strategies to increase and maintain mammography utilization among African American women. Am J Public Health 2010; 100:2526-31. [PMID: 21068422 DOI: 10.2105/ajph.2009.167312] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the impact of a theory-based, culturally relevant intervention designed to increase mammography screening among African American women in 8 underserved counties in Alabama. METHODS Using principles derived from the Stages of Change, Community Health Advisor, and Community Empowerment models, we developed strategies to increase mammography screening. Trained volunteers (N = 143) provided tailored messages to encourage adoption and maintenance of mammography screening. We collected baseline and follow-up data on 1513 women in the communities targeted for the intervention. Our goal was to decrease the number of women in stage 1 (never screened) while increasing the number of women in stage 2 (infrequently screened) and stage 3 (regularly screened). RESULTS At baseline, 14% (n = 211) of the women were in stage 1, 16% (n = 247) were in stage 2, and 70% (n = 1055) were in stage 3. After the 2-year intervention, 4% (n = 61) of the women remained in stage 1, 20% (n = 306) were in stage 2, and 76% (n = 1146) were in stage 3. CONCLUSIONS Tailored motivational messages and peer support can increase mammography screening rates for African American women.
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Affiliation(s)
- Mona N Fouad
- Division of Preventive Medicine, School of Medicine, University of Alabama, Birmingham, AL 35205, USA.
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Mehrabi S, Adams G, Partridge E, Aikhionbare F. Abstract A115: Mitochondrial analysis and epithelial ovarian carcinoma. Cancer Epidemiol Biomarkers Prev 2010. [DOI: 10.1158/1055-9965.disp-10-a115] [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: 11/16/2022] Open
Abstract
Abstract
Survival rates of ovarian cancer patients are low, largely due to late diagnosis. Early detection plays a major role towards improving outcomes in ovarian cancer, however few candidate biomarkers have shown efficacy for the detection of preclinical disease. Human mitochondrial gene mutations have increasingly been associated with various cancers. The mitochondrial genome is highly susceptible to oxidative damage and may accumulate damage over a long period of time. Consequently, variations in (mtDNA) may potentially play a role as a modifying risk factor in the development of age-related diseases such as ovarian cancer. The goal of this study is to examine correlations between mitochondrial gene alterations and three subtypes of ovarian tumor progression.
Mitochondrial DNA fragments were obtained from 120 epithelial ovarian cancer tissue samples (40 serous; 40 endometrioid and 40 mucinous ovarian tumors respectively). The entire mitochondrial genome was PCR amplified using 9 overlapping primers sets and analyzed using both high resolution restriction digest and PCR-based sequencing techniques. Additionally, the levels of carbonyl proteins in cytosolic fraction of tissues were assessed by standard colorimetric technique, using 2-4-dinitrophenylhydrazine (DNPH) to derivatize protein, and measure the absorbance of the DNP-hydrazones at 370 nm. In this study we revealed the presence thirty-nine polymorphisms of which 28 were unreported. The observed mutations with notably frequencies (41-93%) among these samples were at np C7028T, C7256T, G7520A, T8548G, T8588C, A8860G, C9488G, C9500T, T9540C, C9857T, and T9951C. Furthermore, six unreported point mutations with frequencies of 14-41 % were observed at np G7520A, T8548G, C9488G, C9500T, C9857 and T9951C. A combined mutation of G7520A and C7256T was frequent at 45% in endometrioid stage III only. Interestingly, variants C7020T (56%) and at np A8860G (92%) were evenly distributed in all three studied ovarian tumor subtype and stages. Variants T9540C and C7520T showed significant higher frequency in African American samples compare to Caucasian samples and these may be used for further investigation for cancer disparity study. A number of the observed sequence variants were germ-lines with variants found in these mitochondrial genes/regions; D-Loop, 12S rRNA-tRNAphe, tRNAval, COX I, tRNAser, tRNAasp, COX II, tRNAlys, ATPase 6, ATPase 8, COX III, ND2, and ND3 genes among the three subtypes of ovarian cancer. Our results showed the elevation of the ratio of protein carbonyl/total protein in all three types of serous polyp as compare to their surrounding tissue. The level of the ratio of protein carbonyls/total protein decreased as a result of serous ovarian tumor progression.
Our study suggests that certain mitochondrial DNA sequence variants and protein carbonyl (CO) groups, oxidative stress may play a potential role in etiological differences that may exist between the pathogenicity of subtypes and stages of benign and invasive epithelial ovarian tumors.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A115.
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Affiliation(s)
- Edward Partridge
- Comprehensive Cancer Center, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, AL 35294-3300, USA.
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Fouad M, Wynn T, Martin M, Partridge E. Patient navigation pilot project: results from the Community Health Advisors in Action Program (CHAAP). Ethn Dis 2010; 20:155-161. [PMID: 20503896] [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: 05/29/2023] Open
Abstract
To facilitate access to care and to ensure adherence to diagnostic follow-up of positive breast cancer screening or prescribed treatment for confirmed cancer, community volunteers were used as patient navigators (PNs) for a population of low-income, medically underserved women, primarily African Americans. Partnerships were established with local healthcare facilities, residents from the targeted areas were hired as county coordinators, and community volunteers were trained to serve as PNs. Patients who had a suspicious mammogram or confirmed diagnosis of breast cancer were recruited from 23 Alabama counties. For these patients, barriers to diagnostic follow-up or treatment were identified by PNs, who assisted in overcoming these barriers by referring patients to appropriate treatment facilities, guiding them through the healthcare system, and providing the necessary logistical, social, or emotional support. With this intervention, patients kept 93% of their appointments. Thus, for medically underserved patients with breast cancer or a suspicious mammogram, intervention by a network of community volunteers serving as PNs improves adherence to follow-up diagnostic procedures and treatment. PNs can help close the gap between development and delivery of cancer treatments to those who are medically underserved.
