1
|
Capeding TPJ, Rosa JD, Lam H, Gaviola DG, Garfin AMC, Hontiveros C, Cunnama L, Laurence YV, Kitson N, Vassall A, Sweeney S, Garcia-Baena I. Cost of TB prevention and treatment in the Philippines in 2017. Int J Tuberc Lung Dis 2022; 26:392-398. [PMID: 35505478 PMCID: PMC9067429 DOI: 10.5588/ijtld.21.0622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND: The Philippines aims to accelerate TB reduction through the provision of universally accessible and affordable services. The objectives of this paper are to estimate the costs of TB services and interventions using a health systems´ perspective, and to explore cost differences in service delivery via primary care facilities or hospitals.METHODS: Data were collected from a multi-stage stratified random sampling of 28 facilities in accordance with Global Health Cost Consortium costing standards and analysis tools. Unit costs (in US$) estimated using top-down (TD) and bottom-up (BU) approaches, are summarised following Value TB reporting standards and by broad facility type.RESULTS: Cost of delivering 32 TB services and eight interventions varied by costing method and delivery platform. Average BU costs ranged from US$0.38 for treatment support visits, US$2.5 for BCG vaccination, US$19.48 for the Xpert® MTB/RIF test to US$3,677 for MDR-TB treatment using the long regimen. Delivering TB care in hospitals was generally more costly than in primary care facilities, except for TB prevention in children and MDR-TB treatment using the long regimen.CONCLUSION: Comprehensive costing data for TB care in the Philippines are now available to aid in the design, planning, and prioritisation of delivery models to End TB.
Collapse
Affiliation(s)
- T. P. J. Capeding
- Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - J. D. Rosa
- Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - H. Lam
- Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - D. G. Gaviola
- Department of Health, National TB Control Programme, Manila, Philippines
| | - A. M. C. Garfin
- Department of Health, National TB Control Programme, Manila, Philippines
| | - C. Hontiveros
- Department of Health, National TB Control Programme, Manila, Philippines
| | - L. Cunnama
- Health Economics Unit & Health Economics Division, University of Cape Town, Cape Town, South Africa
| | - Y. V. Laurence
- Department of Global Health and Development, Centre for Health Economics in London, London School of Hygiene & Tropical Medicine, London, UK
| | - N. Kitson
- Department of Global Health and Development, Centre for Health Economics in London, London School of Hygiene & Tropical Medicine, London, UK
| | - A. Vassall
- Department of Global Health and Development, Centre for Health Economics in London, London School of Hygiene & Tropical Medicine, London, UK
| | - S. Sweeney
- Department of Global Health and Development, Centre for Health Economics in London, London School of Hygiene & Tropical Medicine, London, UK
| | - I. Garcia-Baena
- Global TB Programme, World Health Organization, Geneva, Switzerland
| |
Collapse
|
2
|
Popovic M, Rico V, DeAngelis C, Lam H, Lim FMY. Online Psychological Intervention in Breast Cancer Survivors: a Review. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2217206] [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: 11/05/2022] Open
Affiliation(s)
- M Popovic
- Odette Cancer Centre, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
| | - V Rico
- Odette Cancer Centre, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
| | - C DeAngelis
- Odette Cancer Centre, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
| | - H Lam
- Odette Cancer Centre, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada
| | - FMY Lim
- Department of Oncology, Prince Margaret Hospital, Hong Kong
| |
Collapse
|
3
|
Taylor P, Chan S, Wan AB, Chan CW, Rodrigues MM, Lam H, Chow E, Lim FMY. Cardiovascular Events and Mortality in Patients Undergoing Adjuvant Radiotherapy for Breast Cancer: a Systematic Review. Hong Kong Journal of Radiology 2021. [DOI: 10.12809/hkjr2117234] [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: 11/05/2022] Open
Affiliation(s)
- P Taylor
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - S Chan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - AB Wan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - CW Chan
- Department of Oncology, Princess Margaret Hospital, Hong Kong
| | - MM Rodrigues
- Centro Oncológico AZ do Noroeste, Patos de Minas, Minas Gerais, Brazil
| | - H Lam
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Chow
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - FMY Lim
- Department of Oncology, Princess Margaret Hospital, Hong Kong
| |
Collapse
|
4
|
Tsang PWM, Liu JP, Lam H, Poon TC. Optimal sampled phase-only hologram (OSPOH). Opt Express 2021; 29:25488-25498. [PMID: 34614879 DOI: 10.1364/oe.430776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A sampled phase-only hologram (SPOH) is the phase component of the hologram of an object image with pixels being sampled with a periodic grid-cross pattern. The reconstructed image of a SPOH is a sparse image with abundant empty voids and degradation in sharpness and contrast. In this paper we proposed a method based on a new sampling scheme, together with stochastic binary search (SBS), to obtain an optimal sampling lattice that can be applied to generate phase-only holograms with enhanced reconstructed image. Experimental results show that with our proposed method, the fidelity and quality of the reconstructed image are increased.
