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Moretz K, Wheless J, Santos C, Segal E, Lancman M, Patten A, Malhotra M. Phase IV PROVE study: Perampanel in real-world clinical care of pediatric patients with epilepsy. Eur J Paediatr Neurol 2024; 50:23-30. [PMID: 38569352 DOI: 10.1016/j.ejpn.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 01/10/2024] [Accepted: 02/17/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION The non-interventional Phase IV PROVE study (NCT03208660) assessed retention, efficacy, safety and tolerability, and perampanel dosing in patients with epilepsy during routine clinical care. This analysis evaluated final data from patients aged <4 years and 4-<12 years. METHODS Data were obtained retrospectively from medical/pharmacy records of patients in the United States initiating perampanel after January 1, 2014, according to treating clinician recommendations. Retention rate was the primary endpoint. Secondary assessments included median percent changes in seizure frequency, seizure-freedom rates, investigator impression of seizure effect, and safety and tolerability. RESULTS The Safety Analysis Set (SAS) included 41 patients (<4 years; mean maximum dose, 3.5 mg/day) and 203 patients (4-<12 years; mean maximum dose, 5.3 mg/day); 24-month retention rates were 35.7% (n = 5/14) and 42.0% (n = 47/112), respectively. In the Full Analysis Set, during Months 1-3, median percent reductions in seizure frequency were 33.3% (n = 8 [<4 years]) and 26.0% (n = 32 [4-<12 years]), and seizure-freedom rates were 12.5% in both groups (n = 1/8 and n = 4/32); patient numbers were low at later time points. Most patients showed improvements in seizure control (45.9% [<4 years] versus 52.4% [4-<12 years]) or no change (45.9% versus 34.5%) (SAS). Treatment-emergent adverse events (TEAEs) were reported in 12 (<4 years: 29.3%; most common, irritability [7.3%]) and 64 patients (4-<12 years: 31.5%; most common, aggression [6.9%]). CONCLUSIONS Perampanel was generally well tolerated with <21% of TEAEs leading to withdrawal at 24 months, had favorable retention rates (≥50% and >35% at 12 and 24 months, respectively), and sustained efficacy in pediatric patients during routine clinical care.
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Affiliation(s)
- Katherine Moretz
- Meridian Clinical Research, LLC, 6602 Waters Avenue, Building C, Savannah, GA, 31406, USA
| | - James Wheless
- University of Tennessee Health Science Center, Le Bonheur Children's Hospital, 49 N Dunlap Street, Memphis, TN, 38105, USA.
| | - Cesar Santos
- Valley Children's Hospital, 9300 Valley Children's Place Madera, CA, 93636, USA.
| | - Eric Segal
- Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack Meridian School of Medicine, 30 Prospect Avenue, Hackensack, NJ 07601, USA.
| | - Marcelo Lancman
- Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack Meridian School of Medicine, 30 Prospect Avenue, Hackensack, NJ 07601, USA.
| | - Anna Patten
- Eisai Europe Ltd., European Knowledge Centre, Mosquito Way, Hatfield, Hertfordshire, AL10 9SN, UK.
| | - Manoj Malhotra
- Formerly: Eisai Inc., 200 Metro Blvd., Nutley, NJ, 07110, USA.
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Perry MS, Scheffer IE, Sullivan J, Brunklaus A, Boronat S, Wheless JW, Laux L, Patel AD, Roberts CM, Dlugos D, Holder D, Knupp KG, Lallas M, Phillips S, Segal E, Smeyers P, Lal D, Wirrell E, Zuberi S, Brünger T, Wojnaroski M, Maru B, O'Donnell P, Morton M, James E, Vila MC, Huang N, Gofshteyn JS, Rico S. Severe communication delays are independent of seizure burden and persist despite contemporary treatments in SCN1A+ Dravet syndrome: Insights from the ENVISION natural history study. Epilepsia 2024; 65:322-337. [PMID: 38049202 DOI: 10.1111/epi.17850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Dravet syndrome (DS) is a developmental and epileptic encephalopathy characterized by high seizure burden, treatment-resistant epilepsy, and developmental stagnation. Family members rate communication deficits among the most impactful disease manifestations. We evaluated seizure burden and language/communication development in children with DS. METHODS ENVISION was a prospective, observational study evaluating children with DS associated with SCN1A pathogenic variants (SCN1A+ DS) enrolled at age ≤5 years. Seizure burden and antiseizure medications were assessed every 3 months and communication and language every 6 months with the Bayley Scales of Infant and Toddler Development 3rd edition and the parent-reported Vineland Adaptive Behavior Scales 3rd edition. We report data from the first year of observation, including analyses stratified by age at Baseline: 0:6-2:0 years:months (Y:M; youngest), 2:1-3:6 Y:M (middle), and 3:7-5:0 Y:M (oldest). RESULTS Between December 2020 and March 2023, 58 children with DS enrolled at 16 sites internationally. Median follow-up was 17.5 months (range = .0-24.0), with 54 of 58 (93.1%) followed for at least 6 months and 51 of 58 (87.9%) for 12 months. Monthly countable seizure frequency (MCSF) increased with age (median [minimum-maximum] = 1.0 in the youngest [1.0-70.0] and middle [1.0-242.0] age groups and 4.5 [.0-2647.0] in the oldest age group), and remained high, despite use of currently approved antiseizure medications. Language/communication delays were observed early, and developmental stagnation occurred after age 2 years with both instruments. In predictive modeling, chronologic age was the only significant covariate of seizure frequency (effect size = .52, p = .024). MCSF, number of antiseizure medications, age at first seizure, and convulsive status epilepticus were not predictors of language/communication raw scores. SIGNIFICANCE In infants and young children with SCN1A+ DS, language/communication delay and stagnation were independent of seizure burden. Our findings emphasize that the optimal therapeutic window to prevent language/communication delay is before 3 years of age.
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Affiliation(s)
- M Scott Perry
- Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Ingrid E Scheffer
- University of Melbourne, Austin Health, Melbourne, Victoria, Australia
| | - Joseph Sullivan
- University of California, San Francisco, San Francisco, California, USA
| | | | | | | | - Linda Laux
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Anup D Patel
- Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Dennis Dlugos
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Deborah Holder
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | | | - Matt Lallas
- Nicklaus Children's Hospital, Miami, Florida, USA
| | | | - Eric Segal
- Northeast Regional Epilepsy Group & Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | | | | | | | - Sameer Zuberi
- School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | | | | | - Magda Morton
- Encoded Therapeutics, South San Francisco, California, USA
| | - Emma James
- Encoded Therapeutics, South San Francisco, California, USA
| | | | - Norman Huang
- Encoded Therapeutics, South San Francisco, California, USA
| | | | - Salvador Rico
- Encoded Therapeutics, South San Francisco, California, USA
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3
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Wheless J, Wechsler RT, Penovich P, Segal E, Chez M, Coppola A, Datta A, D'Souza W, Najm I, Cappucci S, Sainz-Fuertes R, Villanueva V. Effectiveness, safety and tolerability of perampanel by age group when used to treat people with focal and generalized epilepsy in clinical practice: The PERMIT Extension study. Epilepsy Behav 2023; 147:109369. [PMID: 37619459 DOI: 10.1016/j.yebeh.2023.109369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To assess the effectiveness and safety/tolerability of perampanel (PER) in people with epilepsy (PWE) treated in everyday clinical practice for focal and generalized seizures, both in the total cohort and by age group. METHODS The PERMIT Extension study was a pooled analysis of data from PWE included in two large previous clinical practice studies (PERMIT and PROVE). Retention was assessed over 12 months. Effectiveness was assessed based on total seizures and by seizure type (focal and generalized) after 3, 6, and 12 months of PER treatment and at final follow-up (last observation carried forward; "last visit"); assessments included responder rate (≥50% seizure frequency reduction from baseline) and seizure freedom rate (no seizures since at least the previous visit). Safety/tolerability was assessed throughout PER treatment by evaluating adverse events (AEs). All assessments were conducted for the total population and by age category (<12, ≥12 to <18, ≥18 to <65, and ≥65 years at baseline). RESULTS Full Analysis Set included 6,822 PWE (51.1% female; mean age, 36.9 years; mean duration of epilepsy 21.4 years) with 6,433, 4,648, and 6,233 PWE assessed for retention, effectiveness, and safety/tolerability, respectively. The majority of PWE (81.1%) were aged 18-64 at baseline, with 4.5% aged <12 years, 8.4% aged 12-17 years, and 5.9% aged ≥65 years. In the overall population, retention rates at 3, 6, and 12 months were 88.0%, 77.6%, and 61.4%, respectively; responder rates at 12 months were 58.5% for total seizures, 54.6% for focal seizures, and 77.7% for generalized seizures, and corresponding seizure freedom rates were 23.6%, 19.0%, and 51.3%, respectively. PER was effective regardless of age category, although effectiveness was greatest in PWE aged ≥65 years, for both focal and generalized seizures. In the overall population, the incidence of AEs was 49.2% and the most frequent AEs (≥5% of PWE) were dizziness/vertigo (13.4%), somnolence (8.8%), irritability (7.3%), and behavioral disorders (5.3%); AEs led to treatment discontinuation in 18.3% of PWE over 12 months. The incidence of AEs and the discontinuation rate due to AEs increased with increasing age (55.0% and 23.9%, respectively, in PWE aged ≥65 years). CONCLUSION In this study, the largest pooled analysis of PER clinical practice data conducted to date, PER was shown to be effective and generally well tolerated when used to treat people with focal or generalized epilepsy in everyday clinical practice, regardless of age category. No new or unexpected side effects emerged following long-term use in the real-world setting.
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Affiliation(s)
- James Wheless
- University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN, USA.
| | | | | | - Eric Segal
- Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA.
| | - Michael Chez
- Sutter Neuroscience Institute, Roseville, CA, USA.
| | - Antonietta Coppola
- Department of Neuroscience, Odontostomatological and Reproductive Sciences, Federico II University of Naples, Naples, Italy.
| | - Anita Datta
- BC Children's Hospital, Vancouver, BC, Canada.
| | - Wendyl D'Souza
- Department of Medicine, St Vincent's Hospital Melbourne, The University of Melbourne, Victoria, Australia.
| | - Imad Najm
- Cleveland Clinic, Cleveland, OH, USA.
| | | | | | - Vicente Villanueva
- Refractory Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
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Segal E, Dababo N, Bhalla D, Bucklan D. Prostate Adenocarcinoma Metastasis to the Rectal Submucosa and Mesorectal Lymph Node on 18 F-PSMA PET/CT. Clin Nucl Med 2023; 48:e506-e508. [PMID: 37656605 DOI: 10.1097/rlu.0000000000004795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
ABSTRACT We report a case of biopsy-proven prostate cancer metastasis to the rectum and presumed metastasis to a mesorectal lymph node, identified as radiotracer-avid lesions on prostate-specific membrane antigen PET/CT during workup for biochemically recurrent prostate cancer. This case adds to a growing number of atypical sites of metastatic prostate cancer being reported since the approval of prostate-specific membrane antigen PET/CT for staging of prostate cancer.
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Affiliation(s)
- Eric Segal
- From the Department of Radiology, Froedtert & the Medical College of Wisconsin, Milwaukee, WI
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Flamini RJ, Comi AM, Bebin EM, Chez MG, Clark G, Devinsky O, Hussain SA, Lyons PD, Patel AD, Rosengard JL, Sahebkar F, Segal E, Seltzer L, Szaflarski JP, Weinstock A. Efficacy of cannabidiol in convulsive and nonconvulsive seizure types associated with treatment-resistant epilepsies in the Expanded Access Program. Epilepsia 2023; 64:e156-e163. [PMID: 37243404 DOI: 10.1111/epi.17665] [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: 12/22/2022] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 05/28/2023]
Abstract
The cannabidiol (CBD) Expanded Access Program (EAP), initiated in 2014, provided CBD (Epidiolex) to patients with treatment-resistant epilepsy (TRE). In the final pooled analysis of 892 patients treated through January 2019 (median exposure = 694 days), CBD treatment was associated with a 46%-66% reduction in median monthly total (convulsive plus nonconvulsive) seizure frequency. CBD was well tolerated, and adverse events were consistent with previous findings. We used pooled EAP data to investigate the effectiveness of add-on CBD therapy for individual convulsive seizure types (clonic, tonic, tonic-clonic, atonic, focal to bilateral tonic-clonic), nonconvulsive seizure types (focal with and without impaired consciousness, absence [typical and atypical], myoclonic, myoclonic absence), and epileptic spasms. CBD treatment was associated with a reduction in the frequency of convulsive seizure types (median percentage reduction = 47%-100%), and nonconvulsive seizure types and epileptic spasms (median percentage reduction = 50%-100%) across visit intervals through 144 weeks of treatment. Approximately 50% of patients had ≥50% reduction in convulsive and nonconvulsive seizure types and epileptic spasms at nearly all intervals. These results show a favorable effect of long-term CBD use in patients with TRE, who may experience various convulsive and nonconvulsive seizure types. Future controlled trials are needed to confirm these findings.