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Affiliation(s)
- Mona Fouad
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA.
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Abstract
e17522 Background: An exceptional survivor of cancer is an individual who has outlived actuarial predictions for his/her particular form of cancer or experienced a complete regression. This pilot study was designed to determine if there were any biological, psychosocial, cultural or lifestyle characteristics exceptional survivors of cancer that can be measured and transferred through interventions to other cancer patients. Methods: The sample consisted of 21 survivors of cancer who were identified by oncologists at UAB as exceptional survivors. The study gathered qualitative data through semi-structured interviews and two validated scales measuring resilience, sense of coherence. A new cancer ‘catastrophizing’ scale based on the pain catastrophizing scale (PCS) was tested for its concordance with the two validated scales. The diagnosis and treatment information on these patients was collected through a questionnaire completed by the patient's oncologist. Results: Eight oncologists referred twenty-five patients to the study. Twenty-one patients agreed to participate. A unifying theme across all patient interviews was a deep spiritual connection with a supreme being. Praying for healing, intercessory prayer, and seeking guidance through faith with respect to best treatment options were common. The patients verbalized faith in physicians and were willing to seek more experimental treatments largely due to their spirituality. In general, the survivors were highly resilient as measured by the resilience scale and had a high sense of coherence as measured by the sense of coherence scale. They were also unlikely to conceptualize the diagnosis as a ‘catastrophe’ as measured by the new cancer catastrophizing scale. Conclusions: This study provides preliminary evidence of a relationship between spirituality and exceptional survivorship. Findings suggest exceptional survivors may be more willing to participate in clinical trials than other populations of cancer patients. Future studies should prospectively follow cancer patients to ascertain the temporal nature of the association between spirituality and exceptional survivorship. No significant financial relationships to disclose.
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Chu KC, Chen MS, Dignan MB, Taylor E, Partridge E. Parallels between the development of therapeutic drugs and cancer health disparity programs: implications for Disparities Reduction. Cancer 2008; 113:2790-6. [PMID: 18780311 DOI: 10.1002/cncr.23879] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND There are analogies between the development of therapeutic drugs for cancer and the development of interventions for reducing cancer health disparities. In both cases, it can take between 12 and 15 years for the benefits to become apparent. METHODS The initial preclinical phase of drug development is analogous to the development of community partnerships and helping the community learn about cancer. The preclinical phase of in vitro and in vivo testing is analogous to identifying the disparities in the community. Then clinical testing begins with phase 1, toxicity, and dose-establishing studies. Analogously, community-based participatory research is used to develop disparities-reducing interventions (DRIs) within the community. RESULTS The phase 2 clinical studies to determine whether the drug has activity are analogous to the DRI being implemented in the community to determine whether it can cause behavioral changes that will reduce cancer health disparities. If a drug passes phase 1 and 2 studies, phase 3 clinical trials are initiated. These are controlled studies to examine the efficacy of the drug. The similar activity for disparities research is to determine whether the DRI is better than the current standard/usual practice in controlled trials. If the drug is beneficial, the final phase is the dissemination and adoption of the drug. Analogously in disparities, if the DRI is beneficial, it is disseminated and is culturally adapted to other racial/ethnic groups and finally adopted as standard practice. CONCLUSIONS The process of creating an effective DRI can be envisioned to have 4 stages, which can be used to aid in measuring the progress being made in reducing cancer health disparities.
