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Lee PA, DuMontier C, Yu W, Ask L, Zhou J, Testa MA, Kim D, Abel G, Travison T, Manor B, Lo OY. Validity and Reliability of a Smartphone Application for Home Measurement of Four-Meter Gait Speed in Older Adults. Bioengineering (Basel) 2024; 11:257. [PMID: 38534531 DOI: 10.3390/bioengineering11030257] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/01/2024] [Accepted: 03/02/2024] [Indexed: 03/28/2024] Open
Abstract
The four-meter gait speed (4MGS) is a recommended physical performance test in older adults but is challenging to implement clinically. We developed a smartphone application (App) with a four-meter ribbon for remote 4MGS testing at home. This study aimed to assess the validity and reliability of this smartphone App-based assessment of the home 4MGS. We assessed the validity of the smartphone App by comparing it against a gold standard video assessment of the 4MGS conducted by study staff visiting community-dwelling older adults and against the stopwatch-based measurement. Moreover, we assessed the test-retest reliability in two supervised sessions and three additional sessions performed by the participants independently, without staff supervision. The 4MGS measured by the smartphone App was highly correlated with video-based 4MGS (r = 0.94), with minimal differences (mean = 0.07 m/s, ± 1.96 SD = 0.12) across a range of gait speeds. The test-retest reliability for the smartphone App 4MGS was high (ICC values: 0.75 to 0.93). The home 4MGS in older adults can be measured accurately and reliably using a smartphone in the pants pocket and a four-meter strip of ribbon. Leveraging existing technology carried by a significant portion of the older adult population could overcome barriers in busy clinical settings for this well-established objective mobility test.
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Affiliation(s)
- Pei-An Lee
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Clark DuMontier
- VA Boston Healthcare System, Harvard Medical School, Boston, MA 02130, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Wanting Yu
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
| | - Levi Ask
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
| | - Junhong Zhou
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Marcia A Testa
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Dae Kim
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Gregory Abel
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Tom Travison
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Brad Manor
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - On-Yee Lo
- Hebrew SeniorLife, Harvard Medical School, Boston, MA 02131, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Gong IY, Cheung MC, Chan KKW, Arya S, Faught N, Calzavara A, Liu N, Odejide OO, Abel G, Kurdyak P, Raphael MJ, Kuczmarski T, Prica A, Mozessohn L. Mortality among patients with diffuse large B-cell lymphoma and mental disorders: a population-based study. J Natl Cancer Inst 2023; 115:1194-1203. [PMID: 37531271 DOI: 10.1093/jnci/djad149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), but studies examining their association with mortality are lacking. METHODS We conducted a population-based study using linked administrative health-care databases from Ontario, Canada. All patients with DLBCL 18 years of age or older treated with rituximab-based therapy between January 1, 2005, and December 31, 2017, were identified and followed until March 1, 2020. Mental disorders were defined as either preexisting or postdiagnosis (after lymphoma treatment initiation). Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) between mental disorders and 1-year and all-cause mortality while controlling for covariates. RESULTS We identified 10 299 patients with DLBCL. The median age of the cohort was 67 years; 46% of patients were female, and 28% had a preexisting mental disorder. At 1-year follow-up, 892 (9%) had a postdiagnosis mental disorder, and a total of 2008 (20%) patients died. Preexisting mental disorders were not associated with 1-year mortality (adjusted HR = 1.06, 95% confidence interval [CI] = 0.96 to 1.17, P = .25), but postdiagnosis disorders were (adjusted HR = 1.51, 95% CI = 1.26 to 1.82, P = .0001). During a median follow-up of 5.2 years, 2111 (22%) patients had a postdiagnosis mental disorder, and 4084 (40%) patients died. Both preexisting and postdiagnosis mental disorders were associated with worse all-cause mortality (preexisting adjusted HR = 1.12, 95% CI = 1.04 to 1.20, P = .0024; postdiagnosis adjusted HR = 1.63, 95% CI = 1.49 to 1.79, P < .0001). CONCLUSIONS Patients with DLBCL and mental disorders had worse short-term and long-term mortality, particularly those with postdiagnosis mental disorders. Further studies are needed to examine mental health service utilization and factors mediating the relationship between mental disorders and inferior mortality.
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Affiliation(s)
- Inna Y Gong
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthew C Cheung
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Kelvin K W Chan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, Canada
| | - Sumedha Arya
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Neil Faught
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - Ning Liu
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Centre for Addition and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Michael J Raphael
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - Thomas Kuczmarski
- University of Washington Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Anca Prica
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Lee Mozessohn
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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DeZern AE, Goll JB, Lindsley RC, Bejar R, Wilson SH, Hebert D, Deeg J, Zhang L, Gore S, Al Baghdadi T, Maciejewski J, Liu J, Padron E, Komrojki R, Saber W, Abel G, Kroft SH, Harrington A, Grimes T, Reed H, Fulton RS, DiFronzo NL, Gillis N, Sekeres MA, Walter MJ. Utility of targeted gene sequencing to differentiate myeloid malignancies from other cytopenic conditions. Blood Adv 2023; 7:3749-3759. [PMID: 36947201 PMCID: PMC10368770 DOI: 10.1182/bloodadvances.2022008578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 03/23/2023] Open
Abstract
The National Heart, Lung, and Blood Institute-funded National MDS Natural History Study (NCT02775383) is a prospective cohort study enrolling patients with cytopenia with suspected myelodysplastic syndromes (MDS) to evaluate factors associated with disease. Here, we sequenced 53 genes in bone marrow samples harvested from 1298 patients diagnosed with myeloid malignancy, including MDS and non-MDS myeloid malignancy or alternative marrow conditions with cytopenia based on concordance between independent histopathologic reviews (local, centralized, and tertiary to adjudicate disagreements when needed). We developed a novel 2-stage diagnostic classifier based on mutational profiles in 18 of 53 sequenced genes that were sufficient to best predict a diagnosis of myeloid malignancy and among those with a predicted myeloid malignancy, predict whether they had MDS. The classifier achieved a positive predictive value (PPV) of 0.84 and negative predictive value (NPV) of 0.8 with an area under the receiver operating characteristic curve (AUROC) of 0.85 when classifying patients as having myeloid vs no myeloid malignancy based on variant allele frequencies (VAFs) in 17 genes and a PPV of 0.71 and NPV of 0.64 with an AUROC of 0.73 when classifying patients as having MDS vs non-MDS malignancy based on VAFs in 10 genes. We next assessed how this approach could complement histopathology to improve diagnostic accuracy. For 99 of 139 (71%) patients (PPV of 0.83 and NPV of 0.65) with local and centralized histopathologic disagreement in myeloid vs no myeloid malignancy, the classifier-predicted diagnosis agreed with the tertiary pathology review (considered the internal gold standard).