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Affiliation(s)
| | - Anne M Comi
- Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - E Martina Bebin
- University of Alabama School of Medicine, Birmingham, Alabama, USA
| | | | - Gary Clark
- Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Orrin Devinsky
- NYU Langone Comprehensive Epilepsy Center, New York, New York, USA
| | - Shaun A Hussain
- David Geffen School of Medicine and UCLA Mattel Children's Hospital, Los Angeles, California, USA
| | - Paul D Lyons
- Virginia Comprehensive Epilepsy Program, Winchester, Virginia, USA
| | - Anup D Patel
- Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jillian L Rosengard
- Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Eric Segal
- Northeast Region Epilepsy Group, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Laurie Seltzer
- University of Rochester Medical Center, Rochester, Minnesota, USA
| | | | - Arie Weinstock
- University at Buffalo and Oishei Children's Hospital, Buffalo, New York, USA
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Peters JM, Puri V, Segal E, Misra SN, Rabinowicz AL, Carrazana E. Concomitant cannabidiol does not impact safety and effectiveness of diazepam nasal spray for seizure clusters: Post hoc analysis of a phase 3 safety study. Epilepsy Behav 2023; 144:109248. [PMID: 37210793 DOI: 10.1016/j.yebeh.2023.109248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/13/2023] [Accepted: 04/27/2023] [Indexed: 05/23/2023]
Abstract
People with epilepsy may experience episodes of frequent seizure activity (seizure clusters, acute repetitive seizures), and benzodiazepines are the cornerstone of rescue treatment. Cannabidiol (CBD) can be used as an adjunctive treatment for epilepsy, and it may interact with other antiseizure drugs, such as benzodiazepines. Here, we examined the safety and effectiveness of intermittent use of diazepam nasal spray in patients with seizure clusters who also received CBD treatment. This analysis included data from patients aged 6 to 65 years enrolled in a phase 3, long-term safety study of diazepam nasal spray. Age- and weight-based dosing of diazepam nasal spray were administered during a 12-month treatment period. Concomitant CBD use was recorded, and treatment-emergent adverse events (TEAEs) were collected. Of 163 treated patients, 119 (73.0%) did not receive CBD, 23 (14.1%) received the US Food and Drug Administration-approved highly purified CBD and 21 (12.9%) received another form of CBD. On average, patients receiving highly purified CBD were younger and more likely to have epileptic encephalopathies, including Dravet syndrome or Lennox-Gastaut syndrome, than patients who received another CBD preparation or no CBD. Rates of TEAEs and serious TEAEs were greater in patients who received any form of CBD (90.9% and 45.5%, respectively) compared with no CBD (79.0% and 26.1%, respectively). However, the lowest rates of TEAEs attributed to diazepam nasal spray were reported in patients who received highly purified CBD (13.0%), and this result was maintained in those who received concomitant clobazam. Use of second doses of diazepam nasal spray, a proxy for effectiveness, was lowest in the highly purified-CBD group (8.2%) compared with the no-CBD (11.6%) and other-CBD groups (20.3%). These results suggest that CBD does not alter the safety and effectiveness of diazepam nasal spray and supports concomitant use in appropriate patients.
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Affiliation(s)
- Jurriaan M Peters
- Harvard Medical School and Boston Children's Hospital, 300 Longwood Ave, FE9, Boston, MA 02115, USA.
| | - Vinay Puri
- Norton Children's Neuroscience Institute, University of Louisville, 411 E. Chestnut St., Suite 645, Louisville, KY 40202, USA
| | - Eric Segal
- Hackensack University Medical Center and Northeast Regional Epilepsy Group, 20 Prospect Avenue, Suite 800, Hackensack, NJ 07601, USA
| | - Sunita N Misra
- Neurelis, Inc., 3430 Carmel Mountain Road, Suite 300, San Diego, CA 92121, USA
| | - Adrian L Rabinowicz
- Neurelis, Inc., 3430 Carmel Mountain Road, Suite 300, San Diego, CA 92121, USA
| | - Enrique Carrazana
- Neurelis, Inc., 3430 Carmel Mountain Road, Suite 300, San Diego, CA 92121, USA; John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
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Braun E, Gualano FM, Siddarth P, Segal E. Second-line cannabis therapy in patients with epilepsy. Clin Neurol Neurosurg 2023; 227:107638. [PMID: 36870086 DOI: 10.1016/j.clineuro.2023.107638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/06/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Marijuana-based therapies (MBTs) have been shown to reduce seizure frequency in patients with severe and drug-resistant epilepsy (DRE). Pharmaceutical-grade CBD (EpidiolexⓇ) was approved by the FDA in 2018 for the treatments of Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS) and subsequently in 2020 for tuberous sclerosis complex (TSC). It is unclear what the utility would be in prescribing one type of MBT if a previous, alternative type failed. We conducted a retrospective study to determine if an alternative formulation of MBT reduces seizure frequency if the patient has not had a meaningful response from an initial MBT. We also investigated the clinical impact that a second MBT has on side effect profile. METHODS We reviewed the charts of patients with DRE who were at least 2 years old and who took at least 2 different formulations of MBT, including a pharmacologic formulation of CBD (EpidiolexⓇ), artisanal marijuana, and/or a hemp-based formulation. We reviewed medical records in patients 2 years of age and older; however, subjects' historical data, such as age of first seizure onset, may be prior to the age of 2 years. We extracted data on demographics, type of epilepsy, history of epilepsy, medication history, seizure count, and drug side effects. Seizure frequency, side effect profiles, and predictors of responder status were evaluated. RESULTS Thirty patients were identified as taking more than 1 type of MBT. Our findings suggest that seizure frequencies do not change significantly from baseline to after the first MBT and to after the second MBT (p = .4). However, we did find that patients with greater baseline seizure frequency were significantly more likely to respond to treatment after the second MBT (p = .03). To our second endpoint of side effect profile, we found that patients who experienced side effects after a second MBT had significantly greater seizure frequency compared to those who did not (p = .04). CONCLUSION We found no significant seizure frequency reduction from baseline to after a second MBT in patients who tried at least 2 different formulations of MBT. This suggests a low probability of seizure frequency reduction with a second MBT therapy in patients with epilepsy who tried at least two different MBTs. While these findings need to be replicated in a larger sample, they suggest that clinicians should not delay care by trying alternative MBT formulations after a patient has already tried one. Instead, it may be more prudent to attempt an alternative class of therapy.
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Affiliation(s)
- Erica Braun
- Joseph M. Sanzari Children's Hospital, Hackensack, NJ 07601, USA
| | | | - Prabha Siddarth
- Semel Institute for Neuroscience and Human Behavior, School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Eric Segal
- Hackensack University Medical Center, Hackensack, NJ 07601, USA; Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA; Northeast Regional Epilepsy Group, Hackensack, NJ 07601, USA
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Cogliati M, Arikan-Akdagli S, Barac A, Bostanaru AC, Brito S, Çerikçioğlu N, Efstratiou MA, Ergin Ç, Esposto MC, Frenkel M, Gangneux JP, Gitto A, Gonçalves CI, Guegan H, Gunde-Cimerman N, Güran M, Jonikaitė E, Kataržytė M, Klingspor L, Mares M, Meijer WG, Melchers WJG, Meletiadis J, Nastasa V, Babič MN, Ogunc D, Ozhak B, Prigitano A, Ranque S, Romanò L, Rusu RO, Sabino R, Sampaio A, Silva S, Stephens JH, Tehupeiory-Kooreman M, Velegraki A, Veríssimo C, Segal E, Brandão J. Environmental and bioclimatic factors influencing yeasts and molds distribution along European shores. Sci Total Environ 2023; 859:160132. [PMID: 36400291 DOI: 10.1016/j.scitotenv.2022.160132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
The present study employed data collected during the Mycosands survey to investigate the environmental factors influencing yeasts and molds distribution along European shores applying a species distribution modelling approach. Occurrence data were compared to climatic datasets (temperature, precipitation, and solar radiation), soil datasets (chemical and physical properties), and water datasets (temperature, salinity, and chlorophyll-a concentration) downloaded from web databases. Analyses were performed by MaxEnt software. Results suggested a different probability of distribution of yeasts and molds along European shores. Yeasts seem to tolerate low temperatures better during winter than molds and this reflects a higher suitability for the Northern European coasts. This difference is more evident considering suitability in waters. Both distributions of molds and yeasts are influenced by basic soil pH, probably because acidic soils are more favorable to bacterial growth. Soils with high nitrogen concentrations are not suitable for fungal growth, which, in contrast, are optimal for plant growth, favored by this environment. Finally, molds show affinity with soil rich in nickel and yeasts with soils rich in cadmium resulting in a distribution mainly at the mouths of European rivers or lagoons, where these metals accumulate in river sediments.
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Affiliation(s)
- M Cogliati
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy.
| | - S Arikan-Akdagli
- Mycology Laboratory at Department of Medical Microbiology of Hacettepe University Medical School, Ankara, Turkey
| | - A Barac
- Clinical Centre of Serbia, Clinic for Infectious and Tropical Diseases, Faculty of Medicine, University of Belgrade, Serbia
| | - A C Bostanaru
- Ion Ionescu de la Brad University of Life Sciences, Iasi, Romania
| | - S Brito
- Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - N Çerikçioğlu
- Mycology Laboratory at Department of Medical Microbiology of Marmara University Medical School, Istanbul, Turkey
| | - M A Efstratiou
- Department of Marine Sciences, University of the Aegean, University Hill, Mytilene, Greece
| | - Ç Ergin
- Department of Medical Microbiology, Medical Faculty, Pamukkale University, Denizli, Turkey
| | - M C Esposto
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - M Frenkel
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J P Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - A Gitto
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, and UCD Conway Institute, University College Dublin, Ireland
| | - C I Gonçalves
- Department of Biology and Environment, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - H Guegan
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - N Gunde-Cimerman
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Slovenia
| | - M Güran
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, Northern Cyprus, Mersin, Turkey
| | - E Jonikaitė
- Marine Research Institute, Klaipėda University, Klaipėda, Lithuania
| | - M Kataržytė
- Marine Research Institute, Klaipėda University, Klaipėda, Lithuania
| | - L Klingspor
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Mares
- Ion Ionescu de la Brad University of Life Sciences, Iasi, Romania
| | - W G Meijer
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, and UCD Conway Institute, University College Dublin, Ireland
| | - W J G Melchers
- Medical Microbiology, Radboud University Medical Centre (Radboudumc), Nijmegen, the Netherlands
| | - J Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - V Nastasa
- Ion Ionescu de la Brad University of Life Sciences, Iasi, Romania
| | - M Novak Babič
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Slovenia
| | - D Ogunc
- Department of Medical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - B Ozhak
- Department of Medical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - A Prigitano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - S Ranque
- Aix Marseille Univ, IHU-Méditerranée Infection, AP-HM, IRD, SSA, VITROME, Marseille, France
| | - L Romanò
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - R O Rusu
- Ion Ionescu de la Brad University of Life Sciences, Iasi, Romania
| | - R Sabino
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal; Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - A Sampaio
- Department of Biology and Environment, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, Vila Real, Portugal
| | - S Silva
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - J H Stephens
- UCD School of Biomolecular and Biomedical Science, UCD Earth Institute, and UCD Conway Institute, University College Dublin, Ireland
| | - M Tehupeiory-Kooreman
- Medical Microbiology, Radboud University Medical Centre (Radboudumc), Nijmegen, the Netherlands
| | - A Velegraki
- Mycology Research Laboratory and UOA/HCPF Culture Collection, Microbiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Mycology Laboratory, BIOMEDICINE S.A., Athens, Greece
| | - C Veríssimo
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
| | - E Segal
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J Brandão
- Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal; Centre for Environmental and Marine Studies (CESAM) - Department of Animal Biology, University of Lisbon, Lisbon, Portugal
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D'Alessandro V, Barán E, Alaimo F, Rentería F, Finocchiaro J, Monaldi G, Herrera J, Cano L, Moncada K, Ditondo J, Nabais I, Varas C, Antoniolli C, Segal E. 19 Analysis of survival in cystic fibrosis for a state of Argentina: 2016–2020. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00710-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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10
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Segal E, Moretz K, Wheless J, Penovich P, Lancman M, Patten A, Malhotra M. PROVE-Phase IV Study of Perampanel in Real-World Clinical Care of Patients with Epilepsy: Interim Analysis in Pediatric Patients. J Child Neurol 2022; 37:256-267. [PMID: 34994582 DOI: 10.1177/08830738211047665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROVE is a retrospective, phase IV study assessing retention, dosing, efficacy, and safety of perampanel when administered to patients during routine clinical care. We report an interim analysis of preadolescent (1 to <12 years) and adolescent (12 to <18 years) patients. Data were obtained from medical records of patients with epilepsy initiating perampanel after January 1, 2014; cut-off date for this analysis was October 10, 2018. Overall, 151 preadolescent and 183 adolescent patients were included. Retention rates following 24 months on perampanel were 42.5% (preadolescent subgroup; n = 31/73) and 55.7% (adolescent subgroup; n = 54/97). Treatment-emergent adverse events occurred in 53 (35.1%) preadolescent (most common: aggression, irritability, and somnolence) and 78 (42.6%) adolescent patients (most common: somnolence, aggression, and dizziness). These data indicate that daily oral doses of perampanel are generally well tolerated during routine clinical care, with favorable retention rates for ≤2 years, in patients aged 1 to <18 years.