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Affiliation(s)
- Kenneth C Chu
- Disparities Research Branch, Center to Reduce Cancer Health Disparities, National Cancer Institute, Bethesda, Maryland
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Meredith R, Alvarez R, Huh W, Partridge E, Grizzle W, LoBuglio A. Long Term Outcome of Intraperitoneal Radioimmunotherapy for Ovarian Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1185] [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: 10/21/2022]
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Aikhionbare FO, Mehrabi S, Thompson W, Yao X, Grizzle W, Partridge E. mtDNA sequence variants in subtypes of epithelial ovarian cancer stages in relation to ethnic and age difference. Diagn Pathol 2008; 3:32. [PMID: 18662401 PMCID: PMC2494992 DOI: 10.1186/1746-1596-3-32] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 07/28/2008] [Indexed: 11/10/2022] Open
Abstract
Epithelial ovarian cancer is the fifth leading cause of cancer mortality among women in the United States. For this disease, differences in age-adjusted incidence and survival rates between African American and Caucasian women are substantial. The objective of this study was to examine mtDNA sequence variants in 118 frozen tissues of three subtypes of epithelial ovarian cancer (serous, n = 48 endometrioid, n = 47 and mucinous, n = 23) and matched paracancerous normal tissues (n = 18) in relation to racial/ethnic and age differences. Restriction fragment length polymorphism (RFLP) and polymerase chain reaction (PCR)-based sequencing were used to evaluate two regions of mtDNA spanning 5317 to 7608 and 8282 to 10110 bp and including ND subunits 2, 3, MT-COI, II, and III, ATPase 8, a part of ATPase 6, and tRNA genes in frozen ovarian tissues obtained from the southern regional Cooperative Human Tissue Network (CHTN) and University of Alabama-Birmingham (UAB) Ovarian Spore Center. Thirty-nine mtDNA variants were detected of which 28 were previously unreported. One somatic variant of C9500T was observed. A variant, C7028T in the MT-CO1 gene, had an ascending frequency from borderline (8%) to stages III/IV (75%) among the three ovarian cancer subtypes and stages. It was found in 86% (42/49) of African-American and 43% (37/87) of the Caucasian women. A variant, T8548G in the ATPase 6 gene was detected at a frequency of 72% (18/25) in ovarian serous subtype tissues in stages III/IV. Of the African American patients under age 40, 95% (20/21) harbored the T8548G variant; this was in contrast to only 22% (8/35) of Caucasian patients in same age group. Variants C7256T and G7520A had a frequency of 54% (6/11) in endometrioid stage III; no corresponding variants were observed in mucinous subtype stage III. Furthermore, variants C7256T and G7520A were absent in serous ovarian cancer subtype. Interestingly, the C7520T variant in tRNA gene was present in 74% (36/49) of African American and 26% (23/87) of Caucasian patients. Taken together, our results suggest that, with respect to ethnic and age difference, these mtDNA variants may be involved in epithelial ovarian carcinogenesis.
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Affiliation(s)
- Felix O Aikhionbare
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA.
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Johnson E, Johnson-Holiday C, Singh S, Singh U, Partridge E, Lillard J. CCL25-CCR9 axis role in ovarian cancer progression (96.2). The Journal of Immunology 2007. [DOI: 10.4049/jimmunol.178.supp.96.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Ovarian cancer (OvCa) is the most lethal among gynecologic malignancies. Recently, chemokines have been shown to function in non-random tumor-cell metastasis to distant organs in a fashion that is similar to chemokine-directed lymphocyte migration. Also, the interactions between CCR9 and its ligand, CCL25, have been implicated in leukocyte trafficking to the small intestines, a frequent metastatic site for OvCa. Previously, our laboratory has shown that ovarian cancer cells strongly express CCR9. We have also shown that CCL25 induces the chemotaxis of OvCa cell lines and increases the invasive potential of OvCa cells. Recent studies in T cells, have shown that CCR9-CCL25 interaction can induce anti-apoptotic pathways, namely through Akt/protein kinase B activation, which is PI3K- and G?i protein-dependent. Activated Akt phosphorylates multiple down stream targets that are involved in cell survival signals, which include glycogen synthase kinase-3? and forkhead transcriptional factor. Cisplatin is a commonly used anticancer drug for the treatment of OvCa. It has been shown that the anti-apoptotic signals of the PI3K-Akt survival pathways are involved in tumor cell cisplatin resistance. Here we characterize the molecular mechanisms of CCL25-CCR9 cell-signaling cascades involved in ovarian cancer survival and show that CCL25-CCR9 interactions mediate cisplatin survival through the activation of anti-apoptosis pathway. These studies will provide novel information regarding the cellular and molecular mechanisms, following CCL25-CCR9 interaction, that modulate ovarian cell metastasis and cisplatin resistance.
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Affiliation(s)
- Erica Johnson
- 1Morehouse School of Medicine, 720 Westview Drive, S.W., Atlanta, Georgia, 30310-1495,
| | | | - Shailesh Singh
- 2James Graham Brown Cancer Center at the University of Louisville, 529 S. Jackson Street, Louisville, Kentucky, 40202,
| | - Udai Singh
- 1Morehouse School of Medicine, 720 Westview Drive, S.W., Atlanta, Georgia, 30310-1495,
| | - Edward Partridge
- 3University of Alabama - Birmingham, 1824 6th Avenue South, Birmingham, Alabama, 35249
| | - James Lillard
- 1Morehouse School of Medicine, 720 Westview Drive, S.W., Atlanta, Georgia, 30310-1495,
- 2James Graham Brown Cancer Center at the University of Louisville, 529 S. Jackson Street, Louisville, Kentucky, 40202,
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Yuli C, Shao N, Rao R, Aysola P, Reddy V, Oprea-llies G, Lee L, Okoli J, Partridge E, Reddy ESP, Rao VN. BRCA1a has antitumor activity in TN breast, ovarian and prostate cancers. Oncogene 2007; 26:6031-7. [PMID: 17384678 DOI: 10.1038/sj.onc.1210420] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [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: 01/08/2023]
Abstract
Breast cancer gene 1 (BRCA1) mutations predispose women to breast and ovarian cancers and men to increased risks for prostate cancer. We have previously showed BRCA1 splice variant BRCA1a/p110 to induce apoptosis of human breast cancer cells. In the current study, stable expression of BRCA1a/p110 resulted in inhibition of growth of estrogen receptor (ER)-positive and triple-negative (TN) human breast, ovarian, prostate and colon cancer cells and mouse fibroblast cells. Similar to wild-type BRCA1, only those cells with wild-type Rb were sensitive to BRCA1a-induced growth suppression and the status of p53 did not affect the ability of BRCA1a to suppress growth of tumor cells. BRCA1a also significantly inhibited tumor mass in nude mice bearing human CAL-51 TN breast cancer, ES-2 ovarian cancer and PC-3 prostate cancer xenografts. These results suggest that the majority of exon 11 sequences (residues 263-1365) are not required for the tumor suppressor function of BRCA1 proteins. This is the first report demonstrating antitumor activity of BRCA1a in human ER-positive and TN breast, hormone-independent ovarian and prostate cancer cells. Currently, there are no effective treatments against TN breast cancers and results from these studies will provide new treatments for one of the biggest needs in breast cancer research.