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Affiliation(s)
| | | | | | | | | | | | - Joachim Deeg
- Fred Hutchison Cancer Research Center, Seattle, WA
| | | | - Steven Gore
- National Cancer Institute, National Institutes of Health, Rockville, MD
| | | | | | | | | | | | - Wael Saber
- Center for International Blood and Marrow Transplant Research, Milwaukee, WI
| | | | | | | | | | | | - Robert S. Fulton
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO
| | - Nancy L. DiFronzo
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
| | | | | | - Matthew J. Walter
- Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, MO
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Weeks LD, Marinac CR, Redd R, Abel G, Lin A, Agrawal M, Stone RM, Schrag D, Ebert BL. Age-related diseases of inflammation in myelodysplastic syndrome and chronic myelomonocytic leukemia. Blood 2022; 139:1246-1250. [PMID: 34875037 PMCID: PMC8874362 DOI: 10.1182/blood.2021014418] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 01/07/2023] Open
Affiliation(s)
- Lachelle D Weeks
- Department of Medical Oncology
- Center for Prevention of Progression
| | - Catherine R Marinac
- Center for Prevention of Progression
- Division of Population Sciences, Department of Medical Oncology
- Department of Data Science, and
| | - Robert Redd
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - Gregory Abel
- Division of Population Sciences, Department of Medical Oncology
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - Amy Lin
- Center for Prevention of Progression
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | | | - Richard M Stone
- Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - Deborah Schrag
- Division of Population Sciences, Department of Medical Oncology
| | - Benjamin L Ebert
- Department of Medical Oncology
- Center for Prevention of Progression
- Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, MA; and
- Howard Hughes Medical Institute, Boston, MA
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5
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Rosko AE, Cordoba R, Abel G, Artz A, Loh KP, Klepin HD. Advances in Management for Older Adults With Hematologic Malignancies. J Clin Oncol 2021; 39:2102-2114. [PMID: 34043442 PMCID: PMC8260925 DOI: 10.1200/jco.21.00242] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/23/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
- Ashley E. Rosko
- Division of Hematology, The Ohio State University, Columbus, OH
| | - Raul Cordoba
- Lymphoma Unit, Department of Hematology, Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Gregory Abel
- Leukemia Program, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Andrew Artz
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Kah Poh Loh
- James P. Wilmot Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Heidi D. Klepin
- Section on Hematology and Oncology, Wake Forest Baptist Health, Winston-Salem, NC
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Sekeres MA, Guyatt G, Abel G, Alibhai S, Altman JK, Buckstein R, Choe H, Desai P, Erba H, Hourigan CS, LeBlanc TW, Litzow M, MacEachern J, Michaelis LC, Mukherjee S, O'Dwyer K, Rosko A, Stone R, Agarwal A, Colunga-Lozano LE, Chang Y, Hao Q, Brignardello-Petersen R. American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults. Blood Adv 2020; 4:3528-3549. [PMID: 32761235 PMCID: PMC7422124 DOI: 10.1182/bloodadvances.2020001920] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/08/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Older adults with acute myeloid leukemia (AML) represent a vulnerable population in whom disease-based and clinical risk factors, patient goals, prognosis, and practitioner- and patient-perceived treatment risks and benefits influence treatment recommendations. OBJECTIVE These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about management of AML in older adults. METHODS ASH formed a multidisciplinary guideline panel that included specialists in myeloid leukemia, geriatric oncology, patient-reported outcomes and decision-making, frailty, epidemiology, and methodology, as well as patients. The McMaster Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline-development process, including performing systematic evidence reviews (up to 24 May 2019). The panel prioritized clinical questions and outcomes according to their importance to patients, as judged by the panel. The panel used the GRADE approach, including GRADE's Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. RESULTS The panel agreed on 6 critical questions in managing older adults with AML, mirroring real-time practitioner-patient conversations: the decision to pursue antileukemic treatment vs best supportive management, the intensity of therapy, the role and duration of postremission therapy, combination vs monotherapy for induction and beyond, duration of less-intensive therapy, and the role of transfusion support for patients no longer receiving antileukemic therapy. CONCLUSIONS Treatment is recommended over best supportive management. More-intensive therapy is recommended over less-intensive therapy when deemed tolerable. However, these recommendations are guided by the principle that throughout a patient's disease course, optimal care involves ongoing discussions between clinicians and patients, continuously addressing goals of care and the relative risk-benefit balance of treatment.
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Affiliation(s)
- Mikkael A Sekeres
- Leukemia Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Gregory Abel
- Leukemia Division, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Shabbir Alibhai
- Institute of Medical Sciences, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica K Altman
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Rena Buckstein
- Odette Cancer Centre, Division of Medical Oncology and Hematology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Hannah Choe
- Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Pinkal Desai
- Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY
| | - Harry Erba
- Department of Medicine, School of Medicine, Duke University, Durham, NC
| | | | - Thomas W LeBlanc
- Department of Medicine, School of Medicine, Duke University, Durham, NC
| | - Mark Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | - Laura C Michaelis
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Sudipto Mukherjee
- Leukemia Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Kristen O'Dwyer
- Division of Hematology/Oncology, Department of Medicine, University of Rochester, Rochester, NY
| | - Ashley Rosko
- Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Richard Stone
- Leukemia Division, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Arnav Agarwal
- Department of Internal Medicine, University of Toronto, Toronto, ON, Canada
| | - L E Colunga-Lozano
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Health Science Center, Department of Clinical Medicine, Universidad de Guadalajara, Guadalajara, Mexico; and
| | - Yaping Chang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - QiuKui Hao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
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7
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Loh KP, Xu H, Back A, Duberstein PR, Gupta Mohile S, Epstein R, McHugh C, Klepin HD, Abel G, Lee SJ, El-Jawahri A, LeBlanc TW. Patient-hematologist discordance in perceived chance of cure in hematologic malignancies: A multicenter study. Cancer 2019; 126:1306-1314. [PMID: 31809566 DOI: 10.1002/cncr.32656] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/29/2019] [Accepted: 11/07/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Ensuring that patients with hematologic malignancies have an accurate understanding of their likelihood of cure is important for informed decision making. In a multicenter, longitudinal study, the authors examined discordance in patients' perception of their chance of cure versus that of their hematologists, whether patient-hematologist discordance changed after a consultation with a hematologist, and factors associated with persistent discordance. METHODS Before and after consultation with a hematologist, patients were asked about their perceived chance of cure (options were <10%, 10%-19%, and up to 90%-100% in 10% increments, and "do not wish to answer"). Hematologists were asked the same question after consultation. Discordance was defined as a difference in response by 2 levels. The McNemar test was used to compare changes in patient-hematologist prognostic discordance from before to after consultation. A generalized linear mixed model was used to examine associations between factors and postconsultation discordance, adjusting for clustering at the hematologist level. RESULTS A total of 209 patients and 46 hematologists from 4 sites were included in the current study. Before consultation, approximately 61% of dyads were discordant, which improved to 50% after consultation (P < .01). On multivariate analysis, lower educational level (<college vs postgraduate: odds ratio [OR], 2.24; 95% CI, 1.02-4.92), higher social support-affection subscale score (1-unit change in score: OR, 1.15; 95% CI, 1.00-1.32), and discordance before consultation (OR, 6.17; 95% CI, 2.99-12.72) were found to be significantly associated with discordance after consultation. CONCLUSIONS Patient-hematologist concordance in prognostic understanding appears to improve after a hematology consultation, but approximately one-half of patients' views of their prognoses were found to remain discordant with those of their hematologists. Interventions are needed to improve prognostic understanding among patients with hematologic malignancies.
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Affiliation(s)
- Kah Poh Loh
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Huiwen Xu
- Department of Surgery, Cancer Control, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Anthony Back
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Paul R Duberstein
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Supriya Gupta Mohile
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Ronald Epstein
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York.,Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York.,Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.,Palliative Care Program, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Colin McHugh
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York
| | - Heidi D Klepin
- Section on Hematology and Oncology, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Gregory Abel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Areej El-Jawahri
- Department of Hematology-Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Thomas W LeBlanc
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
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Rojas-Bracho L, Gulland FMD, Smith CR, Taylor B, Wells RS, Thomas PO, Bauer B, Heide-Jørgensen MP, Teilmann J, Dietz R, Balle JD, Jensen MV, Sinding MHS, Jaramillo-Legorreta A, Abel G, Read AJ, Westgate AJ, Colegrove K, Gomez F, Martz K, Rebolledo R, Ridgway S, Rowles T, van Elk CE, Boehm J, Cardenas-Hinojosa G, Constandse R, Nieto-Garcia E, Phillips W, Sabio D, Sanchez R, Sweeney J, Townsend F, Vivanco J, Vivanco JC, Walker S. A field effort to capture critically endangered vaquitas Phocoena sinus for protection from entanglement in illegal gillnets. ENDANGER SPECIES RES 2019. [DOI: 10.3354/esr00931] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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9
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DuMontier C, Murillo A, Liu M, Hshieh T, Soiffer R, Stone R, Abel G, Driver J. THE ASSOCIATION OF FUNCTION, MOOD, AND LONELINESS WITH SURVIVAL IN OLDER ADULTS WITH HEMATOLOGIC MALIGNANCIES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C DuMontier
- Division of Gerontology, Beth Israel Deaconess Medical Center and Harvard Medical School
| | | | - M Liu
- University of Arizona College of Medicine
| | - T Hshieh
- Division of Aging, Brigham and Women’s Hospital and Harvard Medical School
| | - R Soiffer
- Dana-Farber Cancer Institute and Harvard Medical School
| | - R Stone
- Dana-Farber Cancer Institute and Harvard Medical School
| | - G Abel
- Dana-Farber Cancer Institute and Harvard Medical School
| | - J Driver
- GRECC, VA Boston Healthcare System, Boston, MA, USA
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10
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Zhou Y, Abel G, Hamilton W, Pritchard-Jones K, Gross C, Walter F, Renzi C, Johnson S, McPhail S, Elliss-Brookes L, Lyratzopoulos G. Defining, Measuring and Preventing the Diagnosis of Cancer as an Emergency: A Critical Review of Current Evidence. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.45300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Many patients with cancer are diagnosed through an emergency presentation, which is associated with inferior clinical and patient-reported outcomes compared with those of patients who are diagnosed electively or through screening. Reducing the proportion of patients with cancer who are diagnosed as emergencies is, therefore, desirable; however, the optimal means of achieving this aim are uncertain owing to the involvement of different tumor, patient and health-care factors, often in combination. Methods: We searched the literature to identify all population-based studies that examined emergency presentation as a diagnosis or independent variable. Results: Most relevant evidence relates to patients with colorectal or lung cancer in a few economically developed countries, and defines emergency presentations contextually (that is, whether patients presented to emergency health-care services and/or received emergency treatment shortly before their diagnosis) as opposed to clinically (whether patients presented with life-threatening manifestations of their cancer). Consistent inequalities in the risk of emergency presentations by patient characteristics and cancer type have been described, but limited evidence is available on whether, and how, such presentations can be prevented. Evidence on patients' symptoms and health-care use before presentation as an emergency is sparse. Conclusion: In this review, we describe the extent, causes and implications of a diagnosis of cancer following an emergency presentation, and provide recommendations for public health and health-care interventions, and research efforts aimed at addressing this underresearched aspect of cancer diagnosis.
