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Lewis KD, Peris K, Sekulic A, Stratigos AJ, Dunn L, Eroglu Z, Chang ALS, Migden MR, Yoo SY, Mohan K, Coates E, Okoye E, Bowler T, Baurain JF, Bechter O, Hauschild A, Butler MO, Hernandez-Aya L, Licitra L, Neves RI, Ruiz ES, Seebach F, Lowy I, Goncalves P, Fury MG. Final analysis of phase II results with cemiplimab in metastatic basal cell carcinoma after hedgehog pathway inhibitors. Ann Oncol 2024; 35:221-228. [PMID: 38072158 DOI: 10.1016/j.annonc.2023.10.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Metastatic basal cell carcinoma (mBCC) is a rare condition with no effective second-line treatment options. Cemiplimab is an immune checkpoint inhibitor that blocks the binding of programmed cell death-1 (PD-1) to its ligands, programmed death-ligand 1 (PD-L1) and programmed death-ligand 2 (PD-L2). Here, we present the final analysis of cemiplimab in patients with mBCC after first-line hedgehog pathway inhibitor (HHI) treatment (NCT03132636). PATIENTS AND METHODS In this open-label, single-arm, phase II study, adults with mBCC and Eastern Cooperative Oncology Group performance status ≤1, post-HHI treatment, received cemiplimab 350 mg intravenously every 3 weeks for ≤93 weeks or until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) by independent central review (ICR). Duration of response (DOR) was a key secondary endpoint. Other secondary endpoints were ORR per investigator assessment, progression-free survival (PFS), overall survival (OS), complete response rate, safety, and tolerability. RESULTS Fifty-four patients were enrolled: 70% were male and the median age of patients was 64 [interquartile range (IQR) 57.0-73.0] years. The median duration of follow-up was 8 months (IQR 4-21 months). The ORR per ICR was 22% [95% confidence interval (CI) 12% to 36%], with 2 complete responses and 10 partial responses. Among responders, the median time to response per ICR was 3 months (IQR 2-7 months). The estimated median DOR per ICR was not reached [95% CI 10 months-not evaluable (NE)]. The disease control rate was 63% (95% CI 49% to 76%) per ICR and 70% (95% CI 56% to 82%) per investigator assessment. The median PFS per ICR was 10 months (95% CI 4-16 months); the median OS was 50 months (95% CI 28 months-NE). The most common treatment-emergent adverse events were fatigue [23 (43%)] and diarrhoea [20 (37%)]. There were no treatment-related deaths. CONCLUSIONS Cemiplimab demonstrated clinically meaningful antitumour activity, including durable responses, and an acceptable safety profile in patients with mBCC who had disease progression on or intolerance to HHI therapy.
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Affiliation(s)
- K D Lewis
- Department of Medicine-Medical Oncology, University of Colorado School of Medicine, Aurora, USA.
| | - K Peris
- Department of Medicine and Translational Surgery, Dermatology, Università Cattolica del Sacro Cuore, Rome; Department of Medical and Surgical Sciences, Dermatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - A Sekulic
- Department of Dermatology, Mayo Clinic, Scottsdale, USA
| | - A J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - L Dunn
- Department of Medicine, Head and Neck Medical Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - Z Eroglu
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa
| | - A L S Chang
- Dermatology Department, Stanford University School of Medicine, Redwood City
| | - M R Migden
- Department of Dermatology and Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston
| | - S-Y Yoo
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - K Mohan
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - E Coates
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - E Okoye
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - T Bowler
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - J-F Baurain
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc and Université Catholique de Louvain, Brussels
| | - O Bechter
- Department of General Medical Oncology, University Hospitals, Leuven, Belgium
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - M O Butler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Hernandez-Aya
- Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St Louis, USA
| | - L Licitra
- Department of Medical Oncology Head and Neck Cancer, Istituto Nazionale dei Tumori, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - R I Neves
- Division of Plastic Surgery, Penn State Milton S. Hershey Medical Center, Hershey
| | - E S Ruiz
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - F Seebach
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - I Lowy
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - P Goncalves
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - M G Fury
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
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Hamilton K, Stanton‐Fay SH, Chadwick PM, Lorencatto F, de Zoysa N, Gianfrancesco C, Taylor C, Coates E, Breckenridge JP, Cooke D, Heller SR, Michie S. Sustained type 1 diabetes self-management: Specifying the behaviours involved and their influences. Diabet Med 2021; 38:e14430. [PMID: 33073393 PMCID: PMC8247296 DOI: 10.1111/dme.14430] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/08/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023]