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Affiliation(s)
- C Yuli
- Program of Cancer Genetics, Department of Biochemistry, Drexel University, Philadelphia, PA, USA
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Dietrich CS, Desimone CP, Modesitt SC, Depriest PD, Ueland FR, Pavlik EJ, Kryscio R, Cibull M, Huh W, Partridge E, Numnum TM, Schilder J, Higgins RV, van Nagell JR. Primary appendiceal cancer: Gynecologic manifestations and treatment options. Gynecol Oncol 2007; 104:602-6. [PMID: 17055559 DOI: 10.1016/j.ygyno.2006.09.014] [Citation(s) in RCA: 28] [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] [Received: 07/10/2006] [Revised: 09/15/2006] [Accepted: 09/18/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the presenting symptoms, gynecologic manifestations, and optimal intraoperative management of women with primary appendiceal cancer. METHODS A multi-institutional investigation was performed to identify female patients with primary appendiceal cancer who were treated from 1990 to present. RESULTS Forty-eight women with primary appendiceal cancer were identified from the tumor registries of participating institutions. The most common symptoms were abdominal pain (40%) and bloating (23%), but only 8% experienced rectal bleeding. Serum CEA was elevated (>2.5 U/ml) in 67% of patients, and serum Ca-125 was elevated (>35 U/ml) in 50% of patients. Thirty-one patients (65%) presented with a right adnexal or right lower quadrant mass and were operated on initially by a gynecologic oncologist. Ovarian involvement by metastatic appendiceal cancer was documented in 18 patients (38%). All of these patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and staging, but only 8 had a right hemicolectomy at the time of initial surgery. Forty-one patients (85%) presented with advanced stage appendiceal cancer (Stage III or IV) and 19 patients (46%) received postoperative chemotherapy, most commonly with a combination of 5-FU/Leukovorin. Following surgery, 22 patients (46%) experienced disease progression or recurrence, and 14 have died of disease. The most common sites of recurrence were abdominal or pelvic peritoneum (18), colon (2), and ovary (2). Patient survival was 70% at 2 years, and 60% at 5 years. CONCLUSION Women with primary appendiceal cancer frequently present with ovarian metastases, and initial surgical intervention is often performed by a gynecologic oncologist. All patients with mucinous epithelial ovarian cancer should undergo appendectomy at the time of surgical staging. The appendix should be examined intraoperatively, and if appendiceal carcinoma is identified, a right hemicolectomy and appropriate surgical staging should be considered.
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Affiliation(s)
- C S Dietrich
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Medical Center-Markey Cancer Center, 800 Rose Street, Lexington, KY 40536, USA
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Aikhionbare FO, Mehrabi S, Kumaresan K, Zavareh M, Olatinwo M, Odunsi K, Partridge E. Mitochondrial DNA sequence variants in epithelial ovarian tumor subtypes and stages. J Carcinog 2007; 6:1. [PMID: 17257433 PMCID: PMC1794240 DOI: 10.1186/1477-3163-6-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Accepted: 01/26/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A majority of primary ovarian neoplasms arise from cell surface epithelium of the ovaries. Although old age and a positive family history are associated risk factors, the etiology of the epithelial ovarian tumors is not completely understood. Additionally, knowledge of factors involved in the histogenesis of the various subtypes of this tumor as well as those factors that promote progression to advanced stages of ovarian malignancy are largely unknown. Current evidence suggests that mitochondrial alterations involved in cellular signaling pathways may be associated with tumorigenesis. METHODS In this study, we determined the presence of polymorphisms and other sequence variants of mitochondrial DNA (mtDNA) in 102 epithelial ovarian tumors including 10 matched normal tissues that paired with some of the tumors. High-resolution restriction endonucleases and PCR-based sequencing were used to assess the mtDNA variants spanning 3.3 kb fragment that comprised the D-Loop and 12S rRNA-tRNAphe, tRNAval, tRNAser, tRNAasp, tRNAlys, ATPase 6, ATPase 8, cytochrome oxidase I and II genes. RESULTS Three hundred and fifty-two (352) mtDNA sequence variants were identified, of which 238 of 352 (68%) have not been previously reported. There were relatively high frequencies of three mutations in the 12S rRNA gene at np 772, 773, and 780 in stage IIIC endometrioid tumors, two of which are novel (773delT and 780delC), and occurred with a frequency of 100% (7/7). Furthermore, two mutations were observed in serous tumors only at np 1657 in stage IV (10/10), and at np 8221delA in benign cystadenomas (3/3) and borderline tumors (4/4). A high frequency, 81% (13/16) of TC insertion at np 310 was found only in early stages of serous subtype (benign cystadenomas, 3/3; borderline tumors, 4/4; stage I tumors, 2/5 and matched normal tissues 4/4). CONCLUSION Our findings indicate that certain mtDNA mutations can reliably distinguish the different histologic subtypes of epithelial ovarian tumors. In addition, these data raise the possibility that certain mtDNA mutations may be useful biomarkers for predicting tumor aggressiveness and may play a potential role in tumorigenesis.