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Affiliation(s)
- Y. Zhou
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - G. Abel
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - W. Hamilton
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - K. Pritchard-Jones
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - C. Gross
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - F. Walter
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - C. Renzi
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - S. Johnson
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - S. McPhail
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - L. Elliss-Brookes
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
| | - G. Lyratzopoulos
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom
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11
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Zhou Y, Mendonca S, Abel G, Hamilton W, Walter F, Johnson S, Shelton J, Elliss-Brookes L, McPhail S, Lyratzopoulos G. Variation in 'Fast-Track' Referrals for Suspected Cancer by Patient Characteristic and Cancer Diagnosis: Evidence From 670,000 Patients With Cancers of 35 Different Sites. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.45100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: In England, 'fast-track' (also known as 'two-week wait') general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. Methods: We examined data from 669,220 patients with 35 cancers diagnosed 2006-2010 following either fast-track or nonfast track primary-to-secondary care referrals using a bespoke English dataset, the 'Routes to Diagnosis' data. We estimated the proportion of fast-track referrals by sociodemographic characteristics and cancer diagnosis and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. Results: There were large variations in the odds of fast-track referral by cancer ( P < 0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35 respectively, using rectal cancer as reference); while patients with brain cancer and leukemias least likely (adjusted odds ratios 0.05 and 0.09 respectively for brain cancer and acute myeloid leukemia). There were sex, age and deprivation differences in the odds of fast-track referral ( P < 0.013), which varied in their size and direction for patients with different cancers ( P < 0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. Conclusion: Fast-track referrals are less likely for cancers characterized by nonspecific presenting symptoms and patients belonging to low incidence demographic strata. Interventions beyond clinical guidelines for “alarm” symptoms are needed to improve diagnostic timeliness.
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Affiliation(s)
- Y. Zhou
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - S. Mendonca
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - G. Abel
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - W. Hamilton
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - F. Walter
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - S. Johnson
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - J. Shelton
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - L. Elliss-Brookes
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - S. McPhail
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
| | - G. Lyratzopoulos
- University of Cambridge, Department of Public Health and Primary Care, Cambridge, United Kingdom,
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Efficace F, Cottone F, Abel G, Niscola P, Gaidano G, Bonnetain F, Anota A, Caocci G, Cronin A, Fianchi L, Breccia M, Stauder R, Platzbecker U, Palumbo GA, Luppi M, Invernizzi R, Bergamaschi M, Borin L, Di Tucci AA, Zhang H, Sprangers M, Vignetti M, Mandelli F. Patient-reported outcomes enhance the survival prediction of traditional disease risk classifications: An international study in patients with myelodysplastic syndromes. Cancer 2017; 124:1251-1259. [PMID: 29231969 DOI: 10.1002/cncr.31193] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/03/2017] [Accepted: 11/20/2017] [Indexed: 11/12/2022]
Abstract
BACKGROUND Current prognostic systems for myelodysplastic syndromes (MDS) are based on clinical, pathologic, and laboratory indicators. The objective of the current study was to develop a new patient-centered prognostic index for patients with advanced MDS by including self-reported fatigue severity into a well-established clinical risk classification: the International Prognostic Scoring System (IPSS). METHODS A total of 469 patients with advanced (ie, IPSS intermediate-2 or high-risk) MDS were analyzed. Untreated patients (280 patients) were recruited into an international prospective cohort observational study to create the index. The index then was applied to an independent cohort including pretreated patients with MDS from the Dana-Farber Cancer Institute in Boston, Massachusetts (189 patients). At baseline, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). RESULTS A new prognostic index was developed: the FA-IPSS(h), in which FA stands for fatigue and h for higher-risk. This new risk classification enabled the authors to distinguish 3 subgroups of patients with distinct survival outcomes (ie, risk-1, risk-2, and risk-3). Patients classified as FA-IPSS(h) risk-1 had a median overall survival (OS) of 23 months (95% confidence interval [95% CI], 19-29 months), whereas those with risk-2 had a median OS of 16 months (95% CI, 12-17 months) and those with risk-3 had a median OS of 10 months (95% CI, 4-13 months). The predictive accuracy of this new index was higher than that of the IPSS alone in both the development cohort as well as in the independent cohort including pretreated patients. CONCLUSIONS The FA-IPSS(h) is a novel patient-centered prognostic index that includes patients' self-reported fatigue severity. The authors believe its use might enhance physicians' ability to predict survival more accurately in patients with advanced MDS. Cancer 2018;124:1251-9. © 2017 American Cancer Society.
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Affiliation(s)
- Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Francesco Cottone
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Gregory Abel
- Division of Population Sciences, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.,Platform Quality of Life and Cancer, INSERM 1098, University of Franche-Comté, Besançon, France
| | - Amelie Anota
- Methodology and Quality of Life in Oncology Unit, University Hospital of Besançon, Besançon, France.,Platform Quality of Life and Cancer, INSERM 1098, University of Franche-Comté, Besançon, France
| | - Giovanni Caocci
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Angel Cronin
- Division of Population Sciences, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Luana Fianchi
- Institute of Hematology, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Breccia
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Reinhard Stauder
- Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
| | - Uwe Platzbecker
- Department of Medicine I, University Hospital Dresden Carl Gustav Carus, Dresden, Germany
| | | | - Mario Luppi
- Department of Hematology, University of Modena, Modena, Italy
| | - Rosangela Invernizzi
- Department of Internal Medicine, University of Pavia, San Matteo IRCCS Policlinic Foundation, Pavia, Italy
| | | | - Lorenza Borin
- Department of Hematology, San Gerardo Hospital, Monza, Italy
| | - Anna Angela Di Tucci
- Hematology and Bone Marrow Transplantation Unit, Armando Businco Hospital, Cagliari, Italy
| | - Huiyong Zhang
- Department of Hematology, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Mirjam Sprangers
- Department of Medical Psychology, Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
| | - Marco Vignetti
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Franco Mandelli
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
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Paudel S, Pal P, Cove MV, Jnawali SR, Abel G, Koprowski JL, Ranabhat R. The Endangered Ganges River dolphin Platanista gangetica gangetica in Nepal: abundance, habitat and conservation threats. ENDANGER SPECIES RES 2015. [DOI: 10.3354/esr00702] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bona K, London WB, Guo D, Abel G, Lehmann L, Wolfe J. Prevalence and Impact of Financial Hardship among New England Pediatric Stem Cell Transplantation Families. Biol Blood Marrow Transplant 2015; 21:312-8. [DOI: 10.1016/j.bbmt.2014.10.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/18/2014] [Indexed: 12/16/2022]
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15
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Mujica-Mota RE, Roberts M, Abel G, Elliott M, Lyratzopoulos G, Roland M, Campbell J. Common patterns of morbidity and multi-morbidity and their impact on health-related quality of life: evidence from a national survey. Qual Life Res 2014; 24:909-18. [PMID: 25344816 PMCID: PMC4366552 DOI: 10.1007/s11136-014-0820-7] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2014] [Indexed: 12/01/2022]
Abstract
Background There is limited evidence about the impact of specific patterns of multi-morbidity on health-related quality of life (HRQoL) from large samples of adult subjects. Methods We used data from the English General Practice Patient Survey 2011–2012. We defined multi-morbidity as the presence of two or more of 12 self-reported conditions or another (unspecified) long-term health problem. We investigated differences in HRQoL (EQ-5D scores) associated with combinations of these conditions after adjusting for age, gender, ethnicity, socio-economic deprivation and the presence of a recent illness or injury. Analyses were based on 831,537 responses from patients aged 18 years or older in 8,254 primary care practices in England. Results Of respondents, 23 % reported two or more chronic conditions (ranging from 7 % of those under 45 years of age to 51 % of those 65 years or older). Multi-morbidity was more common among women, White individuals and respondents from socio-economically deprived areas. Neurological problems, mental health problems, arthritis and long-term back problem were associated with the greatest HRQoL deficits. The presence of three or more conditions was commonly associated with greater reduction in quality of life than that implied by the sum of the differences associated with the individual conditions. The decline in quality of life associated with an additional condition in people with two and three physical conditions was less for older people than for younger people. Multi-morbidity was associated with a substantially worse HRQoL in diabetes than in other long-term conditions. With the exception of neurological conditions, the presence of a comorbid mental health problem had a more adverse effect on HRQoL than any single comorbid physical condition. Conclusion Patients with multi-morbid diabetes, arthritis, neurological, or long-term mental health problems have significantly lower quality of life than other people. People with long-term health conditions require integrated mental and physical healthcare services. Electronic supplementary material The online version of this article (doi:10.1007/s11136-014-0820-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R E Mujica-Mota