Collapse
|
5
|
Collins D, Lam H, Firdaus H, Antipolo J, Mangao P. Modeling the likely economic cost of non-adherence to TB medicines in the Philippines. Int J Tuberc Lung Dis 2020; 24:902-909. [PMID: 33156756 DOI: 10.5588/ijtld.19.0652] [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: 11/10/2022] Open
Abstract
SETTING: The Philippines has a population of over 90 million people and is one of the 22 highest TB burden countries in the world.OBJECTIVE: To understand the economic cost of non-adherence to TB medicines due to loss to follow up and stock-outs in the Philippines.DESIGN: Data were collected on the economic costs of non-adherence to TB medicines and a model was developed to show those costs under different scenarios.RESULTS: The model showed that as many as 1958 and 233 persons are likely to have died as a result of DS-TB and MDR-TB loss to follow up, respectively, and 588 persons are likely to have died as a result of TB medicine stock outs. The related economic impact in each case is likely have been to be as much as US$72.2 million, US$13.4 million and US$21.0 million, respectively.CONCLUSION: The economic costs of non-adherence to TB medicines due to loss to follow-up and stock-outs represent a significant economic burden for the country and it is likely that the cost of addressing these problems would be much less than this burden and, therefore, a wise investment.
Collapse
Affiliation(s)
- D Collins
- Management Sciences for Health, Medford, MA, Boston University School of Public Health, Boston, MA, USA
| | - H Lam
- University of the Philippines, Ermita, Manila, Philippines
| | - H Firdaus
- Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - J Antipolo
- Management Sciences for Health, Medford, MA
| | - P Mangao
- Management Sciences for Health, Medford, MA
| |
Collapse
|
6
|
Wan BA, Ganesh V, Zhang L, Sousa P, Drost L, Lorentz J, Vesprini D, Lee J, Rakovitch E, Lu FI, Eisen A, Yee C, Lam H, Chow E. Response to: The Survival Time of 8376 Male Breast Cancer Patients. Clin Oncol (R Coll Radiol) 2018; 30:818-819. [PMID: 30213703 DOI: 10.1016/j.clon.2018.08.011] [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] [Received: 05/27/2018] [Revised: 07/20/2018] [Accepted: 08/21/2018] [Indexed: 11/15/2022]
Affiliation(s)
- B A Wan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - V Ganesh
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Zhang
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - P Sousa
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Drost
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Lorentz
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - D Vesprini
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Lee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Rakovitch
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - F-I Lu
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - A Eisen
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - C Yee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - H Lam
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Chow
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
7
|
Chiang T, Lam H, Quijano R, Donham R, Gilliam P, Heinz L. Static and Dynamic Stresses during Valve Closure of a Bileaflet Mechanical Heart Valve Prosthesis. Int J Artif Organs 2018. [DOI: 10.1177/039139889101401207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effect of contact geometry and component compliance on the magnitude, distribution, and state of various types of stresses on a bileaflet mechanical heart valve prosthesis during valve closure was analyzed using an Edwards-Duromedics™ mitral valve as example. Static and dynamic stresses developing on both the leaflet and pivot ball during valve closure were modeled using finite element analysis (FEA). Uniform contact between the leaflet and housing as well as between the pivot ball and pivot slot can significantly reduce both static and dynamic stresses around the contact area. The level of the dynamic flexural stresses can be an order of magnitude higher than that of the static stresses. When both the radial and axial compliance of the housing are taken into consideration, peak dynamic stress was more than 40% less than that generated through the impact between a moving leaflet and a non-compliant rigid housing.