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Affiliation(s)
- Eric Segal
- 3673Hackensack University Medical Center, 576909Hackensack Meridian School of Medicine, Hackensack, NJ, USA.,576909Northeast Regional Epilepsy Center, Hackensack, NJ, USA.,Meridian Clinical Research, LLC, Savannah, GA, USA
| | - Katherine Moretz
- 3673Hackensack University Medical Center, 576909Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - James Wheless
- 12326University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN, USA
| | | | - Marcelo Lancman
- 3673Hackensack University Medical Center, 576909Hackensack Meridian School of Medicine, Hackensack, NJ, USA.,576909Northeast Regional Epilepsy Center, Hackensack, NJ, USA
| | - Anna Patten
- 41951Eisai Europe Ltd., European Knowledge Centre, Hatfield, Hertfordshire, UK
| | - Manoj Malhotra
- 42372Eisai Global Neurology Business Unit, Woodcliff Lake, NJ, USA
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11
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Wechsler RT, Wheless J, Zafar M, Huesmann GR, Lancman M, Segal E, Chez M, Aboumatar S, Patten A, Salah A, Malhotra M. PROVE: retrospective, non-interventional, Phase IV study of perampanel in real-world clinical care of patients with epilepsy. Epilepsia Open 2021; 7:293-305. [PMID: 34942053 PMCID: PMC9159249 DOI: 10.1002/epi4.12575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 11/11/2022] Open
Abstract
Objective To assess retention, dosing, efficacy, and safety of perampanel in a large cohort of patients with epilepsy during routine clinical care. Methods PROVE was a retrospective, non‐interventional Phase IV study (NCT03208660). Data were obtained retrospectively from the medical records of patients in the United States initiating perampanel after January 1, 2014, according to treating clinicians' recommendation. Retention rate was the primary efficacy endpoint. Secondary efficacy endpoints included median percent changes in seizure frequency per 28 days from baseline, seizure‐freedom rate, and overall investigator impression of seizure effect. Safety endpoints included incidence of treatment‐emergent adverse events (TEAEs). Efficacy and safety were also assessed according to baseline use of enzyme‐inducing antiseizure medications (EIASMs). Results Overall, 1703 patients were enrolled and included in the Safety Analysis Set (SAS; ≥1 baseline EIASMs, n = 358 [21.0%]; no baseline EIASMs, n = 1345 [79.0%]). Mean (standard deviation [SD]) cumulative duration of exposure to perampanel was 17.4 (15.7) months; mean (SD) daily perampanel dose was 5.6 (2.7) mg. The most frequent perampanel titration intervals were weekly (23.4%) and every 2 weeks (24.7%). Across the SAS, 24‐month retention rate was 48.1% (n = 501/1042). Based on overall investigator impression at the end of treatment, 51.9%, 35.8%, and 12.3% of patients in the SAS experienced improvement, no change, or worsening of seizures, respectively. TEAEs occurred in 704 (41.3%) patients; 79 (4.6%) had serious TEAEs. The most common TEAE was dizziness (7.3%). There was some variation in efficacy according to EIASM use, while retention rates and safety were generally consistent. Significance In this final analysis of >1700 patients with epilepsy receiving perampanel in routine clinical care, favorable retention and sustained efficacy were demonstrated for ≥12 months.
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Affiliation(s)
| | - James Wheless
- University of Tennessee, Le Bonheur Children's Hospital, Memphis, TN, USA
| | | | | | - Marcelo Lancman
- Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Eric Segal
- Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | - Michael Chez
- Sutter Neuroscience Institute, Roseville, CA, USA
| | | | - Anna Patten
- Eisai Europe Ltd, Hatfield, Hertfordshire, UK
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12
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Brandão J, Gangneux JP, Arikan-Akdagli S, Barac A, Bostanaru AC, Brito S, Bull M, Çerikçioğlu N, Chapman B, Efstratiou MA, Ergin Ç, Frenkel M, Gitto A, Gonçalves CI, Guégan H, Gunde-Cimerman N, Güran M, Irinyi L, Jonikaitė E, Kataržytė M, Klingspor L, Mares M, Meijer WG, Melchers WJG, Meletiadis J, Meyer W, Nastasa V, Babič MN, Ogunc D, Ozhak B, Prigitano A, Ranque S, Rusu RO, Sabino R, Sampaio A, Silva S, Stephens JH, Tehupeiory-Kooreman M, Tortorano AM, Velegraki A, Veríssimo C, Wunderlich GC, Segal E. Mycosands: Fungal diversity and abundance in beach sand and recreational waters - Relevance to human health. Sci Total Environ 2021; 781:146598. [PMID: 33812107 DOI: 10.1016/j.scitotenv.2021.146598] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
The goal of most studies published on sand contaminants is to gather and discuss knowledge to avoid faecal contamination of water by run-offs and tide-retractions. Other life forms in the sand, however, are seldom studied but always pointed out as relevant. The Mycosands initiative was created to generate data on fungi in beach sands and waters, of both coastal and freshwater inland bathing sites. A team of medical mycologists and water quality specialists explored the sand culturable mycobiota of 91 bathing sites, and water of 67 of these, spanning from the Atlantic to the Eastern Mediterranean coasts, including the Italian lakes and the Adriatic, Baltic, and Black Seas. Sydney (Australia) was also included in the study. Thirteen countries took part in the initiative. The present study considered several fungal parameters (all fungi, several species of the genus Aspergillus and Candida and the genera themselves, plus other yeasts, allergenic fungi, dematiaceous fungi and dermatophytes). The study considered four variables that the team expected would influence the results of the analytical parameters, such as coast or inland location, urban and non-urban sites, period of the year, geographical proximity and type of sediment. The genera most frequently found were Aspergillus spp., Candida spp., Fusarium spp. and Cryptococcus spp. both in sand and in water. A site-blind median was found to be 89 Colony-Forming Units (CFU) of fungi per gram of sand in coastal and inland freshwaters, with variability between 0 and 6400 CFU/g. For freshwater sites, that number was 201.7 CFU/g (0, 6400 CFU/g (p = 0.01)) and for coastal sites was 76.7 CFU/g (0, 3497.5 CFU/g). For coastal waters and all waters, the median was 0 CFU/ml (0, 1592 CFU/ml) and for freshwaters 6.7 (0, 310.0) CFU/ml (p < 0.001). The results advocate that beaches should be monitored for fungi for safer use and better management.
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Affiliation(s)
- J Brandão
- Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal; Centre for Environmental and Marine Studies (CESAM) - Department of Animal Biology, University of Lisbon, Lisbon, Portugal.
| | - J P Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - S Arikan-Akdagli
- Mycology Laboratory at Department of Medical Microbiology of Hacettepe University Medical School, Ankara, Turkey
| | - A Barac
- Clinical Centre of Serbia, Clinic for Infectious and Tropical Diseases, Faculty of Medicine, University of Belgrade, Serbia
| | - A C Bostanaru
- Ion Ionescu de la Brad University of Agricultural Sciences and Veterinary Medicine of Iasi, Romania
| | - S Brito
- Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - M Bull
- Quantal Bioscience, North Parramatta, Australia
| | - N Çerikçioğlu
- Mycology Laboratory at Department of Medical Microbiology of Marmara University Medical School, Istanbul, Turkey
| | - B Chapman
- Quantal Bioscience, North Parramatta, Australia
| | - M A Efstratiou
- Department of Marine Sciences, University of the Aegean, University Hill, Mytilene, Greece
| | - Ç Ergin
- Department of Medical Microbiology, Medical Faculty, Pamukkale University, Denizli, Turkey
| | - M Frenkel
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Gitto
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Ireland; UCD Earth Institute, University College Dublin, Ireland; UCD Conway Institute, University College Dublin, Ireland
| | - C I Gonçalves
- Department of Biology and Environment, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - H Guégan
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - N Gunde-Cimerman
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Slovenia
| | - M Güran
- Faculty of Medicine, Eastern Mediterranean University, Famagusta, Northern Cyprus, Mersin 10, Turkey
| | - L Irinyi
- Molecular Mycology Research Laboratory, Centre for Infectious Disease and Microbiology, Sydney Medical School, Westmead Clinical School, Westmead Hospital, Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
| | - E Jonikaitė
- Marine Research Institute, Klaipėda University, Klaipėda, Lithuania
| | - M Kataržytė
- Marine Research Institute, Klaipėda University, Klaipėda, Lithuania
| | - L Klingspor
- Division of Clinical Microbiology, Department of Laboratory Medicin, Karolinska Institutet, Stockholm, Sweden
| | - M Mares
- Ion Ionescu de la Brad University of Agricultural Sciences and Veterinary Medicine of Iasi, Romania
| | - W G Meijer
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Ireland; UCD Earth Institute, University College Dublin, Ireland; UCD Conway Institute, University College Dublin, Ireland
| | - W J G Melchers
- Medical Microbiology, Radboud University Medical Centre (Radboudumc), Nijmegen, the Netherlands
| | - J Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - W Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Disease and Microbiology, Sydney Medical School, Westmead Clinical School, Westmead Hospital, Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
| | - V Nastasa
- Ion Ionescu de la Brad University of Agricultural Sciences and Veterinary Medicine of Iasi, Romania
| | - M Novak Babič
- Department of Biology, Biotechnical Faculty, University of Ljubljana, Slovenia
| | - D Ogunc
- Department of Medical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - B Ozhak
- Department of Medical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - A Prigitano
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - S Ranque
- Aix Marseille Univ, IHU-Méditerranée Infection, AP-HM, IRD, SSA, VITROME, Marseille, France
| | - R O Rusu
- Ion Ionescu de la Brad University of Agricultural Sciences and Veterinary Medicine of Iasi, Romania
| | - R Sabino
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - A Sampaio
- Department of Biology and Environment, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), UTAD, Vila Real, Portugal
| | - S Silva
- Department of Epidemiology, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - J H Stephens
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Ireland; UCD Earth Institute, University College Dublin, Ireland; UCD Conway Institute, University College Dublin, Ireland
| | - M Tehupeiory-Kooreman
- Medical Microbiology, Radboud University Medical Centre (Radboudumc), Nijmegen, the Netherlands
| | - A M Tortorano
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - A Velegraki
- Mycology Research Laboratory and UOA/HCPF Culture Collection, Microbiology Department, Medical School, National and Kapodistrian University of Athens, Athens, Greece and Mycology Laboratory, BIOMEDICINE S.A., Athens, Greece
| | - C Veríssimo
- Reference Unit for Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - G C Wunderlich
- Quantal Bioscience, North Parramatta, Australia; Molecular Mycology Research Laboratory, Centre for Infectious Disease and Microbiology, Sydney Medical School, Westmead Clinical School, Westmead Hospital, Marie Bashir Institute for Emerging Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, The University of Sydney, Westmead, Australia
| | - E Segal
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Sabeti S, Ball KL, Bhattacharya SK, Bitrian E, Blieden LS, Brandt JD, Burkhart C, Chugani HT, Falchek SJ, Jain BG, Juhasz C, Loeb JA, Luat A, Pinto A, Segal E, Salvin J, Kelly KM. Consensus Statement for the Management and Treatment of Sturge-Weber Syndrome: Neurology, Neuroimaging, and Ophthalmology Recommendations. Pediatr Neurol 2021; 121:59-66. [PMID: 34153815 PMCID: PMC9107097 DOI: 10.1016/j.pediatrneurol.2021.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Sturge-Weber syndrome (SWS) is a sporadic, neurocutaneous syndrome involving the skin, brain, and eyes. Because of the variability of the clinical manifestations and the lack of prospective studies, consensus recommendations for management and treatment of SWS have not been published. OBJECTIVE This article consolidates the current literature with expert opinion to make recommendations to guide the neuroimaging evaluation and the management of the neurological and ophthalmologic features of SWS. METHODS Thirteen national peer-recognized experts in neurology, radiology, and ophthalmology with experience treating patients with SWS were assembled. Key topics and questions were formulated for each group and included (1) risk stratification, (2) indications for referral, and (3) optimum treatment strategies. An extensive PubMed search was performed of English language articles published in 2008 to 2018, as well as recent studies identified by the expert panel. The panel made clinical practice recommendations. CONCLUSIONS Children with a high-risk facial port-wine birthmark (PWB) should be referred to a pediatric neurologist and a pediatric ophthalmologist for baseline evaluation and periodic follow-up. In newborns and infants with a high-risk PWB and no history of seizures or neurological symptoms, routine screening for brain involvement is not recommended, but brain imaging can be performed in select cases. Routine follow-up neuroimaging is not recommended in children with SWS and stable neurocognitive symptoms. The treatment of ophthalmologic complications, such as glaucoma, differs based on the age and clinical presentation of the patient. These recommendations will help facilitate coordinated care for patients with SWS and may improve patient outcomes.