- Institute of Health Research, University of Exeter Medical School, Salmon Pool Lane, Exeter, EX2 4SG, UK,
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16
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Efficace F, Baccarani M, Breccia M, Saussele S, Abel G, Caocci G, Guilhot F, Cocks K, Naeem A, Sprangers M, Oerlemans S, Chie W, Castagnetti F, Bombaci F, Sharf G, Cardoni A, Noens L, Pallua S, Salvucci M, Nicolatou-Galitis O, Rosti G, Mandelli F. International development of an EORTC questionnaire for assessing health-related quality of life in chronic myeloid leukemia patients: the EORTC QLQ-CML24. Qual Life Res 2013; 23:825-36. [PMID: 24026634 DOI: 10.1007/s11136-013-0523-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND Health-related quality of life (HRQOL) is a key aspect for chronic myeloid leukemia (CML) patients. The aim of this study was to develop a disease-specific HRQOL questionnaire for patients with CML to supplement the European Organization for Research and Treatment of Cancer (EORTC)-QLQ C30. PATIENTS AND METHODS The process followed a predefined and systematic stepwise iterative process as defined by the EORTC guidelines for questionnaire development. The process was divided into 3 phases: (1) generation of relevant HRQOL issues, (2) operationalization of the HRQOL issues into a set of items, and (3) pretesting the questionnaire for relevance and acceptability. Descriptive statistics and psychometric analyses were also performed. RESULTS Overall, 655 CML patients were enrolled in 10 countries including the USA and countries in Europe and Asia. Interviews with health-care professionals experienced in CML (n = 59) were also conducted. Results from the interviews, clinical experiences, and statistical analyses were used to develop the EORTC QLQ-CML24. The final module consists of 24 items assessing the following aspects: symptom burden, impact on daily life and on worry/mood, body image problems, and satisfaction with care and with social life. Internal consistency, assessed with Cronbach's alpha coefficients, ranged from 0.73 to 0.83 for the proposed scales. CONCLUSION The EORTC QLQ-CML24 is an internationally developed HRQOL questionnaire for CML patients, and its implementation in clinical research and practice can provide important information to facilitate clinical decision-making.
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Affiliation(s)
- Fabio Efficace
- Italian Group for Adult Hematologic Diseases GIMEMA, Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161, Rome, Italy,
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Schönbichler SA, Bittner LKH, Pallua JD, Popp M, Abel G, Bonn GK, Huck CW. Simultaneous quantification of verbenalin and verbascoside in Verbena officinalis by ATR-IR and NIR spectroscopy. J Pharm Biomed Anal 2013; 84:97-102. [PMID: 23810849 DOI: 10.1016/j.jpba.2013.04.038] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [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: 11/19/2012] [Revised: 04/28/2013] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
Abstract
Attenuated-total-reflectance infrared spectroscopy (ATR-IR) and near-infrared diffuse reflectance spectroscopy (NIR) in hyphenation with multivariate analysis was utilized to quantify verbenalin and verbascoside in Verbena officinalis. A new high performance liquid chromatography (HPLC) method as a reference was established and validated. For both vibrational spectroscopic methods test-set and cross validation were performed. Different data-pre-treatments like SNV, 1st and 2nd derivative were applied to remove systematic errors and were evaluated. Quality parameters obtained for the test-set validation revealed that ATR-IR (verbenalin: R(2)=0.94, RPD=4.23; verbascoside: R(2)=0.93, RPD=3.63) has advantages over NIR (verbenalin: R(2)=0.91, RPD=3.75; verbascoside: R(2)=0.80, RPD=2.35) in the given application.
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Affiliation(s)
- S A Schönbichler
- Institute of Analytical Chemistry and Radiochemistry, Leopold-Franzens University, CCB Center for Chemistry and Biomedicine, Innrain 80-82, 6020 Innsbruck, Austria
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18
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D. Pallua J, Pezzei C, Huck-Pezzei V, A. Schonbichler S, K. Bittner L, K. Bonn G, Saeed A, Majeed S, Farooq A, Najam-ul-Haq M, Abel G, Popp M, W. Huck C. Advances of Infrared Spectroscopic Imaging and Mapping Technologies of Plant Material. ACTA ACUST UNITED AC 2011. [DOI: 10.2174/157340711796011179] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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19
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Kasemsook S, Stecher G, Fuchsberger C, Abel G, Popp M, Bonn GK. Use of Chromatographic (SPE-HPLC) and Spectrophotometric Methods for Differentiation of Salix Species Through Correlation Analysis and FreeViz Projection. Comb Chem High Throughput Screen 2010:BSP/CCHTS/E- Pub/00133. [PMID: 21118078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 10/27/2010] [Indexed: 05/30/2023]
Abstract
The major concern of the present article is research into the combination of analytical assessment and multi-correlative data interpretation. For this purpose, a high performance liquid chromatography (HPLC) procedure was developed for the simultaneous quantification of salicin, salicylalcohol derivatives, phenolic acids, flavonoids, and monomeric catechins after solid phase extraction (SPE). On the basis of an established and validated HPLC method, 49 different Salix samples were extracted, purified, and analysed. Furthermore, the quantity of total polyphenols (Folin-Ciocalteau colorimetric reaction) and the antioxidant activity (DPPH radical scavenging activity test) were determined and correlated. This yielded correlation coefficients at P-values less than 0.05 of 0.775, 0.967, 0.932, and 0.989 for Salix fragilis, Salix rubens, Salix purpurea (2006), and Salix purpurea (2007), respectively. Correlation with mean values of each species between total polyphenols content and % DPPH inhibition values occurred at a correlation coefficient (r) of 0.851. Linear correlations of quantified HPLC data with DPPH data and with total polyphenols content could also be found for salicin, gentisic acid, naringin, and salicylic acid. Finally, by combining HPLC data with total polyphenols content and antioxidant capacity through 3-D scatter plots and FreeViz data projection, it was shown that primarily the amount of epicatechin and saligenin beside DPPH values and total polyphenols content enable the classification into plant species and further by year of harvest.
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Affiliation(s)
- S Kasemsook
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innrain 52a, 6020 Innsbruck, Austria.
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Müller KC, Waschki B, Paasch K, Feindt B, Schaper M, Sack AL, Loppow D, Abel G, Magnussen H, Watz H, Holz O. Endotheliale Vorläuferzellen bei Patienten mit COPD unterschiedlichen Schweregrades. Pneumologie 2010. [DOI: 10.1055/s-0030-1251208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Müller KC, Waschki B, Paasch K, Feindt B, Schaper M, Sack AL, Loppow D, Abel G, Magnussen H, Watz H, Holz O. Endotheliale Vorläuferzellen bei Patienten mit COPD – methodische Aspekte. Pneumologie 2010. [DOI: 10.1055/s-0029-1247938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hostanska K, Jürgenliemk G, Nahrstedt A, Abel G, Saller R. Assalix®, a willow bark extract induces apoptosis in cyclooxygenase-2 proficient and deficient human colon and lung cancer cell lines. Eur J Integr Med 2008. [DOI: 10.1016/j.eujim.2008.08.089] [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]
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24
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Roy F, Abel G, Terreault B, Reguer A, Meunier JL, Bolduc M, Ross GG. Online system for temperature and accumulated dose control in plasma-based ion implantation. Rev Sci Instrum 2007; 78:023905. [PMID: 17578121 DOI: 10.1063/1.2472601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Surface treatment optimization requires the control of the ion dose and the workpiece temperature, two parameters that are not trivially measurable in plasma-based ion implantation. A temperature and ion fluence monitoring system has been developed and implemented in a plasma-based ion implanter. It is based on the measurement with a thermopile of the radiation emitted from the back face of a thin copper disk inserted in the stainless steel sample holder. Since the incident ions carry practically all the incident power, the measurement of the Cu disk temperature that increases during implantation can provide an evaluation of the ion fluence in real time. A model has been developed for the deconvolution of the temperature data and has been fitted to the temperature behavior during implantation. A good agreement between the total integrated doses, evaluated with Rutherford backscattering spectroscopy characterization, and the ion fluence calculated by means of this model has been obtained with a discrepancy less than 16%.