Abstract
AIMS Sustained engagement in type 1 diabetes self-management behaviours is a critical element in achieving improvements in glycated haemoglobin (HbA1c) and minimising risk of complications. Evaluations of self-management programmes, such as Dose Adjustment for Normal Eating (DAFNE), typically find that initial improvements are rarely sustained beyond 12 months. This study identified behaviours involved in sustained type 1 diabetes self-management, their influences and relationships to each other. METHODS A mixed-methods study was conducted following the first two steps of the Behaviour Change Wheel framework. First, an expert stakeholder consultation identified behaviours involved in self-management of type 1 diabetes. Second, three evidence sources (systematic review, healthcare provider-generated 'red flags' and participant-generated 'frequently asked questions') were analysed to identify and synthesise modifiable barriers and enablers to sustained self-management. These were characterised according to the Capability-Opportunity-Motivation-Behaviour (COM-B) model. RESULTS 150 distinct behaviours were identified and organised into three self-regulatory behavioural cycles, reflecting different temporal and situational aspects of diabetes self-management: Routine (e.g. checking blood glucose), Reactive (e.g. treating hypoglycaemia) and Reflective (e.g. reviewing blood glucose data to identify patterns). Thirty-four barriers and five enablers were identified: 10 relating to Capability, 20 to Opportunity and nine to Motivation. CONCLUSIONS Multiple behaviours within three self-management cycles are involved in sustained type 1 diabetes self-management. There are a wide range of barriers and enablers that should be addressed to support self-management behaviours and improve clinical outcomes. The present study provides an evidence base for refining and developing type 1 diabetes self-management programmes.
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Affiliation(s)
- K. Hamilton
- Centre for Behaviour ChangeUniversity College LondonLondonUK
| | | | - P. M. Chadwick
- Centre for Behaviour ChangeUniversity College LondonLondonUK
| | - F. Lorencatto
- Centre for Behaviour ChangeUniversity College LondonLondonUK
| | - N. de Zoysa
- Diabetes CentreKing’s College HospitalLondonUK
| | - C. Gianfrancesco
- Sheffield Diabetes and Endocrine CentreSheffield Teaching Hospitals NHSF TrustSheffieldUK
| | - C. Taylor
- Sheffield Diabetes and Endocrine CentreSheffield Teaching Hospitals NHSF TrustSheffieldUK
| | - E. Coates
- School of Health and Related ResearchUniversity of SheffieldSheffieldUK
| | | | - D. Cooke
- School of Health SciencesUniversity of SurreyGuilfordUK
| | - S. R. Heller
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| | - S. Michie
- Centre for Behaviour ChangeUniversity College LondonLondonUK
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Tyrell S, Coates E, Brown SR, Lee MJ. A systematic review of the quality of reporting of interventions in the surgical treatment of Crohn's anal fistula: an assessment using the TIDiER and Blencowe frameworks. Tech Coloproctol 2021; 25:359-369. [PMID: 33599902 PMCID: PMC8016786 DOI: 10.1007/s10151-020-02359-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/10/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Crohn's anal fistula is a challenging condition, and may require multiple surgical procedures. To replicate successful procedures, these must be adequately reported in the literature. The aim of this study was to review the quality of reporting of components of surgical interventions for Crohn's anal fistula. METHODS A systematic review was conducted. It was registered with PROSPERO (CRD:42019135157). The Medline and EMBASE databases were searched for studies reporting interventions intended to close fistula in patients with Crohn's disease, published between 1999 and August 2019. Abstracts and full texts were screened for inclusion by two reviewers. Dual extraction of data was performed to compare reporting to the TIDiER and Blencowe frameworks for reporting of interventions. RESULTS Initial searches identified 207 unique studies; 38 full texts were screened for inclusion and 33 were included. The most common study design was retrospective cohort (17/33), and the most frequently reported interventions were anal fistula plug (n = 8) and fibrin glue (n = 6). No studies showed coverage of all domains of TIDieR. Reporting was poor among domains related to who provided an intervention, where it was provided, and how it was tailored. Reporting of domains in the Blencowe framework was poor; the majority of studies did not report the component steps of procedures or efforts to standardise them. CONCLUSIONS This study demonstrates that reporting on technical aspects of interventions for Crohn's anal fistula is poor. Surgeons should aim to improve reporting to allow accurate reproduction of techniques both in clinical practice and in clinical trials.