Collapse
Affiliation(s)
- T.H. Chiang
- Baxter Healthcare Corporation-Edwards CVS Division, Irvine, CA
| | - H. Lam
- Baxter Healthcare Corporation-Edwards CVS Division, Irvine, CA
| | - R. Quijano
- Baxter Healthcare Corporation-Edwards CVS Division, Irvine, CA
| | - R. Donham
- PDA Engineering Inc., Costa Mesa, CA - USA
| | - P. Gilliam
- PDA Engineering Inc., Costa Mesa, CA - USA
| | - L.A. Heinz
- PDA Engineering Inc., Costa Mesa, CA - USA
| |
Collapse
|
8
|
Wan BA, Ganesh V, Zhang L, Sousa P, Drost L, Lorentz J, Vesprini D, Lee J, Rakovitch E, Lu FI, Eisen A, Yee C, Lam H, Chow E. Treatment Outcomes in Male Breast Cancer: A Retrospective Analysis of 161 Patients. Clin Oncol (R Coll Radiol) 2018; 30:354-365. [PMID: 29496323 DOI: 10.1016/j.clon.2018.02.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/28/2017] [Accepted: 01/11/2018] [Indexed: 12/31/2022]
Abstract
AIMS Male breast cancer is a rare disease with limited evidence-based guidelines for treatment. This study aimed to identify demographic, pathological and clinical factors associated with its prognosis. MATERIALS AND METHODS A retrospective review of 161 male breast cancer patients diagnosed at a single institution from 1987 to June 2017 was conducted. Patient demographics, disease characteristics, treatment and outcome were extracted and included in competing-risk analysis and the univariate Cox proportional hazard model for univariate analysis. Factors with P < 0.10 were included in multivariable analysis. RESULTS The mean age at diagnosis was 67 years (standard deviation = 11.2) and the median follow-up duration was 5.3 years (range 0-25 years). There were 48 deaths, including 23 cancer-specific deaths. The actuarial median survival was 19.9 years. In multivariable analysis, factors associated with overall survival were size of tumours (hazard ratio 2.0; 95% confidence interval 1.4-2.7, P < 0.0001) and diagnosis of metastatic disease (hazard ratio 8.7; 95% confidence interval 1.9-40.6; P = 0.006). Of 138 patients without metastases at diagnoses, 11 had local-regional recurrence and 26 had distant metastases. In the multivariable model for local-regional recurrence, a more recent year of diagnosis was associated with reduced risk (hazard ratio 0.9, 95% confidence interval 0.8-1.0, P = 0.008), whereas more positive lymph nodes was associated with higher risk (hazard ratio 2.2, 95% confidence interval 1.2-4.0, P = 0.01). A higher risk of metastases was associated with more positive lymph nodes (hazard ratio 1.9; 95% confidence interval 1.1-3.3; P = 0.03) and tumour size (hazard ratio 1.8; 95% confidence interval 1.1-2.9; P = 0.01). A higher risk of any recurrence or metastases was associated with the number of positive nodes (hazard ratio 1.9; 95% confidence interval 1.2-3.0; P = 0.005) and tumour size (hazard ratio 1.6; 95% confidence interval 1.1-2.2; P = 0.01). CONCLUSION In general, tumour size and more positive lymph nodes were associated with worse prognosis. Larger powered studies are needed to identify prognostic factors with smaller effect sizes.
Collapse
Affiliation(s)
- B A Wan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - V Ganesh
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Zhang
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - P Sousa
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Drost
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Lorentz
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - D Vesprini
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - J Lee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Rakovitch
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - F-I Lu
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - A Eisen
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - C Yee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - H Lam
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - E Chow
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
9
|
Raman S, Ganesh V, Chan S, Chow R, Hoskin P, Lam H, Wan B, Drost L, DeAngelis C, Chow E. A Review of Practice Patterns and Clinical Guidelines in the Palliative Radiation Treatment of Uncomplicated Bone Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Morris D, Sherliker P, Clack R, Lam H, Carter J, Halliday A, Bulbulia R, Lewington S. P3230The association of blood glucose and diabetes with peripheral arterial disease involving different vascular territories: results from 628 246 people who attended vascular screening. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
11
|
Hu M, Lam H, Yeh R, Teeratananon M, Qin YX. Comparison of morphological changes of muscle fibers in response to dynamic electrical muscle contraction and dynamic hydraulic stimulation in a rat hindlimb disuse model. Physiol Res 2017; 66:519-530. [PMID: 28248540 DOI: 10.33549/physiolres.933101] [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: 11/25/2022] Open
Abstract
This study attempted to compare the muscle fiber morphological responses to dynamic electrical muscle stimulation (DEMS) and dynamic hydraulic stimulation (DHS) in rats under hindlimb suspension (HLS). DEMS at 1 Hz, 50 Hz and 100 Hz for 10 min/day, 5 days/week were introduced to the animals' right quadriceps. Static and 2 Hz DHS were introduced to the right tibiae of other animal groups on a "10 min on - 5 min off - 10 min on" loading regime for 5 days/week. In the end of the 4-week experiments, histological changes in the corresponding soleus, gastrocnemius and quadriceps of the stimulated sites were examined. Compared to age-matched, HLS led to muscle atrophy and strongly reduced muscle wet weights and averaged cross-sectional fiber areas. Among the tested DEMS frequencies, the averaged cross-sectional quadriceps fiber area in the 50 Hz group was 29 % larger than the 100 Hz group. In contrast, difference in the muscle fiber response to the static and 2 Hz DHS was not observed in either soleus or gastrocnemius. Muscle fiber morphological responses to the active DEMS was in a load frequency dependent manner under disuse condition. Relatively passive compressions, either via static or 2Hz DHS, were unable to induce any difference in the muscle fiber responses under functional disuse.