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Affiliation(s)
- F Roy
- INRS-Energie, Materiaux et Telecommunications, Université du Quebec, 1650 Boulevard Lionel-Boulet, Varennes, Quebec J3X 1S2, Canada
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Huck CW, Abel G, Popp M, Bonn GK. Comparative analysis of naphthodianthrone and phloroglucine derivatives in St. John's Wort extracts by near infrared spectroscopy, high-performance liquid chromatography and capillary electrophoresis. Anal Chim Acta 2006; 580:223-30. [PMID: 17723777 DOI: 10.1016/j.aca.2006.07.062] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2006] [Revised: 07/22/2006] [Accepted: 07/25/2006] [Indexed: 11/24/2022]
Abstract
A near infrared spectroscopic (NIRS) method is established for quantitative determination of naphthodianthrones and phloroglucine derivatives in St. John's Wort extracts. The validated NIRS method is compared with optimised liquid chromatography (LC) and capillary electrophoresis (CE), applying UV as a detection tool. Optimisation of stationary and mobile phase conditions in reversed-phase liquid chromatography (RP-LC) allow separating the derivatives of interest with high peak symmetry and robustness. Elution takes 15 and 25 min on non-porous or porous silica C18 with different porosities, respectively. Capillary electrophoresis (CE) is used for cross-validation of RP-LC. CE enables baseline separation of hypericine and pseudohypericine in less than 2min, but is ten times less sensitive. The validated RP-LC is chosen as a reference method for calibration of the NIRS-system. Analysis of 80 St. John's Wort extracts (320 NIR spectra) and the subsequent chemometric calculations of the best regression model show that NIRS is suitable for analysis of hypericine, pseudohypericine and hyperforine. RP-LC or CE must be employed for the other remaining lower concentrated naphthodianthrone and phloroglucine derivatives. Hypericine and hyperforine are analysed via NIRS with a standard error of estimation (SEE) of 0.52 and 0.50 microg mL(-1) and standard error of prediction (SEP) of 0.64 and 0.71 microg mL(-1) within few seconds. The current study demonstrates the suitability of NIRS as an alternative to LC and CE for St. John's Wort producing phytopharmaceutical industry. The short analysis time of few seconds' assures high sample throughput in routine analysis.
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Affiliation(s)
- C W Huck
- Institute of Analytical Chemistry and Radiochemistry, Leopold-Franzens University, Innrain 52a, 6020-Innsbruck, Austria.
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Affiliation(s)
- E Chargaff
- The Institute of Hygiene, University of Berlin
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Hoy C, Kite P, Abel G, Eastwood K, Sugden S, Puntis J. Quantitative surveillance blood culture in the management of catheter related bloodstream infection. J Infect 2002. [DOI: 10.1016/s0163-4453(02)90355-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Gastrostomy feeding is a well established alternative method to long term nasogastric tube feeding. Many such patients have gastro-oesophageal reflux (GOR) and require a fundoplication. A transgastric jejunal tube is an alternative when antireflux surgery fails, or is hazardous or inappropriate. AIMS To review experience of gastrojejunal (G-J) feeding over six years in two regional centres in the UK. METHODS Retrospective review of all children who underwent insertion of a G-J feeding tube. RESULTS There were 18 children, 12 of whom were neurologically impaired. G-J tubes were inserted at a median age of 3.1 years (range 0.6-14.7) because of persistent symptoms after Nissen fundoplication (n = 8) or symptomatic GOR where fundoplication was inappropriate. Four underwent primary endoscopic insertion of the G-J tube; the remainder had the tube inserted via a previous gastrostomy track. Seventeen showed good weight gain. There was one insertion related complication. During a median follow up of 10 months (range 1-60), four experienced recurrent aspiration, bilious aspirates, and/or diarrhoea. There were 65 tube related complications in 14 patients, necessitating change of the tube at a median of 74 days. Jejunal tube migration was the commonest problem. Five died from complications of their underlying disease. CONCLUSIONS Although G-J feeding tubes were inserted safely and improved nutritional status, their use was associated with a high rate of morbidity. Surgical alternatives such as an Roux-en-Y jejunostomy may be preferable.
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Affiliation(s)
- P Godbole
- Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Sacco RL, Boden-Albala B, Abel G, Lin IF, Elkind M, Hauser WA, Paik MC, Shea S. Race-ethnic disparities in the impact of stroke risk factors: the northern Manhattan stroke study. Stroke 2001; 32:1725-31. [PMID: 11486097 DOI: 10.1161/01.str.32.8.1725] [Citation(s) in RCA: 239] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Stroke risk factors have been determined in large part through epidemiological studies in white cohorts; as a result, race-ethnic disparities in stroke incidence and mortality rates remained unexplained. The aim in the present study was to compare the prevalence, OR, and etiological fraction (EF) of stroke risk factors among white, blacks, and Caribbean Hispanics living in the same urban community of northern Manhattan. METHODS In this population-based incident case-control study, cases (n=688) of first ischemic stroke were prospectively matched 1:2 by age, sex, and race-ethnicity with community controls (n=1156). Risk factors were determined through in-person assessment. Conditional logistic regression was used to calculate adjusted ORs in each race-ethnic group. Prevalence and multivariate EFs were determined in each race-ethnic group. RESULTS Hypertension was an independent risk factor for whites (OR 1.8, EF 25%), blacks (OR 2.0, EF 37%), and Caribbean Hispanics (OR 2.1, EF 32%), but greater prevalence led to elevated EFs among blacks and Caribbean Hispanics. Greater prevalence rates of diabetes increased stroke risk in blacks (OR 1.8, EF 14%) and Caribbean Hispanics (OR 2.1 P<0.05, EF 10%) compared with whites (OR 1.0, EF 0%), whereas atrial fibrillation had a greater prevalence and EF for whites (OR 4.4, EF 20%) compared with blacks (OR 1.7, EF 3%) and Caribbean Hispanics (OR 3.0, EF 2%). Coronary artery disease was most important for whites (OR 1.3, EF 16%), followed by Caribbean Hispanics (OR 1.5, EF 6%) and then blacks (OR 1.1, EF 2%). Prevalence of physical inactivity was greater in Caribbean Hispanics, but an elevated EF was found in all groups. CONCLUSIONS The prevalence, OR, and EF for stroke risk factors vary by race-ethnicity. These differences are crucial to the etiology of stroke, as well as to the design and implementation of stroke prevention programs.
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Affiliation(s)
- R L Sacco
- Columbia University College of Physicians and Surgeons and School of Public Health, New York, NY, USA
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Abstract
OBJECTIVE Assess differences in personal circumstances, risk exposure and risk-taking among female sex workers in different sectors of the New Zealand sex industry in regard to issues of sexual safety, drug use, violence and coercion. METHOD A cross-sectional survey of 303 female sex workers was carried out in Christchurch, New Zealand, May-September 1999. RESULTS There was evidence of 'segmentation': street workers were younger, had started work at a younger age and had less education than indoor workers. More street than indoor workers used money from sex work for drugs and used drugs at work. There was a high level of condom use but little 'negotiation' about them with clients. High levels of violent experiences were reported, but street workers reported more, and more extreme forms of, violence than indoor workers. IMPLICATIONS Although knowledge of condom use and sexual safety appears generally high and women in both sectors report taking the initiative for safer sex, drug use, violence and coercion remain of concern. While sexual safety will need ongoing health promotion and education interventions to support and ensure the uptake of safer sex practice by new workers and prevent any relapse by more experienced workers, issues of violence and coercion also require attention to the power relationships between individuals. Legislation and policy directed at these issues should encourage the control women can exert over their work practice. Reducing exposure to personal risk may require different measures in different sectors.
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Affiliation(s)
- L Plumridge
- Department of Public Health and General Practice, Christchurch School of Medicine, New Zealand.