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Affiliation(s)
- Sara Sabeti
- Department of Dermatology, University of California, Irvine School of Medicine, Irvine, California
| | | | | | - Elena Bitrian
- Department of Ophthalmology & Bascom Palmer Eye Institute, University of Miami, Miami
| | - Lauren S. Blieden
- Department of Ophthalmology & Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
| | - James D. Brandt
- Department of Ophthalmology, University of California, Davis, Sacramento, California
| | - Craig Burkhart
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
| | - Harry T. Chugani
- Department of Neurology, NYU School of Medicine, New York, New York
| | - Stephen J. Falchek
- Department of Neurology, Nemours duPont Hospital for Children, Wilmington, Delaware
| | - Badal G. Jain
- Department of Neurology, Nemours duPont Hospital for Children, Wilmington, Delaware
| | - Csaba Juhasz
- Departments of Pediatrics and Neurology, Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, Michigan
| | - Jeffrey A. Loeb
- Department of Neurology and Rehabilitation Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Aimee Luat
- Departments of Pediatrics and Neurology, Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, Michigan,Department of Pediatrics, Central Michigan University, College of Medicine, Mt. Pleasant, Michigan
| | - Anna Pinto
- Department of Neurology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric Segal
- Hackensack University Medical Center, Hackensack Meridian School of Medicine and Northeast Regional Epilepsy Group, Hackensack, New Jersey
| | - Jonathan Salvin
- Previous affiliation Division of Pediatric Ophthalmology, Nemours duPont Hospital for Children, Wilmington, Delaware
| | - Kristen M. Kelly
- Department of Dermatology, University of California, Irvine School of Medicine, Irvine, California
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14
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Shprits S, Jiang X, Borkum T, Leonard H, Massad-Ivanir N, Halachmi S, Segal E. Urinary tract infection diagnosis and antimicrobial susceptibility testing within <90 minutes. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00524-8] [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: 10/20/2022]
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15
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Bar J, Sarig O, Lotan-Pompan M, Dassa B, Miodovnik M, Weinberger A, Sprecher E, Segal E, Samuelov L. Evidence for cutaneous dysbiosis in dystrophic epidermolysis bullosa. Clin Exp Dermatol 2021; 46:1223-1229. [PMID: 33682945 DOI: 10.1111/ced.14592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/10/2021] [Accepted: 02/01/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND The human microbiome project addresses the relationship between bacterial flora and the human host, in both healthy and diseased conditions. The skin is an ecosystem with multiple niches, each featuring unique physiological conditions and thus hosting different bacterial populations. The skin microbiome has been implicated in the pathogenesis of many dermatoses. Given the role of dysbiosis in the pathogenesis of inflammation, which is prominent in dystrophic epidermolysis bullosa (DEB), we undertook a study on the skin microbiome. AIM To characterize the skin microbiome in a series of patients with DEB. METHODS This was a case-control study of eight patients with DEB and nine control cases enrolled between June 2017 and November 2018. The skin of patients with DEB was sampled at three different sites: untreated wound, perilesional skin and normal-appearing (uninvolved) skin. Normal skin on the forearm was sampled from age-matched healthy controls (HCs). We used a dedicated DNA extraction protocol to isolate microbial DNA, which was then analysed using next-generation microbial 16S rRNA sequencing. Data were analysed using a series of advanced bioinformatics tools. RESULTS The wounds, perilesional and uninvolved skin of patients with DEB demonstrated reduced bacterial diversity compared with HCs, with the flora in DEB wounds being the least diverse. We found an increased prevalence of staphylococci species in the lesional and perilesional skin of patients with DEB, compared with their uninvolved, intact skin. Similarly, the uninvolved skin of patients with DEB displayed increased staphylococcal content and significantly different microbiome diversities (other than staphylococci) compared with HC skin. CONCLUSIONS These findings suggest the existence of a unique DEB-associated skin microbiome signature, which could be targeted by specific pathogen-directed therapies. Moreover, altering the skin microbiome with increasing colonization of bacteria associated with nonchronic wounds may potentially facilitate wound healing in patients with DEB.
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Affiliation(s)
- J Bar
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - O Sarig
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - M Lotan-Pompan
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.,Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - B Dassa
- Bioinformatics Unit, Life Sciences Core Facilities, Weizmann Institute of Science, Rehovot, Israel
| | - M Miodovnik
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - A Weinberger
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.,Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - E Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Segal
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel.,Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel
| | - L Samuelov
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Szaflarski M, McGoldrick P, Currens L, Blodgett D, Land H, Szaflarski JP, Segal E. Attitudes and knowledge about cannabis and cannabis-based therapies among US neurologists, nurses, and pharmacists. Epilepsy Behav 2020; 109:107102. [PMID: 32442891 DOI: 10.1016/j.yebeh.2020.107102] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Use of cannabinoid therapies is on the rise in the United States, but responses of healthcare professionals and their knowledge of these therapies have been mixed. More information is needed about factors associated with healthcare professionals' attitudes and knowledge about medical cannabis. We conducted an online survey of US-based neurologists, nurse practitioners (NPs)/nurses, and pharmacists in August-September of 2018 (n = 451). We constructed perceived knowledge and attitudes scales and a knowledge index from multiple items and assessed state cannabis laws, participant's sociodemographics, workplace type and policies, and patient population. We used ordinary least-squares regression to examine associations among study variables. Over 80% of participants supported use and legalization of medical cannabis, especially cannabidiol (CBD) for epilepsy and when prescribed by a medical provider, but 40-50% (depending on item) felt unfamiliar with cannabinoid pharmacology and clinical applications. A total of 43% favored legal recreational cannabis. Pharmacists scored higher on the knowledge test than neurologists and NPs/nurses, but NPs/nurses had more favorable attitudes than neurologists and higher perceived knowledge than pharmacists. Both knowledge indicators predicted attitudes. State cannabis access and favorable workplace policies were associated with higher knowledge and more favorable attitudes. Healthcare professionals see potential in cannabis therapies but report significant knowledge gaps. Professional cannabinoid education is needed to address growing patient and provider demand for knowledge about cannabinoid therapies.
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Affiliation(s)
- Magdalena Szaflarski
- Department of Sociology, University of Alabama at Birmingham (UAB), HHB 460H, 1720 2nd Ave South, Birmingham, AL 35294-1152, USA.
| | - Patricia McGoldrick
- Division of Child Neurology and Epilepsy, Boston Children's Health Physicians of Westchester and Maria Fareri Children's Hospital, Valhalla, NY, 141 South Central Ave, Hartsdale, NY 10530, USA
| | - Lauryn Currens
- Department of Neurology, University of Massachusetts, 55 Lake Ave North, Worcester, MA 01655, USA.
| | - Dustin Blodgett
- Department of Psychiatry, University of Kentucky, 245 Fountain Court, Lexington, KY 40509, USA.
| | - Hunter Land
- Canopy Health Innovations, Smiths Falls, Ontario, Canada
| | - Jerzy P Szaflarski
- UAB Epilepsy Center, Department of Neurology, University of Alabama at Birmingham, 312 Civitan International Research Center (CIRC 312), 1720 2nd Avenue South, Birmingham, AL 35294-0021, USA.
| | - Eric Segal
- Northeast Regional Epilepsy Group, Hackensack University Medical Center and Hackensack Meridian School of Medicine, 20 Prospect Avenue, Suite 800, Hackensack, NJ 07601, USA.
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Abstract
OBJECTIVE To better understand the humanistic and economic burden of focal seizures in children 2-12 years old. METHODS We conducted a targeted literature review by searching MEDLINE for English-language publications reporting on children 2-12 years old with focal seizures published in the United States since 2008. RESULTS Thirty-five publications were included. Incidence of focal seizures was 23.2 to 47.1 per 100,000 children per year; prevalence was 2.0 per 1,000 children, and ranged from 1.6 - 2.6 per 1,000 in patients of any age. Life expectancy was 47.3-61.8 years among children 3-12 years old. Patients took several antiepileptic drugs and experienced frequent seizures, sleep disorders, mood disorders, migraine, and seizure-related injuries (eg, bone fractures, sprains, open wounds). Children with focal seizures scored below average on cognitive assessments and up to 42%, 16%, and 19% had depression, anxiety, and attention-deficit disorder, respectively. Patients of any age had about 10 outpatient visits (2 epilepsy-related), 2 inpatient visits (less than 1 epilepsy-related), and 24 procedures (1 epilepsy-related) per year. Medication adherence was low: only half of pediatric patients maintained ≥90% adherence over 6 months. Annual total health care costs among patients of any age ranged from $18,369 - 38,549; first-year total health care costs for children were $19,883. CONCLUSIONS Incidence and prevalence of focal seizures is high and the humanistic and economic burdens are significant. Future studies focused exclusively on children with focal seizures are needed to more precisely describe the burden. We also suggest further research and implementation of methods to improve medication adherence as an approach to lessen burden on these young patients.
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Affiliation(s)
- Sarah N Gibbs
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | | | | | - K Hamzah Ahmed
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | - Irina Yermilov
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | - Eric Segal
- Northeast Regional Epilepsy Group, Hackensack, NJ Hackensack University Medical Center, Hackensack, NJ, USA.,Seton Hall School of Medicine, Nutley, NJ, USA
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Gupta S, Schwab M, Valdez-Gonzalez K, Segal E. Rare homozygous nonsense variant in AIMP1 causing Early Onset Epileptic Encephalopathy with Burst Suppression (EOEE-BS). Eur J Med Genet 2020; 63:103970. [PMID: 32531460 DOI: 10.1016/j.ejmg.2020.103970] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/20/2020] [Accepted: 06/01/2020] [Indexed: 11/30/2022]
Abstract
Pathogenic variants in AIMP1 gene are rare causes of neurologic disorders. Homozygous frameshift and nonsense variants in AIMP1 have been described in severe neurodegenerative disease. This is the third report of a homozygous nonsense variant in AIMP1 [c.115 C > T (p.Gln39*)] in a girl with severe neonatal onset epileptic encephalopathy. Like the two other cases reported, our patient is also of Filipino descent. Clinical features include microcephaly, poor visual motor development, shallow breathing, severe hypertonia in extremities, severe global developmental delay, poor gag and suck reflex, failure to thrive in the neonatal period, and early onset intractable seizures. Brain MRI showed hypoplasia of corpus callosum as well as cerebellar vermis, global volume loss and diminished myelination for her age. Electroencephalogram at four months of age showed background consisting of synchronous and asynchronous intervals of burst suppression with intermittent multifocal spikes predominantly in the bi-temporal region, suggestive of Early Onset Epileptic Encephalopathy with Burst Suppression (EOEE-BS) which has not been previously associated with the c.115 C > T variant in AIMP1. Of note, she presented to us in super refractory status epilepticus which was eventually controlled after administration of ketogenic diet and Epidiolex (cannabidiol). This report expands the genetic landscape of EOEE-BS. This is the first case of this specific variant in which Epidiolex was administered, which along with Ketogenic diet aided in controlling patient's super refractory status epilepticus.
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Affiliation(s)
| | - Maria Schwab
- Hackensack University Medical Center, Hackensack, NJ, USA
| | | | - Eric Segal
- Hackensack University Medical Center, Hackensack, NJ, USA; Northeast Regional Epilepsy Group, Hackensack, NJ, USA; Hackensack Meridian School of Medicine, Nutley, NJ, USA
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Myers L, Trobliger R, Bortnik K, Zeng R, Segal E, Lancman M. Dissociation and other clinical phenomena in youth with psychogenic non-epileptic seizures (PNES) compared to youth with epilepsy. Seizure 2019; 70:49-55. [DOI: 10.1016/j.seizure.2019.06.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/19/2019] [Accepted: 06/22/2019] [Indexed: 10/26/2022] Open
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Kornitzer J, Taha F, Segal E. Clinical Presentation and Outcome in Autoimmune Encephalitis Associated With N-Type Voltage-Gated Calcium Channels in Children. J Child Neurol 2019; 34:499-505. [PMID: 31014180 DOI: 10.1177/0883073819840448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We present the diagnostic and clinical course of the first multicenter case series of pediatric patients with autoimmune encephalitis associated with N-type voltage-gated calcium channel antibodies. METHODS Data from 2 university hospitals were retrospectively reviewed and records of 3 patients with autoimmune encephalitis associated with N-type voltage-gated calcium channel antibodies were evaluated. RESULTS The 3 pediatric patients (all female) had symptoms that spanned the clinical spectrum. All 3, however, had regression of expressive language and agitation. Neuroimaging in all 3 patients was normal; electroencephalographic (EEG) findings varied among the 3 patients. Positive titers against the N-type voltage-gated calcium channel antibody were found in their cerebrospinal fluid. Following administration of intravenous immunoglobulin, all 3 had improvement in their core presenting symptoms. CONCLUSION Autoimmune encephalitis associated with N-type voltage-gated calcium channel antibodies in the pediatric population presents with a wide clinical spectrum, although expressive language delay and agitation seem to be common symptoms. Treatment with intravenous immunoglobulin improves core symptoms.