Collapse
Affiliation(s)
- M Hu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.
| | | | | | | | | |
Collapse
|
12
|
Wang Y, Liang C, Chou M, Lin Y, Lam H. LOW BODY MASS INDEX IS ASSOCIATED WITH HIGHER COMPLEXITY OF CARE IN OLDEST OLD MEN WITH DYNAPENIA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1386] [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: 11/12/2022] Open
Affiliation(s)
- Y. Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - C. Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- Aging and Health Research Center, Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei, Taiwan,
- Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - M. Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- Aging and Health Research Center, Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei, Taiwan,
| | - Y. Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - H. Lam
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| |
Collapse
|
13
|
Chou M, Huang T, Liang C, Shen H, Chen H, Liao M, Lin Y, Lam H. DYNAPENIA IS A SIMPLE INDICATOR FOR COMPLEX CARE NEEDS OF OLDER MEN IN VETERANS CARE HOMES IN TAIWAN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2815] [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: 11/13/2022] Open
Affiliation(s)
- M. Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- Aging and Health Research Center, National Yang Ming University, Taipei City, N/A, Taiwan,
| | - T. Huang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, N/A, Taiwan
| | - C. Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- Aging and Health Research Center, National Yang Ming University, Taipei City, N/A, Taiwan,
| | - H. Shen
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - H. Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, N/A, Taiwan
| | - M. Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - Y. Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - H. Lam
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| |
Collapse
|
14
|
Li W, van der Velden J, Raman S, Popovic M, Lam H, Wong K, Ngan R, Burbach M, de Angelis C, McDonald R, Chow E. Prophylaxis of Radiation-Induced Nausea and Vomiting: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Hong K, Herrmann K, Dybala C, Halseth AE, Lam H, Foreyt JP. Naltrexone/Bupropion extended release-induced weight loss is independent of nausea in subjects without diabetes. Clin Obes 2016; 6:305-12. [PMID: 27477337 PMCID: PMC5129540 DOI: 10.1111/cob.12157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/27/2016] [Accepted: 06/06/2016] [Indexed: 12/28/2022]
Abstract
Naltrexone/bupropion extended release (NB) is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index of ≥30 or ≥27 kg m(-2) and ≥1 weight-related comorbidity (e.g. hypertension, type 2 diabetes and dyslipidaemia). In phase 3 clinical studies, nausea occurred in significantly higher proportions of subjects randomized to NB vs. placebo (PBO). In this pooled analysis of three phase 3, 56-week, PBO-controlled studies, we characterized nausea and weight loss in NB- and PBO-treated subjects without diabetes. Subjects receiving NB (n = 1778) lost significantly more weight than those receiving PBO (n = 1160). Weight change was not significantly different between subjects reporting and not reporting nausea in either treatment arm. Severity of nausea was mild to moderate in ≥95% of all cases. In the NB arm, the highest incidence of nausea onset (9%) was reported during week 1. The median duration of mild, moderate and severe nausea in subjects receiving NB was 14, 9 and 13 days, respectively. Our results demonstrate that nausea associated with NB is rarely severe, primarily occurs early in treatment and is not a contributor to weight loss.