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Holz O, Böttcher M, Timm P, Koschyk S, Abel G, Gercken G, Magnussen H, Jörres RA. Flow cytometric analysis of lymphocyte subpopulations in bronchoalveolar lavage fluid after repeated ozone exposure. Int Arch Occup Environ Health 2001; 74:242-8. [PMID: 11401015 DOI: 10.1007/s004200000216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
As known from studies in animal and human subjects, ozone can exert effects on the immune response including allergic sensitisation and allergen responsiveness. The objective of the present study was to assess the changes in lymphocyte subsets in bronchoalveolar lavage fluid (BALF) after single and repeated ozone exposures. Twenty-three healthy subjects underwent single exposures to 200 ppb ozone or filtered air (FA), as well as repeated exposures to 200 ppb ozone on four consecutive days, each during 4 h of intermittent exercise. Bronchoalveolar lavage was performed 20 h after the single exposure or the last of the repeated exposures. Lymphocytes were identified by sideward scatter and CD45 expression, and their subsets by eight different panels of antibodies. Checksums were calculated to assess the validity of the results. The percentage and the absolute number of lymphocytes, mostly comprising T-lymphocytes (CD2+; overall mean 98.8%), increased after single (P < 0.05; each), but not after repeated ozone exposure, compared with FA (7.4 vs 5.8 vs 6.5%; 680 vs 419 vs 301 x 10(3)). In addition, we observed small but statistically significant changes in the proportions of lymphocyte subpopulations. The percentage of CD4+ lymphocytes increased after single (P < 0.05) and repeated ozone exposure (P < 0.01), whereas the percentage of CD8+ cells decreased after repeated exposure (P < 0.05). The proportion of activated lymphocytes (CD25+) was elevated after repeated, compared with single, ozone exposure (P < 0.01), and the percentages of natural killer (NK) cells were decreased after both single (P < 0.05) and repeated (P < 0.01) exposures. Our data suggest that single but not repeated ozone exposures cause a change in absolute numbers of lymphocytes in BALF, whereas the proportions of lymphocyte subsets are affected by single as well as repeated exposures.
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Affiliation(s)
- O Holz
- Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Germany.
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32
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Plumridge L, Abel G. Services and information utilised by female sex workers for sexual and physical safety. N Z Med J 2000; 113:370-2. [PMID: 11050900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
AIMS To examine services utilised by female sex workers in Christchurch for sexual and physical safety. METHOD Estimates were made of the sex worker population in Christchurch before conducting a cross-sectional survey. RESULTS 303 women responded. Almost all went for sexual health check-ups. Most (251) had a general practitioner, but only about half disclosed they were sex workers. Of the 135 women who used their own general practitioner for sexual health checks, 62% disclosed they were sex workers. In general, the women relied upon informal networks for information and advice, but the peer organisation of New Zealand Prostitutes Collective was also important. CONCLUSION While general practitioners were used by the majority of sex workers, high levels of nondisclosure need to be understood and redressed. The preference of sex workers for informal, peer relationships should be considered in future health promotion efforts.
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Affiliation(s)
- L Plumridge
- Department of Public Health and General Practice, Christchurch School of Medicine.
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Page S, Abel G, Stringer MD, Puntis JW. Management of septicaemic infants during long-term parenteral nutrition. Int J Clin Pract 2000; 54:147-50. [PMID: 10829356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Young infants, particularly following gastrointestinal surgery, are at high risk of septicaemia during parenteral nutrition. Febrile illness in the absence of focal infection inevitably raises suspicion of central venous catheter sepsis and poses the following dilemma: remove the catheter (which may then prove uninfected) and lose venous access, or leave the catheter and risk clinical deterioration? We examined retrospectively the isolates from blood culture during febrile episodes in 13 children who received long-term (> 2 months) parenteral nutrition via a central venous catheter, and assessed the effectiveness of through-catheter antibiotic treatment during 76 episodes of blood culture positive sepsis. Coagulase-negative Staphylococci accounted for only 16% of positive isolates, with yeasts accounting for 5%, and Gram-negative organisms accounting for 46%, suggesting that infection was often associated with bacterial translocation from the gastrointestinal tract. Treatment with the central venous catheter left in situ was successful in resolving infection in 53 (70%) of septic episodes. These findings indicate that, in this specific group of patients, through-catheter antibiotic treatment is often effective in treating septicaemia. When long-term venous access is essential, this approach should be tried before recourse to central venous catheter removal.
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Affiliation(s)
- S Page
- Department of Paediatrics and Child Health, University of Leeds, UK
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Puntis JW, Thwaites R, Abel G, Stringer MD. Children with neurological disorders do not always need fundoplication concomitant with percutaneous endoscopic gastrostomy. Dev Med Child Neurol 2000; 42:97-9. [PMID: 10698326 DOI: 10.1017/s0012162200000190] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Whether antireflux surgery should be routinely performed at the time of gastrostomy in children with neurological disorders is debatable because of the risk of gastroesophageal reflux. Some argue that these children should be screened for occult gastroesophageal reflux as this will determine the need for fundoplication. This study retrospectively examines outcome in 29 children with neurological disorders who underwent percutaneous endoscopic gastrostomy (PEG) without concomitant fundoplication. Children were included if they had no clinical evidence of severe gastroesophageal reflux before PEG insertion. The median age of children at PEG insertion was 5.6 years (range 1.1 to 18.0). The children were followed for a median of 2.6 years (range 0.4 to 4.9). Insertion of PEG was technically impossible in two children; and an asymptomatic gastrocolic fistula in another child led to subsequent tube removal. Fourteen of the 26 remaining children developed symptomatic gastroesophageal reflux after PEG; five of these showed no reflux on pH monitoring prePEG. Control of symptoms was achieved by medical intervention in 12, but two required fundoplication. Our findings indicate that in the child with neurological disabilities without symptoms indicating severe gastroesophageal reflux, fundoplication is unlikely to be necessary as a consequence of PEG insertion. We conclude that routine investigation for gastroesophageal reflux in the child without severe vomiting can be avoided and the number of antireflux procedures reduced.
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Affiliation(s)
- J W Puntis
- University of Leeds, The General Infirmary at Leeds, Neonatal Unit, UK.
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Agnello V, Abel G, Elfahal M, Knight GB, Zhang QX. Hepatitis C virus and other flaviviridae viruses enter cells via low density lipoprotein receptor. Proc Natl Acad Sci U S A 1999; 96:12766-71. [PMID: 10535997 PMCID: PMC23090 DOI: 10.1073/pnas.96.22.12766] [Citation(s) in RCA: 688] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Endocytosis of the Flaviviridae viruses, hepatitis C virus, GB virus C/hepatitis G virus, and bovine viral diarrheal virus (BVDV) was shown to be mediated by low density lipoprotein (LDL) receptors on cultured cells by several lines of evidence: by the demonstration that endocytosis of these virus correlated with LDL receptor activity, by complete inhibition of detectable endocytosis by anti-LDL receptor antibody, by inhibition with anti-apolipoprotein E and -apolipoprotein B antibodies, by chemical methods abrogating lipoprotein/LDL receptor interactions, and by inhibition with the endocytosis inhibitor phenylarsine oxide. Confirmatory evidence was provided by the lack of detectable LDL receptor on cells known to be resistant to BVDV infection. Endocytosis via the LDL receptor was shown to be mediated by complexing of the virus to very low density lipoprotein or LDL but not high density lipoprotein. Studies using LDL receptor-deficient cells or a cytolytic BVDV system indicated that the LDL receptor may be the main but not exclusive means of cell entry of these viruses. Studies on other types of viruses indicated that this mechanism may not be exclusive to Flaviviridae but may be used by viruses that associate with lipoprotein in the blood. These findings provide evidence that the family of LDL receptors may serve as viral receptors.
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Affiliation(s)
- V Agnello
- Lahey Clinic Medical Center, Department of Laboratory Medicine, Burlington, MA 01805, USA.
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Liu F, Knight GB, Abel G, Agnello V. A competitive reverse transcription-polymerase chain reaction assay for quantitation of GB virus C/hepatitis G virus RNA that circumvents heteroduplex artifact. J Virol Methods 1999; 79:149-59. [PMID: 10381085 DOI: 10.1016/s0166-0934(99)00007-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The role of GB virus C (GBV-C)/hepatitis G virus (HGV) in hepatitis has been controversial. To investigate its possible pathogenicity and site(s) of replication, it is important to develop an accurate quantitative assay for both positive and negative strand GBV-C/HGV RNA. In this study, a competitive reverse transcription-polymerase chain reaction (RT-PCR) assay for both positive and negative strand GBV-C/HGV RNA quantitation was developed. In developing the quantitative assay, heteroduplex formation was repeatedly observed. A heterologous competitor RNA with GBV-C/HGV primer-binding sequences was introduced, and heteroduplex artifact was circumvented successfully. Two-hundred thirty-seven serum specimens were screened by RT-PCR for GBV-C/HGV RNA. Two of the 62 patients infected with chronic hepatitis C virus (HCV) were found to be positive for GBV-C/HGV RNA. None of the 50 other patients with no evidence of HCV infection and none of the 125 normal individuals were positive for GBV-C/HGV RNA. The sensitivity of RT-PCR was 3000 gE/ml (30 gE in RT-PCR). Alternate methods for residual DNA removal and its detection in synthetic RNA were introduced. A RT control containing no primer before PCR is necessary to evaluate the trace amounts of template DNA remaining in synthesized RNA. The method will differentiate reliably between positive and negative strand RNAs up to a 10(4)-fold difference in titer. The positive and negative strand GBV-C/HGV RNAs were detected in one patient by RT-PCR and hybridization analysis, and the strand titer was determined by RT-PCR.