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Affiliation(s)
- S Tyrell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - E Coates
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Steven R Brown
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - M J Lee
- Academic Directorate of General Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, S10 2RX, UK.
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Hughes D, Dailianis A, Duncan L, Briggs J, McKintyre DA, Silbernagel K, Anderson G, Anderson J, Bannach B, Barratt C, Booyens C, Briggs J, Brooks R, Bryant D, Burnie A, Carver C, Chambers D, Chong J, Clarke D, Coates E, Comontofski G, Deiss K, Destro C, Dillon J, Duncan L, Dundas M, Dymond N, Dziedziczak D, Eglezos S, Gasanov U, Gebler J, Graham T, Haley E, Johnson L, Kurien S, Maczuga J, Matera J, Matthew K, Munyard S, Ramine A, Reed J, Remes A, Subasinghe N, Tan A, Tan J, Tatum M, Taylor M, Torrance H, Twohy C, Vialpando M, Watts K. Modification of Enrichment Protocols for TECRA Listeria Visual Immunoassay Method 995.22: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.2.340] [Citation(s) in RCA: 2] [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: 11/14/2022]
Abstract
Abstract
A collaborative study was conducted to validate new enrichment methods for the TECRA Listeria Visual Immunoassay (TLVIA). These new methods incorporate a newly formulated medium, TECRA Listeria Enrichment Broth, which does not contain the highly toxic antifungal agent, cycloheximide. The new procedures will provide an alternative to the enrichment procedures described in AOAC Method 995.22. Three food types (raw ground beef, lettuce, and ice cream) were analyzed in the United States, and 2 food types (cooked turkey and cooked fish fillets) were analyzed in Australasia. Thirty collaborators participated in the study, 16 in Australasia and 14 in the United States. With the exception of one batch of ground beef, comparison of the proportion of positive test portions (p ≥ 0.05) showed no significant difference between the TLVIA and the reference method for the 5 foods at 3 inoculation levels. For the one batch of naturally contaminated raw ground beef, the TLVIA gave significantly more confirmed positive results than the reference method.
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Affiliation(s)
- Denise Hughes
- TECRA International, 13 Rodborough Rd, French’s Forest, NSW 2086, Australia
| | - Angela Dailianis
- TECRA International, 13 Rodborough Rd, French’s Forest, NSW 2086, Australia
| | - Louise Duncan
- TECRA International, 13 Rodborough Rd, French’s Forest, NSW 2086, Australia
| | - Julie Briggs
- TECRA International, 13 Rodborough Rd, French’s Forest, NSW 2086, Australia
| | | | - Karen Silbernagel
- rtech laboratories, Lexington Ave, N. Arden Hills, Minneapolis, MN 55126
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Losey L, Ogden E, Bisrat F, Solomon R, Newberry D, Coates E, Ward D, Hilmi L, LeBan K, Burrowes V, Perry HB. The CORE Group Polio Project: An Overview of Its History and Its Contributions to the Global Polio Eradication Initiative. Am J Trop Med Hyg 2019; 101:4-14. [PMID: 31760971 PMCID: PMC6776098 DOI: 10.4269/ajtmh.18-0916] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/11/2019] [Indexed: 11/20/2022] Open
Abstract
The CORE Group Polio Project (CGPP) has contributed to polio eradication by successfully engaging civil society, particularly the non-governmental organization (NGO) community. This engagement, which began with a grant from the U.S. Agency for International Development in 1999, has contributed to improvements in routine immunization programs, polio campaign quality, and surveillance for acute flaccid paralysis in many challenging geographic areas. The CGPP has worked closely with polio eradication partners in a collaborative and supportive role. The CGPP has focused largely on high-risk areas with marginalized or hard-to-reach populations where health systems and immunization programs have also been weak and where transmission of poliovirus had not been stopped. The CGPP has engaged local civic leaders and communities in ways to complement top-down vertical efforts of ministries of health and other partners in the Global Polio Eradication Initiative. The CGPP has developed innovative strategies to detect cases using community-based surveillance, promoted independent campaign monitoring, established cross-border initiatives, and developed a strong and creative cadre of community mobilizers to track missed children and deliver behavior change education. Many of the innovations and approaches that the CGPP helped to develop are now being replicated by governments and international agencies to tackle other public health priorities in underserved and marginalized communities around the world. This article is the first in a series of articles describing the work of the CGPP. Because the article describes the work of more than 40 NGOs in 11 countries over 20 years, it provides only an overview, leaving many important details and variations of the CGPP's work to be described elsewhere, including in other articles included in this series.