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Affiliation(s)
- Felix O Aikhionbare
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Sharifeh Mehrabi
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - K Kumaresan
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Mojgan Zavareh
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Moshood Olatinwo
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Kunle Odunsi
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Edward Partridge
- University of Alabama, Comprehensive Cancer Center, Birmingham, AL 35294, USA
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Wynn TA, Johnson RE, Fouad M, Holt C, Scarinci I, Nagy C, Partridge E, Dignan MB, Person S, Parham G. Addressing Disparities through Coalition Building: Alabama REACH 2010 Lessons Learned. J Health Care Poor Underserved 2006; 17:55-77. [PMID: 16809875 DOI: 10.1353/hpu.2006.0096] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 11/11/2022]
Abstract
Community-based coalitions have become accepted vehicles for addressing complex health problems. Few articles have described the challenges and lessons learned from such a process. The purpose of this paper is two-fold: 1) to describe the processes involved in building and maintaining the REACH 2010 Alabama Breast and Cervical Cancer Control Coalition (ABCCCC) and 2) to highlight the lessons learned from this venture. Principles from community-based participatory research were used 1) to establish and maintain the ABCCCC, 2) to build coalition capacity, and 3) to develop breast and cervical cancer interventions. Over 95% of our coalition has been maintained over a 7-year period. The ABCCCC received a total of 17 breast and cervical cancer mini-grants. Adherence to ground rules such as exhibiting respect and trust and practicing open communication helped to solidify our partnership. Lessons learned from the ABCCCC can provide others with an in-depth exploration of the processes involved in coalition formation and maintenance.
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Affiliation(s)
- Theresa Ann Wynn
- Division of Preventive Medicine, University of Alabama, Birmingham, USA.
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Fouad MN, Partridge E, Dignan M, Holt C, Johnson R, Nagy C, Parham G, Person S, Scarinci I, Wynn T. A community-driven action plan to eliminate breast and cervical cancer disparity: successes and limitations. J Cancer Educ 2006; 21:S91-100. [PMID: 17020510 DOI: 10.1207/s15430154jce2101s_16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND The objective of Alabama Racial and Ethnic Approaches to Community Health 2010 is to implement and evaluate a community action plan (CAP) developed by a diverse coalition to reduce breast and cervical cancer screening disparities between African American and White women. METHODS The CAP entailed (1) establishing a core working group (CWG) in each county, (2) training CWG members to promote screenings, and (3) providing coalition members with technical assistance to write mini-grants. RESULTS Overall, 241 CWG members were trained. They have conducted 2800 cancer screening surveys. A total of 8 coalition members received mini-grants. CONCLUSION Community capacity building can lead to a sense of ownership and empowerment.
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Affiliation(s)
- Mona N Fouad
- Division of Preventive Medicine, University of Alabama, Birmingham, AL 35294-4410, USA.
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Wynn TA, Johnson RE, Fouad M, Holt C, Scarinci I, Nagy C, Partridge E, Dignan MB, Person S, Parham G. Addressing Disparities through Coalition Building: Alabama REACH 2010 Lessons Learned. J Health Care Poor Underserved 2006. [DOI: 10.1353/hpu.2006.0083] [Citation(s) in RCA: 6] [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: 11/11/2022]
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Buys SS, Partridge E, Greene MH, Prorok PC, Reding D, Riley TL, Hartge P, Fagerstrom RM, Ragard LR, Chia D, Izmirlian G, Fouad M, Johnson CC, Gohagan JK. Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial. Am J Obstet Gynecol 2005; 193:1630-9. [PMID: 16260202 DOI: 10.1016/j.ajog.2005.05.005] [Citation(s) in RCA: 225] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2004] [Revised: 04/02/2005] [Accepted: 05/02/2005] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Ovarian cancer screening with transvaginal ultrasound (TVU) and CA-125 was evaluated in the Prostate, Lung, Colorectal and Ovarian (PLCO) Trial. STUDY DESIGN This was a randomized controlled trial of screening versus usual care. Baseline screening results are reported. RESULTS Of 39,115 women randomized to receive screening, 28,816 received at least 1 test. Abnormal TVU was found in 1338 (4.7%), and abnormal CA-125 in 402 (1.4%). Twenty-nine neoplasms were identified (26 ovarian, 2 fallopian, and 1 primary peritoneal neoplasm). Nine were tumors of low malignant potential and 20 were invasive. The positive predictive value for invasive cancer was 3.7% for an abnormal CA-125, 1.0% for an abnormal TVU, and 23.5% if both tests were abnormal. CONCLUSION The effect of screening on ovarian cancer mortality in the PLCO cohort has yet to be evaluated and will require longer follow-up. Screening identified both early- and late-stage neoplasms, and the predictive value of both tests was relatively low.
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Affiliation(s)
- Saundra S Buys
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112-5550, USA.