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Affiliation(s)
- F Liu
- Department of Laboratory Medicine, Lahey Clinic Medical Center, Burlington, MA 01805, USA
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Abstract
BACKGROUND/PURPOSE The longer-term sequelae of short bowel syndrome in infancy are reasonably well documented, but little is known about the long-term nutritional and metabolic effects of limited (less than 50 cm) ileal resection. This makes it difficult to formulate a rational follow-up policy in such children. METHODS All children who underwent limited ileal resection for either necrotizing enterocolitis (NEC) or intussusception at our institution between 1984 and 1992 were invited to attend a detailed clinical, anthropometric, hematologic, and biochemical assessment, together with a biliary and renal ultrasound scan and measurement of bone mineral density. RESULTS Twenty-four children (NEC, 17; intussusception, 7) of median age 7.4 years (range, 5.5 to 13.7 years) agreed to participate. Nine previously had undergone an isolated ileal resection, and 15 also had had variable lengths of colon removed. The length of resected ileum ranged from 3 to 44 cm, with a median of 10 cm. Seven control subjects in whom neonatal NEC developed but recovered without surgery were also evaluated. Median height, weight, and body mass index after ileal resection were between the 25th and 50th percentiles; no child was stunted or wasted. After ileal resection, one boy was found to have asymptomatic vitamin B12 deficiency, and three children had low plasma concentrations of vitamin A. Hematologic and biochemical parameters were otherwise normal apart from a few marginally low trace element levels in both subjects and controls. No renal calculi were detected, and bone mineral density measurements were normal in all except one child. Four children had cholelithiasis, all of whom had previously undergone limited ileal resection for NEC (two isolated, two ileocolic). Thus, the prevalence of cholelithasis after limited ileal resection for NEC was 24% at a median age of 7.0 years. CONCLUSIONS Growth and nutritional status are well preserved after limited ileal resection in infancy. Limited ileal resection for NEC is associated with a subsequent high prevalence of cholelithiasis and a risk of vitamin B12 deficiency. These findings are important when planning strategies for long-term follow-up.
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Affiliation(s)
- B W Davies
- Department of Paediatric Surgery, Leeds Teaching Hospitals Trust and Centre for Bone and Body Composition Research, University of Leeds, England
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Affiliation(s)
- A Cade
- Academic Unit of Paediatrics and Child Health, The University of Leeds, United Kingdom
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Abstract
The controversial question of the extent of hepatocyte infection in chronic hepatitis C was re-examined in both chimpanzees and humans using a newly modified in situ hybridization (ISH) method for detecting hepatitis C virus (HCV) RNA. The specificity of the methodology for distinguishing positive- and negative-strand synthetic HCV RNA was at least six magnitudes greater than the reverse-transcription polymerase chain reaction (RT-PCR) assay for HCV. The sensitivity of the methodology as determined by cell culture assay was 14 +/- 2 genomic equivalents (gE) of HCV positive strand per cell, which was three magnitudes less sensitive than RT-PCR quantitation of HCV. In contrast to previous studies in both humans and chimpanzees with chronic hepatitis C, a high percentage of hepatocytes positive for both positive- and negative-strand HCV RNA was found in most specimens studied. In humans, the extent of hepatocyte infection varied with histological activity index (HAI). In the two chimpanzees studied, the liver biopsies showed minimal histological disease activity, but high percentages of hepatocytes were HCV-positive by ISH that correlated with hepatocyte ultrastructural changes associated with HCV infection. Hepatocyte infection was confirmed by RNA extraction and RT-PCR techniques for detecting HCV RNA that minimize the false detection of negative strands. In both human and chimpanzee liver biopsies showing minimal HAI, the hepatocyte concentration of HCV was estimated to be very low. These findings suggested the hypothesis that persistent infection in the liver may be caused in part by low-level HCV replication. The theoretical and clinical implications of these findings are discussed.
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Affiliation(s)
- V Agnello
- Department of Laboratory Medicine, Lahey Clinic Medical Center, Burlington, MA 01805, USA
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Agnello V, Abel G. Localization of hepatitis C virus in cutaneous vasculitic lesions in patients with type II cryoglobulinemia. Arthritis Rheum 1997; 40:2007-15. [PMID: 9365090 DOI: 10.1002/art.1780401113] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the role of hepatitis C virus (HCV) in the pathogenesis of the cutaneous vasculitis in patients with type II cryoglobulinemia. METHODS Using in situ hybridization detection of HCV, we studied 6 test patients and various control subjects. Serum HCV was quantitated, cryoglobulins were analyzed by column chromatography at 37 degrees C, and low-density lipoprotein (LDL) receptors on keratinocytes were detected using LDL labeled with fluorescent dye. RESULTS In the cutaneous vasculitic lesions from test patients, but not control subjects, the HCV virion was found in association with IgM and IgG. HCV alone was detected in some vessel walls, and in skin and ductal epithelium and vascular endothelium in inflamed, but not normal, skin. Cryoglobulins showed HCV, monomeric IgM, and monomeric IgG, with little or no immune complexes. The extent of the lesions correlated with levels of viremia. Up-regulation of LDL receptors on keratinocytes was detected in inflamed, but not normal, skin. CONCLUSION HCV was present in the cutaneous vasculitic lesions, most likely in complexes with IgM and IgG formed in situ. These findings and the correlation of the severity of the rash with the level of viremia suggest that HCV plays a major role in the pathogenesis of cutaneous vasculitis in these patients and strengthens the rationale for antiviral drug therapy. The presence of HCV in keratinocytes and ductal epithelial and vascular endothelial cells may be the in vivo manifestation of endocytosis of HCV by the LDL receptors that has recently been demonstrated in vitro. The up-regulation of LDL receptors on keratinocytes in inflamed skin is consistent with this postulation.
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Affiliation(s)
- V Agnello
- Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA
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Agnello V, Zhang QX, Abel G, Knight GB. The association of hepatitis C virus infection with monoclonal rheumatoid factors bearing the WA cross-idiotype: implications for the etiopathogenesis and therapy of mixed cryoglobulinemia. Clin Exp Rheumatol 1995; 13 Suppl 13:S101-4. [PMID: 8730487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine the prevalence of monoclonal rheumatoid factors (mRF) bearing the WA cross-idiotype (WA XId) in hepatitis C virus (HCV) positive type II mixed cryoglobulins, to review recent studies on the role of HCV in the cutaneous vasculitis lesions in patients with type II cryoglobulinemia and to discuss the implication of these studies for the etiopathogenesis and therapy of the disease. METHODS Thirty type II cryoglobulins were tested for WA and PO XId and for HCV RNA: RESULTS WA mRF were strongly, although not exclusively, associated with HCV in type II mixed cryoglobulinemia. CONCLUSION These and other recent studies from our laboratory suggest that chronic HCV infection may be the stimulus for the production of WA mRF and that HCV may be directly involved in the pathogenesis of the cutaneous vasculitis in patients with type II cryoglobulinemia. The association of HCV infection with the disease provides a rationale for anti-viral therapy and for monitoring therapy by measuring the HCV level in both blood and liver.
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Affiliation(s)
- V Agnello
- Lahey Hitchcock Medical Center, Burlington MA 01805, USA
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Görlach J, Raesecke HR, Abel G, Wehrli R, Amrhein N, Schmid J. Organ-specific differences in the ratio of alternatively spliced chorismate synthase (LeCS2) transcripts in tomato. Plant J 1995; 8:451-6. [PMID: 7550381 DOI: 10.1046/j.1365-313x.1995.08030451.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The primary transcript of one of the two chorismate synthase genes (LeCS2) of tomato is differentially processed due to an alternative splicing of the third intron. A novel observation was made when the abundances of the two LeCS2-specific transcripts in different organs were analysed. The ratio of these two transcripts differs in RNA populations from different organs. Possible explanations for this finding and its potential physiological impact for plant metabolism are discussed.