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Affiliation(s)
- Lee Losey
- CORE Group Polio Project, Washington, District of Columbia
| | - Ellyn Ogden
- United States Agency for International Development, Washington, District of Columbia
| | | | | | - David Newberry
- CORE Group Polio Project, Washington, District of Columbia
| | - Ellen Coates
- CORE Group Polio Project, Washington, District of Columbia
| | - Dora Ward
- CORE Group Polio Project, Washington, District of Columbia
| | - Lisa Hilmi
- CORE Group, Washington, District of Columbia
| | - Karen LeBan
- CORE Group, Washington, District of Columbia
| | - Vanessa Burrowes
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Henry B. Perry
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Laing ME, Coates E, Jopp-McKay A, Scolyer RA, Guitera P. Atypical naevus spilus: detection by in vivo confocal microscopy. Clin Exp Dermatol 2014; 39:616-9. [PMID: 24934914 DOI: 10.1111/ced.12354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 11/27/2022]
Abstract
Naevus spilus (NS) is a naevoid disorder characterized by hyperpigmented macules or papules scattered over a café-au-lait macule. Such café-au-lait macules are often present at birth, and the darker pigmented speckles of NS slowly increase in number and size over a period of several years. NS can therefore be difficult to evaluate clinically for the development of melanoma. In vivo confocal microscopy (IVCM) is a novel method that allows examination at cellular resolution of cutaneous lesions in vivo. IVCM has been shown to have twice the specificity of dermoscopy for the diagnosis of melanoma, with comparable sensitivity. It has been shown to be useful in the detection and grading of dysplastic naevi, which are recognized precursors of melanoma in some cases. In this report, we highlight that IVCM can also be used as a tool complementary to dermoscopy to identify areas of dynamic change in clinically and dermoscopically equivocal lesions. IVCM may thereby assist in the early detection of melanocytic atypia and melanoma arising in NS, in turn leading to excision of melanoma at an early stage, which is associated with a favourable outcome. We also outline some of the difficulties encountered in confocal microscopy and histology when differentiating melanoma from dysplastic naevi.
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Affiliation(s)
- M E Laing
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Department of Dermatology, Royal Prince Alfred Hospital, Sydney, Australia; Melanoma Institute Australia, Sydney, Australia
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Stevens R, Coates E, Street J, Cook E, Darke C. Comprehensive evaluation of two HLA-B17 monoclonal antibodies for flow cytometry-based HLA-B57/B58 screening prior to abacavir prescription. Int J Immunogenet 2012; 40:311-5. [PMID: 23280011 DOI: 10.1111/iji.12025] [Citation(s) in RCA: 5] [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] [Received: 08/07/2012] [Revised: 10/22/2012] [Accepted: 11/05/2012] [Indexed: 12/01/2022]
Abstract
Hypersensitivity reactions to the drug abacavir, used to treat HIV/AIDS patients, is associated with possession of HLA-B*57:01. We have carefully assessed two commercially available HLA-B57/B58 murine monoclonal antibodies [0196HA and BIH0243 (One Lambda Inc.)] in a simple flow cytometry-based assay. The evaluation involved tests on 228 reference and random samples covering 91% of all WHO recognized HLA-A, B and C specificities. These involved donors with six different HLA-B*57 alleles and included 19 examples of B*57:01. Both antibodies unambiguously detected B57, but there were small difference in their reactivity against B57-positive non-B*57:01 samples. Importantly, there was no reactivity against B57/B58-negative samples. The possible amino acid motifs involved in the reactivity of these antibodies with B57/B58 were delineated. Thus, HLA-B57/B58, normally present in <10% of patients, can be easily recognized using these two antibodies and further tested by a DNA-based typing method to identify B*57:01.