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Affiliation(s)
- Jeffrey Kornitzer
- 1 Rutgers New Jersey Medical School, Newark, NJ, USA.,2 St. Joseph's Children's Hospital, Paterson, NJ, USA
| | - Firas Taha
- 3 Northeast Epilepsy Group, Hackensack, NJ, USA.,4 Hackensack University Medical Center, Hackensack, NJ, USA
| | - Eric Segal
- 3 Northeast Epilepsy Group, Hackensack, NJ, USA.,4 Hackensack University Medical Center, Hackensack, NJ, USA
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Pérez-Hansen A, Lass-Flörl C, Lackner M, Aigner M, Alastruey-Izquierdo A, Arikan-Akdagli S, Bader O, Becker K, Boekhout T, Buzina W, Cornely OA, Hamal P, Kidd SE, Kurzai O, Lagrou K, Lopes Colombo A, Mares M, Masoud H, Meis JF, Oliveri S, Rodloff AC, Orth-Höller D, Guerrero-Lozano I, Sanguinetti M, Segal E, Taj-Aldeen SJ, Tortorano AM, Trovato L, Walther G, Willinger B. Antifungal susceptibility profiles of rare ascomycetous yeasts. J Antimicrob Chemother 2019; 74:2649-2656. [DOI: 10.1093/jac/dkz231] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 12/21/2022] Open
Abstract
AbstractObjectivesTo generate antifungal susceptibility patterns for Trichomonascus ciferrii (Candida ciferrii), Candida inconspicua (Torulopsis inconspicua) and Diutina rugosa species complex (Candida rugosa species complex), and to provide key parameters such as MIC50, MIC90 and tentative epidemiological cut-off values (TECOFFs).MethodsOur strain set included isolates of clinical origin: C. inconspicua (n = 168), D. rugosa species complex (n = 90) [Candida pararugosa (n = 60), D. rugosa (n = 26) and Candida mesorugosa (n = 4)], Pichia norvegensis (Candida norvegensis) (n = 15) and T. ciferrii (n = 8). Identification was performed by MALDI-TOF MS or internal transcribed spacer sequencing. Antifungal susceptibility patterns were generated for azoles, echinocandins and amphotericin B using commercial Etest and the EUCAST broth microdilution method v7.3.1. Essential agreement (EA) was calculated for Etest and EUCAST.ResultsC. inconspicua, C. pararugosa and P. norvegensis showed elevated azole MICs (MIC50 ≥0.06 mg/L), and D. rugosa and C. pararugosa elevated echinocandin MICs (MIC50 ≥0.06 mg/L). EA between methods was generally low (<90%); EA averaged 77.45%. TECOFFs were suggested for C. inconspicua and D. rugosa species complex.ConclusionsRare yeast species tested shared high fluconazole MICs. D. rugosa species complex displayed high echinocandin MICs, while C. inconspicua and P. norvegensis were found to have high azole MICs. Overall, the agreement between EUCAST and Etest was poor and therefore MIC values generated with Etest cannot be directly compared with EUCAST results.
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Affiliation(s)
- Antonio Pérez-Hansen
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstraße 41, Innsbruck, Austria
| | - Cornelia Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstraße 41, Innsbruck, Austria
| | - Michaela Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Schöpfstraße 41, Innsbruck, Austria
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22
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D'Alessandro V, Rentería F, Herrera J, Federico A, Barán E, Varas C, Diez G, Cano L, Andreozzi P, Antonioli C, Finocchiaro J, Ditondo J, Nabais I, Palmisciano V, Sirimarco L, Segal E. WS10-5 First report of cystic fibrosis patientś survival from a region of Argentina: data collected by its own Registry. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30176-6] [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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Laux LC, Bebin EM, Checketts D, Chez M, Flamini R, Marsh ED, Miller I, Nichol K, Park Y, Segal E, Seltzer L, Szaflarski JP, Thiele EA, Weinstock A. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy Res 2019; 154:13-20. [PMID: 31022635 DOI: 10.1016/j.eplepsyres.2019.03.015] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/12/2019] [Accepted: 03/24/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Since 2014, patients with severe treatment-resistant epilepsies (TREs) have been receiving add-on cannabidiol (CBD) in an ongoing, expanded access program (EAP), which closely reflects clinical practice. We conducted an interim analysis of long-term efficacy and tolerability in patients with Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) who received CBD treatment through December 2016. METHODS Children and adults with LGS/DS taking stable doses of antiepileptic drugs (AEDs) at baseline were included from 25 EAP sites across the United States. During the 4-week baseline period, parents/caregivers kept diaries of all countable seizure types. Patients received a pharmaceutical formulation of highly purified CBD (Epidiolex®; 100 mg/mL) in oral solution at 2-10 mg/kg/day, titrated until tolerability limit or a maximum dose of 25-50 mg/kg/day. Patient visits were every 2-4 weeks. The percentage change from baseline in median monthly convulsive (ie, major motor) and total seizures was evaluated at 12-week intervals through 96 weeks. The percentages of patients who had ≥50%, ≥75%, and 100% reduction in monthly seizures relative to the baseline period were also evaluated. Adverse events (AEs) were monitored and summarized for the safety analysis set (SAS) through 144 weeks. RESULTS Of the 607 patients in the SAS, 58 had DS and 94 had LGS (N = 152); 455 patients had other TREs. Twenty-eight percent of LGS/DS patients withdrew, primarily owing to lack of efficacy (20%). LGS/DS patients were taking a median of 3 (0-10) concomitant AEDs. Median treatment duration was 78.3 (range, 4.1-146.4) weeks. Between weeks 12 and 96, median CBD dose ranged from 21 to 25 mg/kg/day. At 12 weeks, add-on CBD reduced median monthly major motor seizures by 50% and total seizures by 44%, with consistent reductions in both seizure types through 96 weeks. At 12 weeks, the proportions of patients with ≥50%, ≥75%, and 100% reductions in major motor seizures were 53%, 23%, and 6%; the proportions with corresponding reductions in total seizures were 46%, 26%, and 5%. Responder rates for both seizure types were consistent through 96 weeks. CBD had an acceptable safety profile; the most common AEs were somnolence (30%) and diarrhea (24%). CONCLUSIONS Results from this interim analysis support add-on CBD as an effective long-term treatment option in LGS or DS.
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Affiliation(s)
- Linda C Laux
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| | | | | | | | | | - Eric D Marsh
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ian Miller
- Nicklaus Children's Hospital, Miami, FL, USA
| | | | - Yong Park
- Augusta University Medical Center, Augusta, GA, USA
| | - Eric Segal
- Northeast Regional Epilepsy Group, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Laurie Seltzer
- University of Rochester Medical Center, Rochester, MN, USA
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Helbig KL, Lauerer RJ, Bahr JC, Souza IA, Myers CT, Uysal B, Schwarz N, Gandini MA, Huang S, Keren B, Mignot C, Afenjar A, Billette de Villemeur T, Héron D, Nava C, Valence S, Buratti J, Fagerberg CR, Soerensen KP, Kibaek M, Kamsteeg EJ, Koolen DA, Gunning B, Schelhaas HJ, Kruer MC, Fox J, Bakhtiari S, Jarrar R, Padilla-Lopez S, Lindstrom K, Jin SC, Zeng X, Bilguvar K, Papavasileiou A, Xing Q, Zhu C, Boysen K, Vairo F, Lanpher BC, Klee EW, Tillema JM, Payne ET, Cousin MA, Kruisselbrink TM, Wick MJ, Baker J, Haan E, Smith N, Sadeghpour A, Davis EE, Katsanis N, Corbett MA, MacLennan AH, Gecz J, Biskup S, Goldmann E, Rodan LH, Kichula E, Segal E, Jackson KE, Asamoah A, Dimmock D, McCarrier J, Botto LD, Filloux F, Tvrdik T, Cascino GD, Klingerman S, Neumann C, Wang R, Jacobsen JC, Nolan MA, Snell RG, Lehnert K, Sadleir LG, Anderlid BM, Kvarnung M, Guerrini R, Friez MJ, Lyons MJ, Leonhard J, Kringlen G, Casas K, El Achkar CM, Smith LA, Rotenberg A, Poduri A, Sanchis-Juan A, Carss KJ, Rankin J, Zeman A, Raymond FL, Blyth M, Kerr B, Ruiz K, Urquhart J, Hughes I, Banka S, Hedrich UB, Scheffer IE, Helbig I, Zamponi GW, Lerche H, Mefford HC, Allori A, Angrist M, Ashley P, Bidegain M, Boyd B, Chambers E, Cope H, Cotten CM, Curington T, Davis EE, Ellestad S, Fisher K, French A, Gallentine W, Goldberg R, Hill K, Kansagra S, Katsanis N, Katsanis S, Kurtzberg J, Marcus J, McDonald M, Mikati M, Miller S, Murtha A, Perilla Y, Pizoli C, Purves T, Ross S, Sadeghpour A, Smith E, Wiener J. De Novo Pathogenic Variants in CACNA1E Cause Developmental and Epileptic Encephalopathy with Contractures, Macrocephaly, and Dyskinesias. Am J Hum Genet 2019; 104:562. [PMID: 30849329 DOI: 10.1016/j.ajhg.2019.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Helbig KL, Lauerer RJ, Bahr JC, Souza IA, Myers CT, Uysal B, Schwarz N, Gandini MA, Huang S, Keren B, Mignot C, Afenjar A, Billette de Villemeur T, Héron D, Nava C, Valence S, Buratti J, Fagerberg CR, Soerensen KP, Kibaek M, Kamsteeg EJ, Koolen DA, Gunning B, Schelhaas HJ, Kruer MC, Fox J, Bakhtiari S, Jarrar R, Padilla-Lopez S, Lindstrom K, Jin SC, Zeng X, Bilguvar K, Papavasileiou A, Xing Q, Zhu C, Boysen K, Vairo F, Lanpher BC, Klee EW, Tillema JM, Payne ET, Cousin MA, Kruisselbrink TM, Wick MJ, Baker J, Haan E, Smith N, Sadeghpour A, Davis EE, Katsanis N, Corbett MA, MacLennan AH, Gecz J, Biskup S, Goldmann E, Rodan LH, Kichula E, Segal E, Jackson KE, Asamoah A, Dimmock D, McCarrier J, Botto LD, Filloux F, Tvrdik T, Cascino GD, Klingerman S, Neumann C, Wang R, Jacobsen JC, Nolan MA, Snell RG, Lehnert K, Sadleir LG, Anderlid BM, Kvarnung M, Guerrini R, Friez MJ, Lyons MJ, Leonhard J, Kringlen G, Casas K, El Achkar CM, Smith LA, Rotenberg A, Poduri A, Sanchis-Juan A, Carss KJ, Rankin J, Zeman A, Raymond FL, Blyth M, Kerr B, Ruiz K, Urquhart J, Hughes I, Banka S, Hedrich UB, Scheffer IE, Helbig I, Zamponi GW, Lerche H, Mefford HC, Allori A, Angrist M, Ashley P, Bidegain M, Boyd B, Chambers E, Cope H, Cotten CM, Curington T, Davis EE, Ellestad S, Fisher K, French A, Gallentine W, Goldberg R, Hill K, Kansagra S, Katsanis N, Katsanis S, Kurtzberg J, Marcus J, McDonald M, Mikati M, Miller S, Murtha A, Perilla Y, Pizoli C, Purves T, Ross S, Sadeghpour A, Smith E, Wiener J. De Novo Pathogenic Variants in CACNA1E Cause Developmental and Epileptic Encephalopathy with Contractures, Macrocephaly, and Dyskinesias. Am J Hum Genet 2018; 103:666-678. [PMID: 30343943 DOI: 10.1016/j.ajhg.2018.09.006] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/17/2018] [Indexed: 12/27/2022] Open
Abstract
Developmental and epileptic encephalopathies (DEEs) are severe neurodevelopmental disorders often beginning in infancy or early childhood that are characterized by intractable seizures, abundant epileptiform activity on EEG, and developmental impairment or regression. CACNA1E is highly expressed in the central nervous system and encodes the α1-subunit of the voltage-gated CaV2.3 channel, which conducts high voltage-activated R-type calcium currents that initiate synaptic transmission. Using next-generation sequencing techniques, we identified de novo CACNA1E variants in 30 individuals with DEE, characterized by refractory infantile-onset seizures, severe hypotonia, and profound developmental impairment, often with congenital contractures, macrocephaly, hyperkinetic movement disorders, and early death. Most of the 14, partially recurring, variants cluster within the cytoplasmic ends of all four S6 segments, which form the presumed CaV2.3 channel activation gate. Functional analysis of several S6 variants revealed consistent gain-of-function effects comprising facilitated voltage-dependent activation and slowed inactivation. Another variant located in the domain II S4-S5 linker results in facilitated activation and increased current density. Five participants achieved seizure freedom on the anti-epileptic drug topiramate, which blocks R-type calcium channels. We establish pathogenic variants in CACNA1E as a cause of DEEs and suggest facilitated R-type calcium currents as a disease mechanism for human epilepsy and developmental disorders.