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Affiliation(s)
- J Görlach
- Institute of Plant Sciences, Swiss Federal Institute of Technology, Zürich
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Raman R, Martin F, Quirion B, St-Onge M, Lachambre JL, Michaud D, Sawatzky B, Thomas J, Hirose A, Hwang D, Richard N, Côté C, Abel G, Pinsonneault D, Gauvreau JL, Stansfield B, Décoste R, Côté A, Zuzak W, Boucher C. Experimental demonstration of nondisruptive, central fueling of a tokamak by compact toroid injection. Phys Rev Lett 1994; 73:3101-3104. [PMID: 10057288 DOI: 10.1103/physrevlett.73.3101] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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McKeage MJ, Abel G, Kelland LR, Harrap KR. Mechanism of action of an orally administered platinum complex [ammine bis butyrato cyclohexylamine dichloroplatinum (IV) (JM221)] in intrinsically cisplatin-resistant human ovarian carcinoma in vitro. Br J Cancer 1994; 69:1-7. [PMID: 8286188 PMCID: PMC1968778 DOI: 10.1038/bjc.1994.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Intrinsic resistance to existing clinical platinum drugs is a major cause of treatment failure; moreover, these agents have the drawbacks of cross-resistance and intravenous administration. The mechanism of intrinsic cisplatin resistance and the mechanism of circumvention of intrinsic resistance by a member (JM221) of the ammine/amine platinum (IV) dicarboxylate class of platinum complex was studied in intrinsically resistant (SKOV-3) and sensitive (41M) human ovarian carcinoma cell lines. JM221 reduced the cisplatin resistance factor nine- to 2.7-fold, was more potent than cisplatin and showed marked time-dependent cytotoxicity. Cellular platinum accumulation was 20- to 40-fold greater (P < 0.001), and DNA platination was fourfold greater (P < 0.02), immediately following 2 h equimolar exposure to JM221, compared with cisplatin. DNA platinum levels decreased following cisplatin exposure with a half-life approximating 48 h in both lines, while no net removal of DNA-bound platinum was recorded following JM221 exposure. JM221 caused DNA interstrand cross-linking, but this was 10-20% less frequent with JM221 than with cisplatin when expressed as a proportion of total DNA platinum lesions. Cisplatin DNA interstrand cross-linking was twofold greater in the intrinsically sensitive line (41M) than in the resistant line (SKOV-3) over a range of concentrations and time-points. Neither cellular platinum accumulation, levels of DNA platination nor the rate of removal of DNA-bound platinum in the two cell lines related to their ninefold difference in cisplatin sensitivity. Intrinsic cisplatin resistance appears to be attributable to the inhibition of formation of bifunctional DNA lesions, while the circumvention of intrinsic resistance by JM221 seems to be the result of both improved transport properties and circumvention of DNA repair mechanisms.
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Affiliation(s)
- M J McKeage
- Drug Development Section, Institute of Cancer Research, Sutton, Surrey, UK
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46
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Hampshaw S, Abel G, Rushworth A, Puntis J. Complications of central venous access: a suitable subject for audit. Clin Nutr 1994. [DOI: 10.1016/0261-5614(94)90269-0] [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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Jarman M, Coley HM, Judson IR, Thornton TJ, Wilman DE, Abel G, Rutty CJ. Synthesis and cytotoxicity of potential tumor-inhibitory analogues of trimelamol (2,4,6-tris[(hydroxymethyl)methylamino]-1,3,5-triazine) having electron-withdrawing groups in place of methyl. J Med Chem 1993; 36:4195-200. [PMID: 8277501 DOI: 10.1021/jm00078a008] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In exploring the structural features which determine the antitumor activity of 2,4,6-tris-[(hydroxymethyl)methylamino]-1,3,5-triazine (trimelamol, 1), we have synthesized analogues in which the methyl groups have been replaced by the electron-withdrawing substituents 2,2,2-trifluoroethyl (5), propargyl (13), and cyanomethyl (15) via the respective tris(alkylamino)triazines 3, 12, and 14. Three mono[(hydroxymethyl)amino]triazines (4, 7, and 10) were also prepared. All the new tris(hydroxymethyl) derivatives showed cytotoxicities toward a variety of experimental rodent and human ovarian tumor cell lines similar to those shown by 1, the cyanomethyl analogue (15) having the most favorable profile. Mono(hydroxymethyl) derivatives (4 and 7) were ca. one-third as toxic. The new tris(hydroxymethyl) analogues were more stable to aqueous hydrolysis than was 1. Half-life (pH 7.5) values were, for 1, 120 min, for 5, 690 min, for 13, 450 min, and for 15, 275 min, but at pH 2.0, 15 (t1/2 350 min) was the most stable. This cyanomethyl analogue was also the most water-soluble, being comparable to 1 whereas 5 and 13 were poorly soluble.
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Affiliation(s)
- M Jarman
- Drug Development Section, Institute of Cancer Research, Sutton, Surrey, U.K
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Affiliation(s)
- G Abel
- Department of Laboratory Medicine, Lahey Clinic Medical Center, Burlington, MA 01805
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Levin Y, Khare RK, Abel G, Hill D, Eriotou-Bargiota E, Becker JM, Naider F. Histidine2 of the alpha-factor of Saccharomyces cerevisiae is not essential for binding to its receptor or for biological activity. Biochemistry 1993; 32:8199-206. [PMID: 8394129 DOI: 10.1021/bi00083a021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Seven His2 analogs of the Saccharomyces cerevisiae [Nle12]alpha-factor, WXWLQLKPGQP(Nle)Y, where X = beta-D-thienylalanine, beta-L-thienylalanine, 1-D-methylhistidine, 1-L-methylhistidine, 3-D-methylhistidine, 3-L-methylhistidine, and beta-3-L-pyridylalanine, were synthesized and purified to homogeneity. Assays were carried out on binding to the alpha-factor receptor and of biological activity determined by either growth arrest or morphological changes in target cells. In the L-isomer, replacement of the imidazole of histidine by thiophene or 3-pyridyl groups or derivatization of either nitrogen of the imidazole ring by methylation resulted in a 2-100-fold decrease in bioactivity. D-Isomers of the beta-thienylalanyl-, 1-methylhistidinyl-, or 3-methylhistidinyl-alpha-factors did not possess measurable bioactivity with the exception of comparatively low activity of the 3-D-methylhistidinyl and 1-D-methylhistidinyl-alpha-factors in the morphogenesis assay. In contrast, both active and inactive analogs demonstrated binding affinities 10-20-fold less than that of [Nle12]alpha-factor. These results indicate that the histidine residue of alpha-factor is not required for binding to the receptor or for biological activity and that bioactivity and binding can be dissociated through the use of pheromone analogs.
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Affiliation(s)
- Y Levin
- Department of Chemistry, College of Staten Island, City University of New York 10301
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Kelland LR, Abel G, McKeage MJ, Jones M, Goddard PM, Valenti M, Murrer BA, Harrap KR. Preclinical antitumor evaluation of bis-acetato-ammine-dichloro-cyclohexylamine platinum(IV): an orally active platinum drug. Cancer Res 1993; 53:2581-6. [PMID: 8388318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The cytotoxicity of a novel platinum(IV) complex, bis-acetato-amminedichloro-cyclohexylamine platinum(IV) (JM216), has been evaluated in vitro against a panel of human tumor cell lines (predominantly ovarian) representative of models of intrinsic and acquired to cisplatin. In addition, the activity of JM216 administered by the p.o. route has been determined in vivo using the murine ADJ/PC6 plasmacytoma and four human ovarian carcinoma xenograft lines. In vitro, against seven human ovarian carcinoma cell lines, JM216 showed similar cytotoxicity and pattern of cytotoxicity to cisplatin (mean 50% inhibitory concentrations of 3.5 microM for cisplatin and 1.7 microM for JM216). The cytotoxicity of JM216 was more dependent on the time of drug exposure than that of cisplatin, suggesting that extended split-dosing rather than a single bolus administration might be a more appropriate schedule in patients. Using six pairs of acquired cisplatin-resistant and parent human tumor cell lines (four ovarian, one testicular, and one cervical) JM216 exhibited non-cross-resistance (resistance factor of < 1.5) in three whereas tetraplatin exhibited partial or full cross-resistance in all six pairs. Notably, in two of the acquired cisplatin-resistant lines (41McisR and HX/155cisR) where JM216 retained activity, resistance has previously shown to be due primarily to reduced platinum uptake. In vivo, following p.o. administration using the cisplatin-sensitive murine ADJ/PC6 plasmacytoma, JM216 showed antitumor selectivity far superior to that observed for either cisplatin, carboplatin, or tetraplatin. Across four human ovarian carcinoma xenografts of widely differing sensitivity to cisplatin and carboplatin, JM216 exhibited p.o. activity, broadly comparable to that observed for i.v. administered cisplatin and carboplatin and markedly superior to i.p. administered tetraplatin. These antitumor properties suggest that JM216 provides a structural lead to platinum complexes which may circumvent transport-determined acquired resistance to cisplatin and is a suitable candidate as an p.o. administrable platinum complex for phase I clinical trial.
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Affiliation(s)
- L R Kelland
- Drug Development Section, Institute of Cancer Research, Belmont, Sutton, Surrey, United Kingdom
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