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Rittenberg B, Partridge E, Baker G, Clokie C, Zohar R, Dennis JW, Tenenbaum HC. Regulation of BMP-induced ectopic bone formation by Ahsg. J Orthop Res 2005; 23:653-62. [PMID: 15885488 DOI: 10.1016/j.orthres.2004.11.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [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] [Received: 06/24/2004] [Revised: 10/21/2004] [Accepted: 11/15/2004] [Indexed: 02/08/2023]
Abstract
alpha2-HS-glycoprotein (Ahsg), also known as fetuin is a serum and bone resident glycoprotein, which binds to TGF-beta superfamily members including bone morphogenetic proteins (BMP) and inhibits dexamethasone-induced osteogenesis in bone marrow cultures in vitro. Here we demonstrate that Ahsg reduces cytokine binding to its cognate receptor in HOS osteocyte cells and suppresses intracellular signaling, while in vivo, we test the hypothesis that Ahsg-deficient mice are hyper-responsive to BMP-induced osteogenesis. Human native BMP was implanted into the hindquarter muscles of Ahsg(+/+), Ahsg(+/-) and Ahsg(-/-) mice and 4 weeks later, ossicle formation was analyzed by radiography, bone density scanning (DEXA) and histomorphometry. Alkaline phosphatase (AP) activity was measured in ossicles as a marker for bone cell differentiation, and was significantly higher in Ahsg(-/-) versus Ahsg(+/-) and/or Ahsg(+/+) mice. Ectopic ossicle size in the Ahsg(+/-) mouse was 4-fold greater than that in the wild type (Ahsg(+/+)), and intermediate to that shown in Ahsg(-/-) mouse. Bone mineral density (BMD) was lower in the Ahsg(-/+) and Ahsg(-/-) mice compared to Ahsg(+/+) littermates. The ratio of cortical to cancellous bone was found to be >2-fold higher in Ahsg(-/-) mouse in comparison to the Ahsg(+/+) mice with no significant change in the Ahsg(-/+) mouse. Finally, a significantly higher incidence of satellite ossification; small islands of immature bone, was shown in Ahsg(-/-) mice as compared to Ahsg(+/+) mice. Although Ahsg binds to TGF-beta/BMP and blocks receptor signalling, it may also sequester cytokines in matrix, thereby acting as a reservoir of osteoinductive activity when released. This may explain the non-linear relationship between ectopic bone formation characteristics and Ahsg(+/+), Ahsg(+/-) and Ahsg(-/-) genotypes, although the increase in satellite bone formation might also explain this phenomenon. Our results suggest that Ahsg may be useful for prevention of the heterotopic ossification and the regulation of osteoinductive effects of BMP used with grafts.
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Affiliation(s)
- B Rittenberg
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
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Fouad MN, Partridge E, Wynn T, Green BL, Kohler C, Nagy S. Statewide Tuskegee Alliance for clinical trials. A community coalition to enhance minority participation in medical research. Cancer 2001; 91:237-41. [PMID: 11148586 DOI: 10.1002/1097-0142(20010101)91:1+<237::aid-cncr11>3.3.co;2-l] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Cancer mortality rates for all sites are nearly 2.5 times greater for African-Americans compared with whites. In addition, there are data implying that cancer treatment outcomes for minorities are unfavorable compared with whites. Whether this is due to poor access to health care or a biologic property of malignancies occurring in specific populations remains to be determined. Because of these unknown factors, targeting minorities for clinical trials may contribute toward the reduction of the overall morbidity and mortality associated with specific cancers. METHODS The current study describes the establishment of a genuine collaborative partnership between the targeted minority community and clinical investigators at the University of Alabama at Birmingham. This partnership was formed for the purpose of identifying strategies that would enhance the accrual and retention of minority participants into current and future cancer prevention and control trials. Focus groups and key informant interviews were conducted to ascertain the community's perception of participating in clinical trials. RESULTS The majority of focus group participants were unclear regarding the nature of clinical trials. Participants indicated that they would participate in research studies if they received adequate information regarding the purpose and benefits of the study, and if the charge came from a pastor or physician. Barriers to participation included time commitments, family obligations, whether blood was involved, and past experiences. The majority of the participants indicated that their knowledge of the Tuskegee Syphilis Study did not influence their decision to participate in research. A major outcome of the conference was the formation of the Statewide Tuskegee Alliance Coalition. The planning coalition decided to continue their efforts to work with communities and promote cancer awareness among minorities. After the conference, the coalition conducted several meetings and in July 1998, 1 year after the conference, the coalition selected a chair, co-chair, and a formal name for the organized group. CONCLUSIONS The planning, development, and implementation of this conference provided a valuable experience for researchers and community members. It was discovered that community involvement in the early phase of this project contributed to its success. Furthermore, the partnership that developed between researchers (academic institutions) and communities successfully provided an infrastructure that supported the interest of both groups.
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Affiliation(s)
- M N Fouad
- University of Alabama at Birmingham, Birmingham, Alabama 35294-4410, USA.