Collapse
Affiliation(s)
- K Hong
- Center for Clinical Nutrition & Applied Health Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - K Herrmann
- US Medical Affairs Department, Takeda Pharmaceuticals USA Inc., Deerfield, IL, USA
| | - C Dybala
- US Medical Affairs Department, Takeda Pharmaceuticals USA Inc., Deerfield, IL, USA
| | - A E Halseth
- Clinical Development Department, Orexigen Therapeutics, La Jolla, CA, USA
| | - H Lam
- Quantitative Science Department, Takeda Development Center Americas Inc., Deerfield, IL, USA
| | - J P Foreyt
- Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
16
|
Peng Z, Xu WW, Sham Y, Lam H, Sun D, Cheng L, Rasic NF, Guan Q, James AA, Simons FER. Mosquito salivary allergen Aed a 3: cloning, comprehensive molecular analysis, and clinical evaluation. Allergy 2016; 71:621-8. [PMID: 26608594 DOI: 10.1111/all.12812] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergic reactions to mosquito bites are an increasing clinical concern. Due to the lack of availability of mosquito salivary allergens, they are underdiagnosed. Here, we reported a newly cloned mosquito Aedes (Ae.) aegypti salivary allergen. METHODS A cDNA encoding a 30-kDa Ae. aegypti salivary protein, designated Aed a 3, was isolated from an expression library. The full-length cDNA was cloned into a baculovirus expression vector, and recombinant Aed a 3 (rAed a 3) was expressed, purified, and characterized. Skin prick tests with purified rAed a 3 and Ae. aegypti bite tests were performed in 43 volunteers. Serum rAed a 3-specific IgE levels were measured in 28 volunteers. RESULTS The primary nucleotide sequence, deduced amino acid sequence, and IgE-binding sites of Aed a 3 were identified. rAed a 3-selected antibodies recognized a 30-kDa Ae. aegypti saliva protein. rAed a 3 bound IgE in mosquito-allergic volunteers and the binding could be inhibited by the addition of natural mosquito extract dose dependently. Immediate skin test reactions to rAed a 3 correlated significantly with mosquito bite-induced reactions. Of the bite test-positive volunteers, 32% had a positive rAed a 3 skin test and 46% had specific IgE. No bite test-negative volunteers reacted to rAed a 3 in either the skin tests or the IgE assays, confirming the specificity of the assay. CONCLUSIONS Aed a 3 that corresponds to the Aegyptin protein is a major mosquito salivary allergen. Its recombinant form has biological activity and is suitable for use in skin tests and specific IgE assays in mosquito-allergic individuals.
Collapse
Affiliation(s)
- Z. Peng
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
| | - W. W. Xu
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Biochemistry and Medical Genetics; University of Manitoba; Winnipeg MB Canada
| | - Y. Sham
- Center for Drug Design; Academic Health Center; University of Minnesota; Minneapolis MN USA
| | - H. Lam
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - D. Sun
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - L. Cheng
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - N. F. Rasic
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - Q. Guan
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
| | - A. A. James
- Departments of Microbiology & Molecular Genetics and Molecular Biology & Biochemistry; University of California; Irvine CA USA
| | - F. E. R. Simons
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
| |
Collapse
|
17
|
Lam H, Ku G, Wu D, Cheng K, Rivera A, Tumanan-Mendoza B, Alejandria M. Cost-effectiveness analysis of dengue vaccination in the Philippines. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
18
|
Erdmann E, Harding S, Lam H, Perez A. Ten-year observational follow-up of PROactive: a randomized cardiovascular outcomes trial evaluating pioglitazone in type 2 diabetes. Diabetes Obes Metab 2016; 18:266-73. [PMID: 26592506 DOI: 10.1111/dom.12608] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/05/2015] [Accepted: 11/15/2015] [Indexed: 11/30/2022]
Abstract
AIMS To conduct a 10-year, observational follow-up of patients completing PROactive to investigate whether trends of cardiovascular benefit with pioglitazone and imbalances in specific malignancies persisted over time. METHODS Macrovascular endpoints and malignancies were compared based on original randomization to pioglitazone or placebo and 'any' versus 'no' pioglitazone use for bladder and prostate cancer. RESULTS Of 4873 patients completing the PROactive trial, 74% entered the follow-up. During follow-up (mean 7.8 years), there were no statistically significant differences in the primary [all-cause mortality, myocardial infarction (MI), cardiac intervention, stroke, major leg amputation, leg revascularization] or main secondary (death, MI, stroke) endpoints for subjects originally randomized to pioglitazone and placebo, except for leg amputations during follow-up [4.1% pioglitazone, 5.6% placebo; hazard ratio 0.74, 95% confidence interval (CI) 0.55-0.99; p = 0.046]. During follow-up, the incidence of total malignancies was similar between groups; bladder cancer was reported in 0.8% of patients (n = 14) in the pioglitazone versus 1.2% (n = 21) in the placebo group [relative risk (RR) 0.65, 95% CI 0.33-1.28], and prostate cancer was reported in 44 men (3.7%) in the pioglitazone versus 29 men (2.5%) in the placebo group (RR 1.47, 95% CI 0.93-2.34). CONCLUSIONS The trends of macrovascular benefits of pioglitazone compared with placebo during PROactive did not persist in the absence of continued pioglitazone during this 10-year follow-up. Trends of decreased bladder cancer and increased prostate cancer were observed in the pioglitazone group during follow-up; however, these imbalances should be interpreted with caution because of the limitations of the observational study design.