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Lambert L, Azzi L, Racine N, Tanguay A, Segal E, Ross D, Kouz S, Déry J, Harvey R, L'Allier P.L, Mercier M, Rinfret S, Boothroyd L, de Guise M, Bogaty P. MYOCARDIAL INFARCTION WITH LEFT BUNDLE BRANCH BLOCK: A DEADLY DISEASE WITH A LOW RATE OF REPERFUSION TREATMENT. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.253] [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: 11/29/2022] Open
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Segal E, Martens M, Wang HL, Brazauskas R, Weisdorf D, Sandmaier BM, Khoury HJ, de Lima M, Saber W. Comparing outcomes of matched related donor and matched unrelated donor hematopoietic cell transplants in adults with B-Cell acute lymphoblastic leukemia. Cancer 2017; 123:3346-3355. [PMID: 28452054 DOI: 10.1002/cncr.30737] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/06/2017] [Accepted: 03/21/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allogeneic hematopoietic cell transplantation (HCT) using human leukocyte antigen (HLA)-matched related donors (RDs) and allogeneic HCT using HLA-matched unrelated donors (URDs) produce similar outcomes for patients with acute myelogenous leukemia, whereas the donor source has been reported to be a predictor of outcomes in myelodysplastic syndrome. METHODS Post-HCT outcomes for 1458 acute lymphoblastic leukemia patients from 2000 to 2011 were analyzed, and RD and URD transplants were compared. RESULTS The median age was 37 years (range, 18-69 years). In the multivariate analysis, HLA 8/8 allele-matched URD recipients had similar transplant-related mortality (TRM) and all-cause mortality in comparison with RD recipients (hazard ratios [HRs], 1.16 [95% confidence interval (CI), 0.91-1.48] and 1.01 [95% CI, 0.85-1.19], respectively); 7/8 URD recipients had a greater risk of TRM and all-cause mortality in comparison with RD recipients (HRs, 1.92 [95% CI, 1.47-2.52] and 1.29 [95% CI, 1.05-1.58], respectively). The risk of TRM and all-cause mortality was also greater for 7/8 URD recipients versus 8/8 URD recipients. Compared with RD recipients, both 8/8 and 7/8 URD recipients had a lower risk of relapse (HRs, 0.77 [95% CI, 0.62-0.97] and 0.75 [95% CI, 0.56-1.00], respectively). Both 8/8 and 7/8 URD recipients had a greater risk of acute graft-versus-host disease (GVHD; HRs, 2.18 [95% CI, 1.76-2.70] and 2.65 [95% CI, 2.06-3.42], respectively) and chronic GVHD (HRs, 1.28 [95% CI, 1.06-1.55] and 1.46 [95% CI, 1.14-1.88], respectively) in comparison with RD recipients. CONCLUSIONS In the absence of RD transplantation, 8/8 URD transplantation is a viable alternative with similar survival outcomes, whereas 7/8 URD transplantation is associated with poorer overall survival. Cancer 2017;123:3346-55. © 2017 American Cancer Society.
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Affiliation(s)
- Eric Segal
- Medical College of Wisconsin Affiliated Hospitals, Milwaukee, Wisconsin
| | - Michael Martens
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Hai-Lin Wang
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ruta Brazauskas
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniel Weisdorf
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, Minnesota
| | - Brenda M Sandmaier
- Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, Washington
| | - H Jean Khoury
- Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia
| | - Marcos de Lima
- University Hospitals Case Medical Center, Cleveland, Ohio
| | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
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Risslegger B, Zoran T, Lackner M, Aigner M, Sánchez-Reus F, Rezusta A, Chowdhary A, Taj-Aldeen SJ, Arendrup MC, Oliveri S, Kontoyiannis DP, Alastruey-Izquierdo A, Lagrou K, Lo Cascio G, Meis JF, Buzina W, Farina C, Drogari-Apiranthitou M, Grancini A, Tortorano AM, Willinger B, Hamprecht A, Johnson E, Klingspor L, Arsic-Arsenijevic V, Cornely OA, Meletiadis J, Prammer W, Tullio V, Vehreschild JJ, Trovato L, Lewis RE, Segal E, Rath PM, Hamal P, Rodriguez-Iglesias M, Roilides E, Arikan-Akdagli S, Chakrabarti A, Colombo AL, Fernández MS, Martin-Gomez MT, Badali H, Petrikkos G, Klimko N, Heimann SM, Houbraken J, Uzun O, Edlinger M, Fuente SDL, Lass-Flörl C. A prospective international Aspergillus terreus survey: an EFISG, ISHAM and ECMM joint study. Clin Microbiol Infect 2017; 23:776.e1-776.e5. [PMID: 28412383 DOI: 10.1016/j.cmi.2017.04.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/07/2017] [Accepted: 04/09/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES A prospective international multicentre surveillance study was conducted to investigate the prevalence and amphotericin B susceptibility of Aspergillus terreus species complex infections. METHODS A total of 370 cases from 21 countries were evaluated. RESULTS The overall prevalence of A. terreus species complex among the investigated patients with mould-positive cultures was 5.2% (370/7116). Amphotericin B MICs ranged from 0.125 to 32 mg/L, (median 8 mg/L). CONCLUSIONS Aspergillus terreus species complex infections cause a wide spectrum of aspergillosis and the majority of cryptic species display high amphotericin B MICs.
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Affiliation(s)
- B Risslegger
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - T Zoran
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Lackner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Aigner
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - F Sánchez-Reus
- Servei de Microbiologia, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - A Rezusta
- Microbiologia, Hospital Universitario Miguel Servet, IIS Aragon, Universidad de Zaragoza, Zaragoza, Spain
| | - A Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - S J Taj-Aldeen
- Microbiology Division, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar
| | - M C Arendrup
- Statens Serum Institute, Unit of Mycology, & Department of Clinical Microbiology, Copenhagen University, Rigshospitalet, Copenhagen, Denmark
| | - S Oliveri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - D P Kontoyiannis
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - K Lagrou
- Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - G Lo Cascio
- Unità Operativa Complessa di Microbiologia e virologia, Dipartimento di Patologia e diagnostica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - J F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - W Buzina
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - C Farina
- Microbiology Institute, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - M Drogari-Apiranthitou
- Infectious Diseases Research Laboratory, 4(th) Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A Grancini
- Laboratorio Centrale di Analisi Chimico Cliniche e Microbiologia, IRCCS Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A M Tortorano
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - B Willinger
- Department of Laboratory Medicine, Division of Clinical Microbiology, Medical University of Vienna, Vienna, Austria
| | - A Hamprecht
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Cologne, Germany
| | - E Johnson
- Mycology Reference Laboratory, Public Health England, Bristol, UK
| | - L Klingspor
- Karolinska Institutet, Department of Laboratory Medicine, F 68, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - V Arsic-Arsenijevic
- National Reference Medical Mycology Laboratory, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - O A Cornely
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, Clinical Trials Centre Cologne (ZKS Köln), Centre for Integrated Oncology (CIO Köln-Bonn), German Centre for Infection Research (DZIF), University of Cologne, Cologne, Germany
| | - J Meletiadis
- Clinical Microbiology Laboratory, National Kapodistrian University of Athens, ATTIKON University Hospital Athens, Athens, Greece
| | - W Prammer
- Department of Hygiene and Medical Microbiology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - V Tullio
- Department of Public Health and Pediatrics, Microbiology Division, Turin, Italy
| | - J-J Vehreschild
- Department I for Internal Medicine, University Hospital of Cologne, Cologne and German Centre for Infection Research, Partner Site Bonn-Cologne, Germany
| | - L Trovato
- A.O.U. Policlinico Vittorio Emanuele Catania, Biometec - University of Catania, Italy
| | - R E Lewis
- Infectious Diseases Unit, S. Orsola-Malpighi, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - E Segal
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - P-M Rath
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - P Hamal
- Department of of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - M Rodriguez-Iglesias
- Clinical Microbiology, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - E Roilides
- Infectious Diseases Unit, 3(rd) Department of Paediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
| | - S Arikan-Akdagli
- Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
| | - A Chakrabarti
- Division of Mycology, Department of Medial Microbiology, Chandigarh, India
| | - A L Colombo
- Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - M S Fernández
- Departmento de Micología, Instituto de Medicina Regional, Universidad Nacional del Nordeste, CONICET, Resistencia, Argentina
| | - M T Martin-Gomez
- Division of Clinical Mycology, Department of Microbiology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - H Badali
- Department of Medical Mycology and Parasitology/Invasive Fungi Research Centre, Mazandaran University of Medical Sciences, Sari, Iran
| | - G Petrikkos
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - N Klimko
- Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, Saint Petersburg, Russia
| | - S M Heimann
- Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany
| | - J Houbraken
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - O Uzun
- Hacettepe University Medical School, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - M Edlinger
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - S de la Fuente
- Department of Dermatology, Hospital Ernest Lluch Martin, Calatayud, Zaragoza, Spain
| | - C Lass-Flörl
- Division of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria.