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Affiliation(s)
- R Stevens
- Welsh Transplantation and Immunogenetics Laboratory, Welsh Blood Service, Wales, UK
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Coates E, Provost JR, Rigg B. The Measurement and Assessment of Colour Differences for Industrial Use. IV-The Accuracy of Visual Assessments. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1478-4408.1972.tb03041.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Downing J, Coates E, Street J, Hammond L, Rees TJ, Pepperall J, Darke C. A high-resolution polymerase chain reaction-sequence-specific primer HLA-B*27 typing set and its application in routine HLA-B27 testing. ACTA ACUST UNITED AC 2006; 10:98-103. [PMID: 16792512 DOI: 10.1089/gte.2006.10.98] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We designed a set of 35 polymerase chain reaction sequence-specific primers (PCR-SSP) in 29 SSP mixtures to assign 29 HLA-B*27 4-digit level alleles (B*2701-B*2721 and B*2723-B*2730). This was used in conjunction with our 41 PCR-SSP primer mixture low-resolution HLA-B typing set to fully differentiate B*27 from all other HLA-B alleles. Successful typing set validation used 521 B*27 samples covering 13 (B*2701-B*2710 and B*2712, B*2717, B*2723) alleles. The distribution of B*27 alleles was determined in a random population of 4020 local blood donors and the use of PCR-SSP B*27 typing in our routine flow cytometry-based HLA-B27/B2708 typing strategy is described.
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Affiliation(s)
- J Downing
- Welsh Transplantation and Immunogenetics Laboratory, Welsh Blood Service, Pontyclun, Wales, United Kingdom
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Abstract
We evaluated the HLA-B27 typing reagent Com-B27, which is claimed to show minimal cross-reactivity with HLA-B7, for use in flow cytometry-based typing. This combination reagent consists of the fluorescein-conjugated HLA-B27 mouse monoclonal antibody ABC-m3 and a non-conjugated HLA-B7 monoclonal antibody that is claimed to block the reactivity of ABC-m3 to B7 without affecting its reactivity to B27. It reacted well with B27 (B*2702, B*2705) and B2708 [mean median channel fluorescence intensity (MCFI) 8.40] and weakly with B7 (including cells from homozygous B*07 donors), B42/B73 and B22/B37/B44 reference cells (mean MCFI 2.05, 3.09 and 1.10, respectively). It showed a uniform discrimination between B7 and B27/B2708 with no 'overlap' in MCFI values, which was seen with the standard ABC-m3 antibody. There was complete agreement when our standard three-antibody-based B27/B2708 flow cytometry assay and the Com-B27 reagent alone were used to independently assign B27/B2708 status to 651 random patients. Thus, the Com-B27 reagent provided improved discrimination between B7 and B27/B2708 over the ABC-m3 antibody, and its B27/B2708 assignments were comparable with our standard flow cytometry assay. However, for consistently reliable B27/B2708 typing we continue to recommend the use of a minimum of two B27 reagents in a protocol that includes DNA-based testing of 'equivocal' B27/B2708 assignments.
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Affiliation(s)
- E Coates
- nsplantation and Immunogenetics Laboratory, Welsh Blood Service, Pontyclun, UK
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Mann PA, Xiong L, Mankin AS, Chau AS, Mendrick CA, Najarian DJ, Cramer CA, Loebenberg D, Coates E, Murgolo NJ, Aarestrup FM, Goering RV, Black TA, Hare RS, McNicholas PM. EmtA, a rRNA methyltransferase conferring high-level evernimicin resistance. Mol Microbiol 2001; 41:1349-56. [PMID: 11580839 DOI: 10.1046/j.1365-2958.2001.02602.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Enterococcus faecium strain 9631355 was isolated from animal sources on the basis of its resistance to the growth promotant avilamycin. The strain also exhibited high-level resistance to evernimicin, a drug undergoing evaluation as a therapeutic agent in humans. Ribosomes from strain 9631355 exhibited a dramatic reduction in evernimicin binding, shown by both cell-free translation assays and direct-binding assays. The resistance determinant was cloned from strain 9631355; sequence alignments suggested it was a methyltransferase and therefore it was designated emtA for evernimicin methyltransferase. Evernimicin resistance was transmissible and emtA was localized to a plasmid-borne insertion element. Purified EmtA methylated 50S subunits from an evernimicin-sensitive strain 30-fold more efficiently than those from a resistant strain. Reverse transcription identified a pause site that was unique to the 23S rRNA extracted from resistant ribosomes. The pause corresponded to methylation of residue G2470 (Escherichia coli numbering). RNA footprinting revealed that G2470 is located within the evernimicin-binding site on the ribosome, thus providing an explanation for the reduced binding of the drug to methylated ribosomes.