Collapse
Affiliation(s)
- E Erdmann
- Medical Clinic III, University of Cologne, Cologne, Germany
| | - S Harding
- Takeda Development Centre, London, UK
| | - H Lam
- Takeda Development Center Americas, Inc., Deerfield, IL, USA
| | - A Perez
- Takeda Development Center Americas, Inc., Deerfield, IL, USA
| |
Collapse
|
19
|
Zhou M, Holden L, Lao N, Lam H, Zeng L, Chow E. Accuracy of Clinicians’ Prediction of Survival and Prognostic Factors Indicative of Survival: a Systematic Review. Hong Kong J Radiol 2013. [DOI: 10.12809/hkjr1313179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
20
|
Poon M, Zeng L, Zhang L, Lam H, Emmenegger U, Wong E, Bedard G, Lao N, Chow R, Chow E. Incidence of skeletal-related events over time from solid tumour bone metastases reported in randomised trials using bone-modifying agents. Clin Oncol (R Coll Radiol) 2013; 25:435-44. [PMID: 23582277 DOI: 10.1016/j.clon.2013.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 02/12/2013] [Accepted: 02/13/2013] [Indexed: 11/26/2022]
Abstract
AIMS Skeletal-related events (SREs) in patients with bone metastases decrease a patient's quality of life and functional status. Although bone-modifying agents have been found to reduce the time to first on-trial SRE and decrease the total incidence of SREs in randomised clinical trials, standard practice in the management of bone metastases has changed concurrently. The purpose of this study was to investigate if advances in bone-targeted therapies have decreased the incidence of individual types of SREs and to delineate the trend of SREs. MATERIALS AND METHODS A literature review was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials to identify phase III, randomised bisphosphonate and other bone-targeted therapy trials from 1980 to September 2011. For all studies, a mean year of enrolment ([start of enrolment + end of enrolment]/2) was calculated. The incidences of SREs were tabulated and expressed as percentages of on-trial patients. Generalised linear mixed models were used to search for the trends of SREs over time for all placebo and intervention arms. Regression coefficients were interpreted as the odds ratio, which was calculated using the exponential of the slope. Ninety-five per cent confidence intervals were also calculated. RESULTS In total, 20 eligible studies were identified that reported SRE data from phase III trials, of which 11 were suitable for the quantitative analysis. Most of the articles included patients with breast cancer and the remaining involved patients with prostate, renal cell, bladder and lung cancer or other solid tumours. Enrolment periods for all included data ranged from 1990 to 2009. Statistically significant overall downward trends in pathological fractures and the need for surgery were seen over time. Also significant differences between intervention and placebo were seen with all SREs. CONCLUSION The decrease in SREs over time may not only be a result of the development of new generation bone-targeted agents, but also due to better systemic management and awareness of events associated with bone metastases.
Collapse
Affiliation(s)
- M Poon
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Abstract
BACKGROUND There is a need to assess neurobehavioral performance of children in developing countries using standardized developmental tools. METHODS The Griffiths Mental Development Scales was evaluated in the Philippines by comparing the performance of 742 Filipino children longitudinally at 6, 12 and 24 months old to those of their British counterparts. RESULTS The mean general and subquotient scores of Filipino children were all within average for age. Comparison with British children showed that except for performance subscales, Filipino children had significantly higher developmental subquotients at 6 months old. As the Filipino infants grew older, their developmental subquotients in all subscales were significantly lower, except for personal and social skills at 24 months old. The genetic predisposition as evidenced by modest maternal scores on the Wechsler Intelligence Scales and lack of familiarity with test materials are factors that may influence the developmental patterns of Filipino children. CONCLUSION Although the performance of the Filipino children in the Griffiths test were within average with age, their performance on developmental subquotients at later ages of 12 and 24 months were significantly lower than British children and may have been influenced by differences in ethnicity, cultural traditions and limited environmental resources.