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Rob D, Špunda R, Lindner J, Šmalcová J, Šmíd O, Kovárník T, Linhart A, Bìlohlávek J, Marinoni MM, Cianchi G, Trapani S, Migliaccio ML, Gucci L, Bonizzoli M, Cramaro A, Cozzolino M, Valente S, Peris A, Grins E, Kort E, Weiland M, Shresta NM, Davidson P, Algotsson L, Fitch S, Marco G, Sturgill J, Lee S, Dickinson M, Boeve T, Khaghani A, Wilton P, Jovinge S, Ahmad AN, Loveridge R, Vlachos S, Patel S, Gelandt E, Morgan L, Butt S, Whitehorne M, Kakar V, Park C, Hayes M, Willars C, Hurst T, Best T, Vercueil A, Auzinger G, Adibelli B, Akovali N, Torgay A, Zeyneloglu P, Pirat A, Kayhan Z, Schmidbauer SS, Herlitz J, Karlsson T, Friberg H, Knafelj R, Radsel P, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Maka M, Ollieuz S, Reychler G, Mosaddegh R, Abbasi S, Talaee S, Zotzmann VZ, Staudacher DS, Wengenmayer TW, Dürschmied DD, Bode CB, Nelskylä A, Nurmi J, Jousi M, Schramko A, Mervaala E, Ristagno G, Skrifvars M, Ozsoy G, Kendirli T, Azapagasi E, Perk O, Gadirova U, Ozcinar E, Cakici M, Baran C, Durdu S, Uysalel A, Dogan M, Ramoglu M, Ucar T, Tutar E, Atalay S, Akar R, Kamps M, Leeuwerink G, Hofmeijer J, Hoiting O, Van der Hoeven J, Hoedemaekers C, Konkayev A, Kuklin V, Kondratyev T, Konkayeva M, Akhatov N, Sovershaev M, Tveita T, Dahl V, Wihersaari L, Skrifvars MB, Bendel S, Kaukonen KM, Vaahersalo J, Romppanen J, Pettilä V, Reinikainen M, Lybeck A, Cronberg T, Nielsen N, Friberg H, Rauber M, Steblovnik K, Jazbec A, Noc M, Kalasbail P, Garrett F, Kulstad E, Bergström DJ, Olsson HR, Schmidbauer S, Friberg H, Mandel I, Mikheev S, Podoxenov Y, Suhodolo I, Podoxenov A, Svirko J, Sementsov A, Maslov L, Shipulin V, Vammen LV, Rahbek SR, Secher NS, Povlsen JP, Jessen NJ, Løfgren BL, Granfeldt AG, Grossestreuer A, Perman S, Patel P, Ganley S, Portmann J, Cocchi M, Donnino M, Nassar Y, Fathy S, Gaber A, Mokhtar S, Chia YC, Lewis-Cuthbertson R, Mustafa K, Sabra A, Evans A, Bennett P, Eertmans W, Genbrugge C, Boer W, Dens J, De Deyne C, Jans F, Skorko A, Thomas M, Casadio M, Coppo A, Vargiolu A, Villa J, Rota M, Avalli L, Citerio G, Moon JB, Cho JH, Park CW, Ohk TG, Shin MC, Won MH, Papamichalis P, Zisopoulou V, Dardiotis E, Karagiannis S, Papadopoulos D, Zafeiridis T, Babalis D, Skoura A, Staikos I, Komnos A, Passos SS, Maeda F, Souza LS, Filho AA, Granjeia TAG, Schweller M, Franci D, De Carvalho Filho M, Santos TM, De Azevedo P, Wall R, Welters I, Tansuwannarat P, Sanguanwit P, Langer T, Carbonara M, Caccioppola A, Fusarini CF, Carlesso E, Paradiso E, Battistini M, Cattaneo E, Zadek F, Maiavacca R, Stocchetti N, Pesenti A, Ramos A, Acharta F, Toledo J, Perezlindo M, Lovesio L, Dogliotti A, Lovesio C, Schroten N, Van der Veen B, De Vries MC, Veenstra J, Abulhasan YB, Rachel S, Châtillon-Angle M, Alabdulraheem N, Schiller I, Dendukuri N, Angle M, Frenette C, Lahiri S, Schlick K, Mayer SA, Lyden P, Akatsuka M, Arakawa J, Yamakage M, Rubio J, Mateo-Sidron JAR, Sierra R, Celaya M, Benitez L, Alvarez-Ossorio S, Rubio J, Mateo-Sidron JAR, Sierra R, Fernandez A, Gonzalez O, Engquist H, Rostami E, Enblad P, Toledo J, Ramos A, Acharta F, Canullo L, Nallino J, Dogliotti A, Lovesio C, Perreault M, Talic J, Frenette AJ, Burry L, Bernard F, Williamson DR, Adukauskiene D, Cyziute J, Adukauskaite A, Malciene L, Luca L, Rogobete A, Bedreag O, Papurica M, Sarandan M, Cradigati C, Popovici S, Vernic C, Sandesc D, Avakov V, Shakhova I, Trimmel H, Majdan M, Herzer GH, Sokoloff CS, Albert M, Williamson D, Odier C, Giguère J, Charbonney E, Bernard F, Husti Z, Kaptás T, Fülep Z, Gaál Z, Tusa M, Donnelly J, Aries M, Czosnyka M, Robba C, Liu M, Ercole A, Menon D, Hutchinson P, Smielewski P, López R, Graf J, Montes JM, Kenawi M, Kandil A, Husein K, Samir A, Heijneman J, Huijben J, Abid-Ali F, Stolk M, Van Bommel J, Lingsma H, Van der Jagt M, Cihlar RC, Mancino G, Bertini P, Forfori F, Guarracino F, Pavelescu D, Grintescu I, Mirea L, Alamri S, Tharwat M, Kono N, Okamoto H, Uchino H, Ikegami T, Fukuoka T, Simoes M, Trigo E, Coutinho P, Pimentel J, Franci A, Basagni D, Boddi M, Cozzolino M, Anichini V, Cecchi A, Peris A, Markopoulou D, Venetsanou K, Papanikolaou I, Barkouri T, Chroni D, Alamanos I, Cingolani E, Bocci MG, Pisapia L, Tersali A, Cutuli SL, Fiore V, Palma A, Nardi G, Antonelli M, Coke R, Kwong A, Dwivedi DJ, Xu M, McDonald E, Marshall JC, Fox-Robichaud AE, Charbonney E, Liaw PC, Kuchynska I, Malysh IR, Zgrzheblovska LV, Mestdagh L, Verhoeven EF, Hubloue I, Ruel-laliberte J, Zarychanski R, Lauzier F, Bonaventure PL, Green R, Griesdale D, Fowler R, Kramer A, Zygun D, Walsh T, Stanworth S, Léger C, Turgeon AF, Baron DM, Baron-Stefaniak J, Leitner GC, Ullrich R, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Pérez AG, Silva J, Artemenko V, Bugaev A, Tokar I, Konashevskaya S, Kolesnikova IM, Roitman EV, Kiss TR, Máthé Z, Piros L, Dinya E, Tihanyi E, Smudla A, Fazakas J, Ubbink R, Boekhorst te P, Mik E, Caneva L, Ticozzelli G, Pirrelli S, Passador D, Riccardi F, Ferrari F, Roldi EM, Di Matteo M, Bianchi I, Iotti GA, Zurauskaite G, Voegeli A, Meier M, Koch D, Haubitz S, Kutz A, Bargetzi M, Mueller B, Schuetz P, Von Meijenfeldt G, Van der Laan M, Zeebregts C, Christopher KB, Vernikos P, Melissopoulou T, Kanellopoulou G, Panoutsopoulou M, Xanthis D, Kolovou K, Kypraiou T, Floros J, Broady H, Pritchett C, Marshman M, Jannaway N, Ralph C, Lehane CL, Keyl CK, Zimmer EZ, Trenk DT, Ducloy-Bouthors AS, Jonard MJ, Fourrier F, Piza F, Correa T, Marra A, Guerra J, Rodrigues R, Vilarinho A, Aranda V, Shiramizo S, Lima MR, Kallas E, Cavalcanti AB, Donoso M, Vargas P, Graf J, McCartney J, Ramsay S, McDowall K, Novitzky-Basso I, Wright C, Medic MG, Bielen L, Radonic V, Zlopasa O, Vrdoljak NG, Gasparovic V, Radonic R, Narváez G, Cabestrero D, Rey L, Aroca M, Gallego S, Higuera J, De Pablo R, González LR, Chávez GN, Lucas JH, Alonso DC, Ruiz MA, Valarezo LJ, De Pablo Sánchez R, Real AQ, Wigmore TW, Bendavid I, Cohen J, Avisar I, Serov I, Kagan I, Singer P, Hanison J, Mirza U, Conway D, Takasu A, Tanaka H, Otani N, Ohde S, Ishimatsu S, Coffey F, Dissmann P, Mirza K, Lomax M, Dissmann P, Coffey F, Mirza K, Lomax M, Miner JR, Leto R, Markota AM, Gradišek PG, Aleksejev VA, Sinkovič AS, Romagnoli S, Chelazzi C, Zagli G, Benvenuti F, Mancinelli P, Boninsegni P, Paparella L, Bos AT, Thomas O, Goslar T, Knafelj R, Perreault M, Martone A, Sandu PR, Rosu VA, Capilnean A, Murgoi P, Frenette AJ, Lecavalier A, Jayaraman D, Rico P, Bellemare P, Gelinas C, Williamson D, Nishida T, Kinoshita T, Iwata N, Yamakawa K, Fujimi S, Maggi L, Sposato F, Citterio G, Bonarrigo C, Rocco M, Zani V, De Blasi RA, Alcorn D, Barry L, Riedijk MA, Milstein DM, Caldas J, Panerai R, Camara L, Ferreira G, Bor-Seng-Shu E, Lima M, Galas F, Mian N, Nogueira R, de Oliveira GQ, Almeida J, Jardim J, Robinson TG, Gaioto F, Hajjar LA, Zabolotskikh I, Musaeva T, Saasouh W, Freeman J, Turan A, Saseedharan S, Pathrose E, Poojary S, Messika J, Martin Y, Maquigneau N, Henry-Lagarrigue M, Puechberty C, Stoclin A, Martin-Lefevre L, Blot F, Dreyfuss D, Dechanet A, Hajage D, Ricard J, Almeida E, Almeida J, Landoni G, Galas F, Fukushima J, Fominskiy E, De Brito C, Cavichio L, Almeida L, Ribeiro U, Osawa E, Boltes R, Battistella L, Hajjar L, Fontela P, Lisboa T, Junior LF, Friedman GF, Abruzzi F, Primo JAP, Filho PM, de Andrade JS, Brenner KM, boeira MS, Leães C, Rodrigues C, Vessozi A, Machado AS, Weiler M, Bryce H, Hudson A, Law T, Reece-Anthony R, Molokhia A, Abtahinezhadmoghaddam F, Cumber E, Channon L, Wong A, Groome R, Gearon D, Varley J, Wilson A, Reading J, Wong A, Zampieri FG, Bozza FA, Ferez M, Fernandes H, Japiassú A, Verdeal J, Carvalho AC, Knibel M, Salluh JI, Soares M, Gao J, Ahmadnia E, Patel B, McCartney J, MacKay A, Binning S, Wright C, Pugh RJ, Battle C, Hancock C, Harrison W, Szakmany T, Mulders F, Vandenbrande J, Dubois J, Stessel B, Siborgs K, Ramaekers D, Soares M, Silva UV, Homena WS, Fernandes GC, Moraes AP, Brauer L, Lima MF, De Marco F, Bozza FA, Salluh JI, Maric N, Mackovic M, Udiljak N, Bosso CE, Caetano RD, Cardoso AP, Souza OA, Pena R, Mescolotte MM, Souza IA, Mescolotte GM, Bangalore H, Borrows E, Barnes D, Ferreira V, Azevedo L, Alencar G, Andrade A, Bierrenbach A, Buoninsegni LT, Bonizzoli M, Cecci L, Cozzolino M, Peris A, Lindskog J, Rowland K, Sturgess P, Ankuli A, Molokhia A, Rosa R, Tonietto T, Ascoli A, Madeira L, Rutzen W, Falavigna M, Robinson C, Salluh J, Cavalcanti A, Azevedo L, Cremonese R, Da Silva D, Dornelles A, Skrobik Y, Teles J, Ribeiro T, Eugênio C, Teixeira C, Zarei M, Hashemizadeh H, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Lignos M, Crissanthopoulou E, Flevari K, Dimopoulos P, Armaganidis A, Golub JG, Markota AM, Stožer AS, Sinkovič AS, Rüddel H, Ehrlich C, Burghold CM, Hohenstein C, Winning J, Sellami W, Hajjej Z, Bousselmi M, Gharsallah H, Labbene I, Ferjani M, Sattler J, Steinbrunner D, Poppert H, Schneider G, Blobner M, Kanz KG, Schaller SJ, Apap K, Xuereb G, Xuereb G, Apap K, Massa L, Xuereb G, Apap K, Massa L, Delvau N, Penaloza A, Liistro G, Thys F, Delattre IK, Hantson P, Roy PM, Gianello P, Hadîrcă L, Ghidirimschi A, Catanoi N, Scurtov N, Bagrinovschi M, Sohn YS, Cho YC, Golovin B, Creciun O, Ghidirimschi A, Bagrinovschi M, Tabbara R, Whitgift JZ, Ishimaru A, Yaguchi A, Akiduki N, Namiki M, Takeda M, Tamminen JN, Reinikainen M, Uusaro A, Taylor CG, Mills ED, Mackay AD, Ponzoni C, Rabello R, Serpa A, Assunção M, Pardini A, Shettino G, Corrêa T, Vidal-Cortés PV, Álvarez-Rocha L, Fernández-Ugidos P, Virgós-Pedreira A, Pérez-Veloso MA, Suárez-Paul IM, Del Río-Carbajo L, Fernández SP, Castro-Iglesias A, Butt A, Alghabban AA, Khurshid SK, Ali ZA, Nizami IN, Salahuddin NS, Alshahrani M, Alsubaie AW, Alshamsy AS, Alkhiliwi BA, Alshammari HK, Alshammari MB, Telmesani NK, Alshammari RB, Asonto LP, Zampieri FG, Damiani LP, Bozza F, Salluh JI, Cavalcanti AB, El Khattate A, Bizrane M, Madani N, Belayachi J, Abouqal R, Ramnarain D, Gouw-Donders B, Benstoem C, Moza A, Meybohm P, Stoppe C, Autschbach R, Devane D, Goetzenich A, Taniguchi LU, Araujo L, Salgado G, Vieira JM, Viana J, Ziviani N, Pessach I, Lipsky A, Nimrod A, O´Connor M, Matot I, Segal E, Kluzik A, Gradys A, Smuszkiewicz P, Trojanowska I, Cybulski M, De Jong A, Sebbane M, Chanques G, Jaber S, Rosa R, Robinson C, Bessel M, Cavalheiro L, Madeira L, Rutzen W, Oliveira R, Maccari J, Falavigna M, Sanchez E, Dutra F, Dietrich C, Balzano P, Rezende J, Teixeira C, Sinha S, Majhi K, Gorlicki JG, Pousset FP, Kelly J, Aron J, Gilbert AC, Urankar NP, Knafelj R, Irazabal M, Bosque M, Manciño J, Kotsopoulos A, Jansen N, Abdo W, Casey ÚM, O’Brien B, Plant R, Doyle B. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3). Crit Care 2017. [PMCID: PMC5374552 DOI: 10.1186/s13054-017-1630-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hurduc N, Odochian L, Segal E, Schneider IA. Über die Kinetik der thermischen Zersetzungen einiger Picolinkomplexe des Nickel(II)-ChIorids. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1968-23708] [Citation(s) in RCA: 3] [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: 11/15/2022]
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Segal E, Pedro H, Valdez-Gonzalez K, Parisotto S, Gliksman F, Thompson S, Sabri J, Fertig E. Diagnostic Yield of Epilepsy Panels in Children With Medication-Refractory Epilepsy. Pediatr Neurol 2016; 64:66-71. [PMID: 27726903 DOI: 10.1016/j.pediatrneurol.2016.06.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND When no chromosomal variations are identified, patients with suspected genetic etiologies can be tested using next-generation sequencing utilizing epilepsy panels. The primary objective of this study was to analyze the diagnostic yield of next-generation sequencing epilepsy panels in medication-resistant epilepsy subjects with non-clinically significant comparative genomic hybridization microarray results. METHODS We completed a single-center retrospective review of the diagnostic yield of next-generation sequencing epilepsy panels in medication-resistant epilepsy subjects aged 18 years or less who had non-clinically significant comparative genomic hybridization microarray results from January 2011 to December 2014. The primary end point was the yield of clinically significant next-generation sequencing results. RESULTS Forty-nine subjects (21 male) with medication-refractory epilepsy and clinically in significant comparative genomic hybridization microarray results were identified. Next-generation sequencing abnormalities were seen in 28 subjects (57%): seven of these 28 subjects (25%) had clinically significant findings. Mutations were found in the SCN1A gene in three subjects, in the PCDH19 gene in two subjects, and in DLG3, MECP2, TSC2, and SLC9A6 genes in one subject each. Only the MECP2 mutation was found to be pathogenic in this last subject. The additional yield of next-generation sequencing with uninformative chromosomal microarray was 14%. Positive findings were primarily seen in those with Dravet syndrome, all with SCN1A mutations (42% of clinically significant results). Given the small sample size, a larger prospective study would help to determine the clinical yield of next-generation sequencing. CONCLUSION Next-generation sequencing seizure panels could be a useful tool in the diagnosis of nonacquired pediatric medication-refractory epilepsy with uninformative comparative genomic hybridization microarray.