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MESH Headings
- Aminoglycosides
- Animals
- Anti-Bacterial Agents/metabolism
- Anti-Bacterial Agents/pharmacology
- Base Sequence
- Binding Sites
- Cloning, Molecular
- DNA Transposable Elements/genetics
- DNA, Bacterial/genetics
- Drug Resistance, Bacterial/genetics
- Drug Resistance, Bacterial/physiology
- Enterococcus faecium/drug effects
- Enterococcus faecium/enzymology
- Enterococcus faecium/genetics
- Genes, Bacterial
- Humans
- Methyltransferases/genetics
- Methyltransferases/metabolism
- Molecular Sequence Data
- Nucleic Acid Conformation
- Plasmids/genetics
- RNA, Bacterial/chemistry
- RNA, Bacterial/genetics
- RNA, Bacterial/metabolism
- RNA, Ribosomal/chemistry
- RNA, Ribosomal/genetics
- RNA, Ribosomal/metabolism
- Ribosomes/metabolism
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Affiliation(s)
- P A Mann
- Schering Plough Research Institute, 2015 Galloping Hill Road, Kenilworth, NJ 07033, USA
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Abstract
Patient HLA-B27 typing is widely performed as an aid to the diagnosis of several diseases, particularly ankylosing spondylitis. Typing by flow cytometry, using monoclonal antibodies, has been shown to be a potentially useful alternative to classical serology on account of its speed, simplicity and economy. However, we required a flow cytometry typing procedure that would accurately differentiate HLA-B27 (Bw4) from B2708 (Bw6) and not be confounded by other HLA-B7/B27 cross-reactive group antigens. Accordingly, we evaluated the simultaneous use of two monoclonal antibody preparations, ABC-m3-FITC (anti-B27 + weak B7)/BB7.1-PE (anti-B7) and FD705-FITC (anti-B27), by testing a highly selected panel of 62 reference lymphocytes containing examples of all HLA-B7/B27 cross-reactive group antigens, including: HLA-B42, B47, B48, B73, B703, B2702, B2705 and B2708. In addition, 268 whole blood samples from routine patient requests for B27-associated disease typing were tested in parallel with HLA-B typing using the standard complement-dependent microlymphocytoxicity test. The detailed specificity of the three monoclonal antibodies was established and the products of HLA-B*2702, B*2705 and B*2708 were found to be readily differentiated from each other and all other HLA-B7/B27 cross-reactive HLA-B antigens.
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Affiliation(s)
- E Coates
- Regional Tissue Typing Laboratory, Welsh Blood Service, Wales, UK
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Abstract
This study aimed to assess oral health status and the social impact of oral conditions among dental patients with HIV infection in comparison with general dental patients receiving public-funded care in Adelaide, South Australia. DMFT and CPITN indices were recorded by one dentist at a clinic for HIV dental patients. The data were compared with information from an existing survey of general dental patients. Social impact was assessed using the Oral Health Impact Profile questionnaire and responses from HIV dental patients were compared with responses from a telephone interview survey of Adelaide residents. HIV patients were aged 21 to 49 years (median = 34), 90.7 percent were male and 29.6 percent had stage 4 HIV infection. Oral candida was present among 32.0 percent, hairy leukoplakia among 24.1 percent, HIV gingivitis among 18.5 percent, and HIV periodontitis among 33.3 percent. The DMFT index and its components did not differ significantly between HIV and general dental patients, while CPITN scores were lower among HIV patients (p = 0.01). However social impact among HIV patients was frequent: 64.6 percent reported toothache, 43.7 percent avoided foods, and 16.7 percent avoided going out because of dental problems. HIV patients reported significantly greater levels of social impact than the Adelaide sample (p < 0.01). Patients to this clinic frequently presented with severe and disabling oral conditions which were not adequately captured using standard clinical indices.