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Fouad MN, Partridge E, Green BL, Kohler C, Wynn T, Nagy S, Churchill S. Minority recruitment in clinical trials: a conference at Tuskegee, researchers and the community. Ann Epidemiol 2000; 10:S35-40. [PMID: 11189091 DOI: 10.1016/s1047-2797(00)00199-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [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: 11/26/2022]
Abstract
PURPOSE This article describes the planning, implementation, and evaluation of a 2-day conference designed to examine the factors related to the participation of African Americans in cancer clinical trials. METHODS Pre-conference formative evaluations (e.g., focus group discussions and key informant interviews with community leaders and health providers) were conducted in several rural and urban counties in the state of Alabama to determine African Americans' perceptions of participation in clinical research. The findings from these evaluations were used to develop a conference format and agenda. The 2-day conference included: (i) a pretest of African Americans' perceptions of cancer research, participation factors, and communication and recruitment issues; (ii) individual presentations high-lighting community leaders, church leaders, and researchers' perspectives regarding minority participation in research; (iii) working group discussions regarding the barriers and solutions to minority participation in research; and (iv) a posttest evaluation to measure changes in African Americans' perceptions of research. RESULTS Several recruitment barriers and solutions were identified and reported by the working groups. Comparisons of the pretest and posttest measures showed significant (p > .05) and favorable shifts in the areas of perceptions of cancer research, participation factors, communication issues, and recruitment issues. Participation in the conference reflected a positive change in attitudes on these measures. However, the theme, "barriers that contributed to nonparticipation," did not show any significant changes during the two testing periods. The most critical lesson that resulted from this conference was the need for researchers and community members to have open dialogue about participation in research. CONCLUSIONS This conference demonstrated that progress can be made when all parties are at the "table" and can be heard. In this model, community members proved to be valuable resources in providing researchers with information that was vital to the success of recruitment and retention studies and trials.
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Affiliation(s)
- M N Fouad
- The University of Alabama at Birmingham, 35205-4410, USA
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Fusé M, Zhang JR, Partridge E, Nachman RJ, Orchard I, Bendena WG, Tobe SS. Effects of an allatostatin and a myosuppressin on midgut carbohydrate enzyme activity in the cockroach Diploptera punctata. Peptides 1999; 20:1285-93. [PMID: 10612442 DOI: 10.1016/s0196-9781(99)00133-3] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.1] [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: 11/18/2022]
Abstract
Neuropeptides of the cockroach allatostatin (AST) family are known for their ability to inhibit the production of juvenile hormone by the corpora allata of cockroaches. Since their discovery, they have also been shown to modulate myotropic activity in a range of insect species as well as to act as neurotransmitters in Crustaceans and possibly in insects. The midgut of cockroaches contains numerous endocrine cells, some of which produce AST whereas others produce the FMRFamide-related peptide, leucomyosuppressin (LMS). We have determined if ASTs and LMS are also able to influence carbohydrate-metabolizing enzyme activity in the midgut of the cockroach, Diploptera punctata. Dippu-AST 7 stimulates activity of both invertase and alpha-amylase in a dose-dependent fashion in the lumen contents of ligatured midguts in vitro, but not in midgut tissue, whereas the AST analog AST(b)phi2, a cyclopropyl-ala, hydrocinnamic acid analog of Dippu-AST 6, has no effect. Leucomyosuppressin also stimulates enzyme activity in lumen contents only, although the EC50 is considerably greater than for Dippu-AST. Dippu-AST is also able to inhibit proctolin-induced contractions of midgut muscle, and this action had already been described for LMS [18]. Thus, in this organ, AST and LMS have at least two distinct physiological effects.
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Affiliation(s)
- M Fusé
- Department of Zoology, University of Toronto, ON, Canada
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Partridge E. Now is time for philosophers to come to the aid of their planet. Glob Bioeth 1998. [DOI: 10.1080/11287462.1998.10800731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Janzen DL, Partridge E, Logan PM, Connell DG, Duncan CP. The snapping hip: clinical and imaging findings in transient subluxation of the iliopsoas tendon. Can Assoc Radiol J 1996; 47:202-8. [PMID: 8640418] [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: 02/01/2023] Open
Abstract
OBJECTIVE To define the clinical, ultrasonographic and magnetic resonance imaging (MRI) findings in patients with painful snapping of the hip secondary to transient subluxation of the iliopsoas tendon. PATIENTS AND METHODS Seven patients, ranging in age from 17 to 30 years, with a total of eight painful snapping hips were examined with static and dynamic ultrasonography and MRI during hip motion producing the painful snapping. The duration of symptoms, the level of disability and the response to therapy were recorded. RESULTS Static ultrasonography showed thickening of the iliopsoas tendon (tendinitis) in two cases and a peritendinous fluid collection in two cases. In all cases dynamic ultrasonography of the iliopsoas tendon during hip motion showed distinct abnormal motion of the tendon corresponding temporally to the painful palpable and audible sensation. MRI showed normal intra-articular structures in all cases, tendinitis in two cases and iliopsoas bursitis in one case. Clinically, subluxation of the iliopsoas tendon is a chronic (mean duration of symptoms in this series, 23 months) disabling condition that may be relieved by surgical tendon release. CONCLUSIONS Dynamic ultrasonography is useful for detecting transient subluxation of the iliopsoas tendon in patients with a painful snapping hip. MRI is useful for excluding intra-articular abnormalities in patients with this condition.