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Affiliation(s)
- Eric Segal
- Northeast Regional Epilepsy Group, Hackensack, New Jersey.
| | - Helio Pedro
- Division of Genetics, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey
| | - Karen Valdez-Gonzalez
- Division of Genetics, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey
| | - Sarah Parisotto
- Division of Genetics, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey
| | - Felicia Gliksman
- Division of Pediatric Neurology, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey
| | - Stephen Thompson
- Division of Pediatric Neurology, Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey
| | - Jomard Sabri
- Northeast Regional Epilepsy Group, Hackensack, New Jersey
| | - Evan Fertig
- Northeast Regional Epilepsy Group, Hackensack, New Jersey
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Lambert L, Azzi L, Harvey R, Kouz S, Maire S, Racine N, Rinfret S, Ross D, Segal E, Déry J, L'Allier P, Boothroyd L, Carroll C, Beauchamp C, Bogaty P. A COMPARISON OF QUALITY OF CARE OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION BY CHOICE OF REPERFUSION STRATEGY: RESULTS OF A QUÉBEC-WIDE, SYSTEMATIC FIELD EVALUATION (2013-14). Can J Cardiol 2016. [DOI: 10.1016/j.cjca.2016.07.322] [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: 11/24/2022] Open
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Urmann K, Arshavsky-Graham S, Walter JG, Scheper T, Segal E. Whole-cell detection of live lactobacillus acidophilus on aptamer-decorated porous silicon biosensors. Analyst 2016; 141:5432-40. [PMID: 27381045 DOI: 10.1039/c6an00810k] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This work describes the design of optical aptamer-based porous silicon (PSi) biosensors for the direct capture of Lactobacillus acidophilus. Aptamers are oligonucleotides (single-stranded DNA or RNA) that can bind their targets with high affinity and specificity, making them excellent recognition elements for biosensing applications. Herein, aptamer Hemag1P, which specifically targets the important probiotic L. acidophilus, was utilized for direct bacteria capture onto oxidized PSi Fabry-Pérot thin films. Monitoring changes in the reflectivity spectrum (using reflective interferometric Fourier transform spectroscopy) allows for bacteria detection in a label-free, simple and rapid manner. The performance of the biosensor was optimized by tuning the PSi nanostructure, its optical properties, as well as the immobilization density of the aptamer. We demonstrate the high selectivity and specificity of this simple "direct-capture" biosensing scheme and show its ability to distinguish between live and dead bacteria. The resulting biosensor presents a robust and rapid method for the specific detection of live L. acidophilus at concentrations relevant for probiotic products and as low as 10(6) cells per mL. Rapid monitoring of probiotic bacteria is crucial for quality, purity and safety control as the use of probiotics in functional foods and pharmaceuticals is becoming increasingly popular.
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Affiliation(s)
- K Urmann
- Institute of Technical Chemistry, Leibniz University of Hannover, Callinstr. 5, 30167 Hannover, Germany
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Frenkel M, Mandelblat M, Alastruey-Izquierdo A, Mendlovic S, Semis R, Segal E. Pathogenicity of Candida albicans isolates from bloodstream and mucosal candidiasis assessed in mice and Galleria mellonella. J Mycol Med 2016; 26:1-8. [DOI: 10.1016/j.mycmed.2015.12.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/24/2015] [Accepted: 12/26/2015] [Indexed: 01/11/2023]
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Schampaert E, L'Allier P, Kouz S, Whittom L, Ross D, Gagné C, Segal E, Diodati J, Montigny M, McNicoll S, Huynh T, Tardif J. IM QUÉBEC: A STEMI DATABASE - UNIVERSITY OF MONTRÉAL INTEGRATED HEALTH NETWORK QUALITY ASSURANCE INITIATIVE: REPERFUSION DELAYS AND IN-HOSPITAL OUTCOMES OVER THE FIRST 4 YEARS OF UTILISATION. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.034] [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: 10/22/2022] Open
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Lambert L, Boothroyd L, Azzi L, Segal E, Ross D, Maire S, Harvey R, Racine N, Kouz S, L'Allier P, Rinfret S, Carroll C, Beauchamp C, Bogaty P. PRIMARY ANGIOPLASTY TREATMENT DELAYS AFTER THE IMPLEMENTATION OF A PROVINCE-WIDE PREHOSPITAL ECG PROGRAM. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.032] [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: 10/22/2022] Open
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Lambert L, Azzi L, Harvey R, Kouz S, L'Allier P, Maire S, Racine N, Rinfret S, Ross D, Segal E, Carroll C, Beauchamp C, Boothroyd L, Bogaty P. TREATMENT DELAYS ON HOURS VERSUS OFF HOURS IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION ACROSS ALL HOSPITALS PERFORMING PRIMARY ANGIOPLASTY IN QUÉBEC, CANADA: RESULTS OF A THIRD FIELD EVALUATION. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.036] [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: 10/22/2022] Open
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Segal E. [The aging physician: when does physician's age have an impact on the quality of medicine?]. Harefuah 2015; 154:263-264. [PMID: 26065224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Semis R, Nahmias M, Lev S, Frenkel M, Segal E. Evaluation of antifungal combinations of nystatin-intralipid against Aspergillus terreus using checkerboard and disk diffusion methods. J Mycol Med 2015; 25:63-70. [DOI: 10.1016/j.mycmed.2014.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 12/21/2014] [Accepted: 12/31/2014] [Indexed: 10/24/2022]
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Shemesh R, Krepker M, Natan M, Danin-Poleg Y, Banin E, Kashi Y, Nitzan N, Vaxman A, Segal E. Novel LDPE/halloysite nanotube films with sustained carvacrol release for broad-spectrum antimicrobial activity. RSC Adv 2015. [DOI: 10.1039/c5ra16583k] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Halloysite nanotubes are employed as nanocarriers of carvacrol, allowing for its high-temperature melt compounding with polyethylene, and resulting in highly potent antimicrobial films.
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Affiliation(s)
- R. Shemesh
- Department of Biotechnology and Food Engineering
- Technion – Israel Institute of Technology
- Haifa 32000
- Israel
- Carmel Olefins Ltd
| | - M. Krepker
- Department of Biotechnology and Food Engineering
- Technion – Israel Institute of Technology
- Haifa 32000
- Israel
| | - M. Natan
- Institute for Nanotechnology and Advanced Materials
- The Mina and Everard Goodman Faculty of Life Sciences
- Bar-Ilan University
- Ramat-Gan 52900
- Israel
| | - Y. Danin-Poleg
- Department of Biotechnology and Food Engineering
- Technion – Israel Institute of Technology
- Haifa 32000
- Israel
| | - E. Banin
- Institute for Nanotechnology and Advanced Materials
- The Mina and Everard Goodman Faculty of Life Sciences
- Bar-Ilan University
- Ramat-Gan 52900
- Israel
| | - Y. Kashi
- Department of Biotechnology and Food Engineering
- Technion – Israel Institute of Technology
- Haifa 32000
- Israel
| | - N. Nitzan
- StePac L.A./DS Smith Plastics
- Western Galilee 24959
- Israel
| | | | - E. Segal
- Department of Biotechnology and Food Engineering
- Technion – Israel Institute of Technology
- Haifa 32000
- Israel
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Huynh T, Tardif J, Segal E, Nguyen M, Dery J, Afilalo M, Mansour S, Montigny M, Harvey R, Kouz S, Eisenberg M, Lynch A, Whittom L, Vadeboncoeur A, Lauzon C, Schampaert E. KNOWLEDGE TRANSLATION TO REDUCE DELAYS OF PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS IN QUÉBEC - INSIGHTS FROM THE AMI ON TIME STUDY. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.429] [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: 10/24/2022] Open
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Affiliation(s)
- G. Mechrez
- Department of Chemical Engineering, Technion; Israel Institute of Technology; Haifa 32000 Israel
| | - R. Y. Suckeveriene
- Department of Chemical Engineering, Technion; Israel Institute of Technology; Haifa 32000 Israel
- Kinneret College in the Jordan Valley; Department of Water Industries Engineering; Zemach Israel
| | - E. Segal
- Department of Biotechnology and Food Engineering; Technion - Israel Institute of Technology; Haifa 32000 Israel
- The Russell Berrie Nanotechnology Institute; Technion - Israel Institute of Technology; Haifa 32000 Israel
| | - M. Narkis
- Department of Chemical Engineering, Technion; Israel Institute of Technology; Haifa 32000 Israel
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Tepper S, Shahar DR, Geva D, Avizohar O, Nodelman M, Segal E, Ish-Shalom S. Identifying the threshold for vitamin D insufficiency in relation to cardiometabolic markers. Nutr Metab Cardiovasc Dis 2014; 24:489-494. [PMID: 24418378 DOI: 10.1016/j.numecd.2013.10.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 09/22/2013] [Accepted: 10/07/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND AIMS To determine the association between vitamin D status and cardiometabolic indicators, and to determine the vitamin threshold that affects these parameters. METHODS AND RESULTS High-tech employees were recruited from a periodic occupational health examination clinic and via the study's website. Diastolic and systolic blood pressure (DBP, SBP), body mass index (BMI), and waist circumference were measured. Serum concentrations of 25(OH)D, fasting plasma insulin (FPI), fasting plasma glucose (FPG), triglycerides (TG), and high sensitive C-Reactive Protein (hs-CRP) were measured in fasting blood samples. Of the 400 men who agreed to participate, 358 (90%) completed the study. Mean age was 48.8 ± 10.2 y, BMI 27.0 ± 3.8 k/m(2), serum 25(OH)D 22.1 ± 7.9 ng/l. Deficiency (defined as serum 25(OH)D < 12 ng/ml) was observed among 10.6%, 29.9% were insufficient (12 < 25(OH)D < 20 ng/ml), and 59.5% had sufficient levels (25(OH)D > 20 ng/ml). BMI, waist circumference, FPI, HOMA-IR, TG, hs-CRP levels, DBP, and SBP were negatively associated with serum 25(OH)D. A curved linear association was found with insulin and HOMA-IR with a significant spline knot at 11 ng/ml. For hs-CRP a spline knot at 14 ng/ml was observed. TG, SBP, and DBP exhibited linear associations with 25(OH)D. CONCLUSIONS Vitamin D status is related to cardiometabolic indicators in healthy men. We suggest a 25(OH)D threshold of 11-14 ng/ml for these outcomes. Future studies are required to address temporal relationships and the impact of vitamin D supplementation.
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Affiliation(s)
- S Tepper
- Department of Epidemiology and Health Services Evaluation, The S. Daniel International Center for Health and Disease, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - D R Shahar
- Department of Epidemiology and Health Services Evaluation, The S. Daniel International Center for Health and Disease, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - D Geva
- Department of Epidemiology and Health Services Evaluation, The S. Daniel International Center for Health and Disease, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - O Avizohar
- Center of Preventive Medicine, Rambam Health Care Campus, Haifa, Israel
| | - M Nodelman
- Metabolic Bone Disease Unit, Rambam Health Care Campus, Haifa, Israel
| | - E Segal
- Metabolic Bone Disease Unit, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
| | - S Ish-Shalom
- Metabolic Bone Disease Unit, Rambam Health Care Campus, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
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Lambert L, Xiao Y, Sas G, Segal E, Kouz S, Harvey R, Ross D, Rinfret S, L'Allier P, Nasmith J, Bogaty P. A Comparison of Causes of Short-Term and Long-Term Death Among Stemi and Nstemi Patients: Results From a Province-Wide Field Evaluation. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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46
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Affiliation(s)
- E. A. Schneider
- The University of Texas at Austin, Department of Mechanical Engineering 204 East Dean Keeton Street, Austin, Texas 78712
| | - U. B. Phathanapirom
- The University of Texas at Austin, Department of Mechanical Engineering 204 East Dean Keeton Street, Austin, Texas 78712
| | - R. Eggert
- Colorado School of Mines, 1500 Illinois Street, Golden, Colorado 80401
| | - E. Segal
- Colorado School of Mines, 1500 Illinois Street, Golden, Colorado 80401
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Lambert L, Xiao Y, Rinfret S, L'Allier P, Maire S, Kouz S, Ross D, Segal E, Vanasse A, Nasmith J, Bogaty P. 728 Short Term Mortality in ST-Elevation Myocardial Infarction (STEMI) Patients Treated With Primary Angioplasty (PPCI): A Province-Wide, Systematic Field Evaluation. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.659] [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: 11/28/2022] Open
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Lambert L, Xiao Y, Rinfret S, L'Allier P, Segal E, Maire S, Kouz S, Ross D, Vanasse A, Nasmith J, Bogaty P. 727 A Comparison of Outcomes of Patients with ST-Elevation Myocardial Infarction by Type of Hospital and Choice of Treatment: Results of a Québec-Wide, Systematic Field Evaluation (2008-2009). Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.658] [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: 11/29/2022] Open
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Bogaty P, Xiao Y, Rinfret S, L'Allier P, Segal E, Maire S, Kouz S, Ross D, Vanasse A, Nasmith J, Lambert L. 725 Clinical Profiles Associated With Timing of Death in Patients With ST-Elevation Myocardial Infarction: Results of a Province-Wide Field Evaluation. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.656] [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: 11/30/2022] Open
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50
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D'Alessandro V, Renteria F, Segal E, Diez G. 228 Pulmonary and nutritional outcomes in children with cystic fibrosis diagnosed by meconium ileus in Argentina. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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