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Affiliation(s)
- E Coates
- South Australian Dental Service, Adelaide
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Kharasch SJ, Vinci RJ, Hirsch E, Cranley W, Coates E. The routine use of radiography and arterial blood gases in the evaluation of blunt trauma in children. Ann Emerg Med 1994; 23:212-5. [PMID: 8304601 DOI: 10.1016/s0196-0644(94)70033-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
STUDY OBJECTIVE To evaluate the usefulness of routine radiographs and arterial blood gases in children with blunt trauma. DESIGN Retrospective chart review. TYPE OF PARTICIPANTS Ninety patients who met triage criteria for our trauma team evaluation and who were less than 15 years old were evaluated. Patients with a Glasgow Coma Scale score (GCS) of 15 (lie, mild to moderately injured children) were the focus of this study. METHODS Children seen from May 1991 through August 1992 had charts reviewed systematically and within 24 hours of emergency department evaluation. Standard radiologic evaluation, including cervical-spine, chest, and pelvic radiographs, as well as arterial blood gas analysis, were obtained. The severity of injury was graded according to the Modified Injury Severity Scale. RESULTS The mean age of patients was 6.4 years, and the injuries observed were exclusively extremity fractures. The correlation between physical examination findings and radiologic evaluation was assessed. Forty-three patients had an abnormal physical examination (ie, gross deformity, limitation of motion, or pain), and 26 had a fracture identified on radiograph. Forty-seven patients had a normal physical examination and none had a fracture identified on radiograph (P < .001; sensitivity of positive signs and symptoms, 100%; false-negative findings, 0%). Four patients with abnormal blood gases are described. No patient had any vascular or solid organ injury identified. CONCLUSION In children with a GCS score of 15, selected radiologic and laboratory tests based on clinical findings are recommended. Careful observation and repeat examinations by trained clinicians can select a group of children at low risk for occult injury.
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Affiliation(s)
- S J Kharasch
- Department of Pediatrics, Boston University School of Medicine, Boston City Hospital, Massachusetts
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Abstract
The purpose of this study was to assess the use of analgesic agents for invasive medical procedures in pediatric and neonatal intensive care units. The directors of 38 pediatric units and 31 neonatal units reported that analgesics were infrequently used for intravenous cannulation (10%), suprapubic bladder aspiration (8%), urethral catheterization (2%), or venipuncture (2%). Analgesics were used significantly more regularly in pediatric than in neonatal intensive care units for arterial line placement, bone marrow aspiration, central line placement, chest tube insertion, paracentesis, and lumbar puncture.
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Affiliation(s)
- H Bauchner
- Department of Pediatrics, Boston City Hospital, Massachusetts 02118
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Talbot D, Cavanagh G, Coates E, Givan AL, Shenton BK, Lennard TW, Proud G, Taylor RM. Improved graft outcome and reduced complications due to flow cytometric crossmatching and DR matching in renal transplantation. Transplantation 1992; 53:925-8. [PMID: 1566358 DOI: 10.1097/00007890-199204000-00039] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Several previous studies, including our own, have indicated that flow cytometric assays can identify an at-risk population of kidney transplant recipients. We used the assay for recipient selection for a period of twelve months. Recipients with donor T cell-directed IgG were excluded from transplantation and those with B cell-directed IgG were treated with increased immunosuppression. The transplants performed over this period (n = 126) were compared with an earlier series (n = 118) where, although the flow cytometric crossmatches were performed, the results did not influence patient management. In the series where the flow cytometric crossmatch was used in management, a lower failure rate was found at three months (P = 0.037 chi square), primary non-function was reduced (P less than 0.0001, Mann-Whitney), rejection episodes were reduced (P less than 0.0001, Mann-Whitney) and the hospital stay was shorter (P less than 0.0001, Student's t). The risk factors of ischemic times, panel reactivity, exposure to previous grafts and A/B locus matching were identical between the two groups. However DR matching was found to be higher in the series with the improved results (P less than 0.0001, Mann-Whitney). In view of the significant improvement in graft success and low complication rate, we intend to continue with the policy of recipient selection by flow cytometric crossmatching and DR matching.