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Affiliation(s)
- D L Janzen
- Department of Radiology, University of British Columbia, Vancouver
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Partridge E, Zwirewich CV, Salvian AJ. Facial artery pseudoaneurysm: diagnosis by colour Doppler ultrasonography. Can Assoc Radiol J 1995; 46:458-60. [PMID: 7583727] [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: 01/26/2023] Open
Abstract
Pseudoaneurysms of the facial region are rare and usually result from direct penetrating or blunt trauma. The authors report a pseudoaneurysm of the facial artery in a 22-year-old man injured in a motor vehicle accident. Colour Doppler ultrasonography was used to locate the aneurysm sac and establish its relation to the adjacent facial artery. Successful operative repair of the aneurysm was performed on the basis of the sonographic findings alone, without selective angiography.
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Affiliation(s)
- E Partridge
- Department of Radiology, Vancouver Hospital, BC
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Meredith R, Partridge E, Alvarez R, Plott G, Russell C, Wheeler R, Dixon P, LoBuglio A. Intraperitoneal radioimmunotherapy for ovarian cancer: results of a phase i study with high affinity monoclonal antibody. Int J Radiat Oncol Biol Phys 1994. [DOI: 10.1016/0360-3016(94)90845-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Ultrasound and more recently colour Doppler ultrasound has been successfully used in the diagnosis of lower limb venous occlusive disease. Colour Doppler ultrasound has shown promise in the diagnosis of calf vein thrombosis but to date there has been no prospective trial to specifically evaluate its potential. In view of this, we carried out a prospective trial of 50 patients comparing the accuracy of colour Doppler ultrasound with venography in the diagnosis of deep venous thrombosis both above and below knee but in particular with respect to the detection of calf vein clot. Of the 50 patients studied, 10 had only one imaging modality performed as there were eight venographic failures and two ultrasonic failures. Comparison was only thus possible in 40 cases. As in previous studies, colour Doppler ultrasound was shown to be accurate in the diagnosis of thrombosis within the femoro-popliteal veins and had a sensitivity and specificity of 100% respectively. With respect to calf vein lesions, there was one false negative scan using the ultrasonic technique giving a sensitivity of 95%, specificity of 100% and accuracy of 97.5%. We feel colour Doppler ultrasound can and should be used as a first line alternative to venography and can be employed for the exclusion of both above and below knee deep venous thrombosis. Venography should now be reserved for those patients who are unsuitable for ultrasound examination or who have an equivocal ultrasound scan.
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Affiliation(s)
- G M Baxter
- Department of Radiology, Western Infirmary, Glasgow
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Edwards R, Delcambre C, Banks G, Dixon D, Partridge E, Mestecky J. Pregnancy alters HPV-specific IGA activity in cervical neoplasia. Gynecol Oncol 1992. [DOI: 10.1016/0090-8258(92)90541-p] [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: 11/26/2022]
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Patsner B, Orr JW, Mann WJ, Taylor PT, Partridge E, Allmen T. Does serum CA-125 level prior to second-look laparotomy for invasive ovarian adenocarcinoma predict size of residual disease? Int J Gynaecol Obstet 1991. [DOI: 10.1016/0020-7292(91)90404-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Borst M, Tran-Paterson R, Baker V, Friend S, Dixon D, Crawford E, Nelson C, Partridge E, Miller D. RB susceptibility gene alterations in gynecologic sarcomas. Gynecol Oncol 1991. [DOI: 10.1016/0090-8258(91)90171-z] [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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Gallion H, Averette H, Partridge E, Copeland L, Cain J, Husseinzadeh N, Nahhas W, Pursell S, Higgins R, Van Nagell J, Depriest P, Maggard A, Kryscio R. The prognostic implications of low serum CA-125 levels prior to second-look operation for stage III and IV epithelial ovarian cancer. Gynecol Oncol 1991. [DOI: 10.1016/0090-8258(91)90138-u] [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]
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Patsner B, Orr JW, Mann WJ, Taylor PT, Partridge E, Allmen T. Does serum CA-125 level prior to second-look laparotomy for invasive ovarian adenocarcinoma predict size of residual disease? Gynecol Oncol 1990; 38:373-6. [PMID: 2227551 DOI: 10.1016/0090-8258(90)90076-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The records of 125 patients with nonmucinous invasive ovarian adenocarcinoma who underwent cytoreductive surgery, cisplatin-based combination chemotherapy, and second-look laparotomy were analyzed to correlate pre-second-look serum CA-125 levels with the size of residual ovarian cancer. The majority of patients with negative second-look laparotomy had normal serum CA-125 levels (46/50 or 92%). Of the 75 patients with positive second-look, 56 (75%) had normal CA-125 levels preoperatively. Twenty-three of twenty-four (96%) patients with residual disease less than or equal to 1 cm had normal CA-125 levels as did 20 of 28 (71%) patients with disease 1.1-2.0 cm. Although elevated serum CA-125 levels were invariably associated with visible/gross disease and increasing size of residual disease tended to be associated with increasing elevations of CA-125, normal CA-125 levels often occurred in the presence of large-volume (greater than 2 cm) disease (13/23, 57% of patients). The considerable overlap of serum CA-125 levels for all sizes of residual disease precluded precise prediction of residual disease size based on serum CA-125 level alone.
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Affiliation(s)
- B Patsner
- Division of Gynecologic Oncology, Watson Clinic, Lakeland, Florida 33804-5000
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