Collapse
Affiliation(s)
- A Reyes
- Institute of Child Health and Human Development, University of the Philippines, National Institutes of Health, Manila, Philippines.
| | | | | | | | | | | |
Collapse
|
22
|
Lam H, Munzner TM, Rensink RA. The invariance of visual long-term memory to geometric transformation. J Vis 2010. [DOI: 10.1167/6.6.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
23
|
Qin YX, Lam H, Ferreri S, Rubin C. Dynamic skeletal muscle stimulation and its potential in bone adaptation. J Musculoskelet Neuronal Interact 2010; 10:12-24. [PMID: 20190376 PMCID: PMC4961074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To identify mechanotransductive signals for combating musculoskeletal deterioration, it is essential to determine the components and mechanisms critical to the anabolic processes of musculoskeletal tissues. It is hypothesized that the interaction between bone and muscle may depend on fluid exchange in these tissues by mechanical loading. It has been shown that intramedullary pressure (ImP) and low-level bone strain induced by muscle stimulation (MS) has the potential to mitigate bone loss induced by disuse osteopenia. Optimized MS signals, i.e., low-intensity and high frequency, may be critical in maintaining bone mass and mitigating muscle atrophy. The objectives for this review are to discuss the potential for MS to induce ImP and strains on bone, to regulate bone adaptation, and to identify optimized stimulation frequency in the loading regimen. The potential for MS to regulate blood and fluid flow will also be discussed. The results suggest that oscillatory MS regulates fluid dynamics with minimal mechanical strain in bone. The response was shown to be dependent on loading frequency, serving as a critical mediator in mitigating bone loss. A specific regimen of dynamic MS may be optimized in vivo to attenuate disuse osteopenia and serve as a biomechanical intervention in the clinical setting.
Collapse
Affiliation(s)
- Y X Qin
- Orthopaedic Bioengineering Research Laboratory, Department of Biomedical Engineering, State University of New York at Stony Brook, Stony Brook, NY 11794-5281, USA.
| | | | | | | |
Collapse
|
24
|
Leonard B, Lam H, Smaill B, LeGrice I. Increased Strain in Interventricular Septum Following Chronic MI in Rats. Heart Lung Circ 2010. [DOI: 10.1016/j.hlc.2010.06.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
25
|
Crossingham G, Sice P, Roberts M, Gale T, Lam H, Anderson I, Carr A, Davies P, Langton J. Improving work place assessments in anaesthesia. Anaesthesia 2010. [DOI: 10.1111/j.1365-2044.2009.06184_9.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
26
|
|
27
|
Adams D, Sice P, Anderson I, Gale T, Lam H, Langton J, Davies P, Carr A. Validation of simulation for recruitment to training posts in anaesthesia. Anaesthesia 2009. [DOI: 10.1111/j.1365-2044.2009.05966_18.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Chan KHN, Tang WYM, Hau KC, Lam WY, Lam H, Kwan TH, Lo KK. Nephrogenic systemic fibrosis in a Chinese renal-transplant recipient. Clin Exp Dermatol 2009; 34:244-6. [DOI: 10.1111/j.1365-2230.2008.02764.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
29
|
Tiwari A, Chan KL, Fong D, Leung WC, Brownridge DA, Lam H, Wong B, Lam CM, Chau F, Chan A, Cheung KB, Ho PC. The impact of psychological abuse by an intimate partner on the mental health of pregnant women. BJOG 2008; 115:377-84. [PMID: 18190375 PMCID: PMC2253706 DOI: 10.1111/j.1471-0528.2007.01593.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The objective of this first population-based study in Hong Kong was to assess the impact of psychological abuse by an intimate partner on the mental health of pregnant women. Design Survey. Setting Antenatal clinics in seven public hospitals in Hong Kong. Population Three thousand two hundred and forty-five pregnant women. Methods The Abuse Assessment Screen (AAS) and demographic questionnaires were administered face-to-face at 32–36 weeks of gestation. At 1 week postpartum, the AAS, Edinburgh Postnatal Depression Scale and SF-12 Health Survey were administered by telephone. Main outcome measures Intimate partner violence, postnatal depression and health-related quality of life. Results Two hundred and ninety six (9.1%) of the participants reported abuse by an intimate