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Affiliation(s)
- D Talbot
- Department of Surgery, Medical School, University of Newcastle upon Tyne, United Kingdom
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Shenton BK, Glenville BE, Mitcheson AE, Coates E, Talbot D, Givan AL, Kirk A, Dark JH. Use of flow cytometric crossmatching in cardiac transplantation. Transplant Proc 1991; 23:1153-4. [PMID: 1989175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- B K Shenton
- Department of Surgery, Medical School, University of Newcastle, Newcastle Upon Tyne, England
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Talbot D, Givan AL, Shenton BK, Stratton A, Coates E, Parrott NR, Forsythe JL, Rigg K, Lennard TW, Proud G. The prospective value of the preoperative flow cytometric crossmatch assay in renal transplantation. Transplantation 1990; 49:809-10. [PMID: 2326875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- D Talbot
- Department of Surgery, Medical School, University of Newcastle upon Tyne
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Coates E, Palmer S. Primary health care. Promoting good food and health. Nurs Stand 1990; 4:49-50. [PMID: 2109212 DOI: 10.7748/ns.4.23.49.s52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Walker DJ, Griffiths M, Dewar P, Coates E, Dick WC, Thompson M, Griffiths ID. Association of MHC antigens with susceptibility to and severity of rheumatoid arthritis in multicase families. Ann Rheum Dis 1985; 44:519-25. [PMID: 3927858 PMCID: PMC1001694 DOI: 10.1136/ard.44.8.519] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A study of HLA association with rheumatoid arthritis (RA) in multicase families has been performed in north east England. Two hundred and nineteen individuals from 13 families were assessed for the presence of RA, and all were HLA typed. Thirty-nine were found to have classical or definite RA by American Rheumatism Association (ARA) criteria. Thirty-five (90%) of these possess HLA-DR4, confirming the previously reported association of RA with DR4. A further 19 individuals were found to have probable RA or gave a convincing history of previous inflammatory polyarthritis. Thirteen (68%) of these possess HLA-DR4, and this is not significantly different from non-affected family members of whom 63% possess DR4. These results suggest that HLA-DR4 is associated only with the more severe forms of RA. Homozygosity for HLA-DR4 was not associated with either earlier onset or more severe disease when compared with heterozygous DR4. Possession of the haplotype most commonly inherited with the RA in individual families was not associated with earlier onset but may be associated with more severe disease. The severity of RA appears to be influenced by the major histocompatibility complex (MHC) in these families.
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Coates E, Evans JR, Marsden CG, Rigg B. Complex formation. Data for solochrome Violet R. Part 6.—Some metal-dye-cysteine complexes. ACTA ACUST UNITED AC 1971. [DOI: 10.1039/tf9716701404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bailley NA, Coates E, Robertson GB, Bonati F, Ugo R. The crystal and molecular structures of acetylacetonatobiscarbonyl-rhodium(I) and of some fluoro-substituted complexes. ACTA ACUST UNITED AC 1967. [DOI: 10.1039/c19670001041] [Citation(s) in RCA: 8] [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: 11/21/2022]
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Coates E, Rigg B, Saville B, Skelton D. 1045. Complexes of amines with zinc dialkyldithiocarbamates. Part II. A study of the influence of amine structure on the stability of complexes of zinc dimethyldithiocarbamate. ACTA ACUST UNITED AC 1965. [DOI: 10.1039/jr9650005613] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bastable MJR, Beardwell A, Besterman E, Cash M, Coates E, Corbett M, Colston J, Cracroft P, Davies U, Davies C, Edwards P, Edelston R, Emerson P, Feldman C, Goetzee B, Goodman H, Hepton S, Jones S, Lessof L, Paterson UH, Last P, Pritchard J, Rhodes K, Sidaway M. Lost Potential in Medical Manpower. West J Med 1964. [DOI: 10.1136/bmj.2.5424.1597-b] [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: 11/04/2022]
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Coates E, Evans JR, Rigg B. Complex formation. Data for Solochrome Violet R. Part 5.—Some metal-dye-aminoacid complexes. ACTA ACUST UNITED AC 1963. [DOI: 10.1039/tf9635902369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lister JH, Ramage GR, Coates E. Hydropteridines. Part II. Formyl derivatives of some 5 : 6 : 7 : 8-tetrahydropteridines. ACTA ACUST UNITED AC 1954. [DOI: 10.1039/jr9540004109] [Citation(s) in RCA: 4] [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: 11/21/2022]
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Solomon W, Cottrell TL, Gill JE, Moubasher R, Mostafa A, Bowen EJ, Coates E, Gridgeman NT, Hunter RF, Williams NE. Notes. ACTA ACUST UNITED AC 1947. [DOI: 10.1039/jr9470000129] [Citation(s) in RCA: 6] [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: 11/21/2022]
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