partner in the past year. Of those abused, 216 (73%) reported psychological abuse only and 80 (27%) reported physical and/or sexual abuse. Forty six (57.5%) in the physical and/or sexual abuse group also reported psychological abuse. Women in the psychological abuse only group had a higher risk of postnatal depression compared with nonabused women (adjusted OR: 1.84, 95% CI: 1.12–3.02). They were also at a higher risk of thinking about harming themselves (adjusted OR: 3.50, 95% CI: 1.49–8.20) and had significantly poorer mental health-related quality of life (P < 0.001). The higher risks of postnatal depression and thinking of harming themselves were not observed in the physical and/or sexual abuse group although significantly poorer mental health-related quality of life (P < 0.001) was observed. Conclusions Psychological abuse by an intimate partner against pregnant women has a negative impact on their mental health postdelivery. Furthermore, psychological abuse in the absence of physical and/or sexual abuse can have a detrimental effect on the mental health of abused women. The findings underscore the importance of screening pregnant women for abuse by an intimate partner and the need for developing, implementing and evaluating interventions to address psychological abuse. Please cite this paper as: Tiwari A, Chan K, Fong D, Leung W, Brownridge D, Lam H, Wong B, Lam C, Chau F, Chan A, Cheung K, Ho P. The impact of psychological abuse by an intimate partner on the mental health of pregnant women. BJOG 2008;115:377–384.
Collapse
Affiliation(s)
- A Tiwari
- Department of Nursing Studies, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Harcourt M, Lam H, Harcourt S, Flynn M. Discrimination in hiring against immigrants and ethnic minorities: the effect of unionization. The International Journal of Human Resource Management 2008. [DOI: 10.1080/09585190701763958] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
31
|
Leung W, Lau E, Ngai C, Lam H, Leung K, Lee C, Lao T, Tang M. A Prospective Study on the Effect of Rapid Aneuploidy Testing (Amnio-PCR) on Anxiety Levels and Quality of Life Measures in Women and Their Partners with Positive Down Screening Result. Fetal Diagn Ther 2008; 24:165-9. [DOI: 10.1159/000151332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2007] [Accepted: 05/23/2007] [Indexed: 11/19/2022]
|
32
|
Lo TK, Lau WL, Lai FK, Lam H, Tse HY, Leung WC, Chin RKH. The effect of gestational age on the outcome of second-trimester termination of pregnancies for foetal abnormalities. Prenat Diagn 2008; 28:508-11. [DOI: 10.1002/pd.2012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
33
|
Rearden T, Schwartzberg L, Yee L, Mirtsching B, Charu V, Lam H, Lillie T, Burkes R, Silberstein P. A phase 2 study to evaluate the efficacy of darbepoetin-alfa administered using an extended dose schedule versus weekly dosing in cancer patients with chemotherapy-induced anemia. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19501] [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
19501 Background: Chemotherapy-induced anemia (CIA) can be effectively treated with darbepoetin alfa (DA) using different dosing schedules. Since chemotherapy (CTX) regimens involve various dosing schedules, the ability to synchronize DA dose with CTX could be beneficial. Methods: This phase 2, 25-week (wk), randomized, open-label study compares the efficacy and safety of DA administered using an extended dose schedule (EDS) (every 2 wks [Q2W] or every 3 wks [Q3W]) vs weekly (QW) dosing in patients (pts) with CIA. Pts were randomly assigned to receive DA EDS (either 300 mcg Q2W [with CTX QW, Q2W, or Q4W] or 500 mcg Q3W [with CTX Q3W]) vs 150 mcg DA QW (with CTX QW, Q2W, Q3W, or Q4W). Randomization was stratified by length of CTX cycle, screening hemoglobin (Hb) (< 10 vs = 10 g/dL), and type of cancer (lung/gynecological vs other cancers). The primary endpoint was the change in Hb from baseline (BL) to wk 13; other endpoints included the change in Hb from BL to end of study (EOS), percentage of pts with = 1 transfusion (TFN) from BL to wk 13 and EOS, and safety. Results: Final data for the total 25-wk study period will be presented. Results from a planned interim analysis for all pts who were enrolled in the study and received = 1 dose of DA (n = 752) are shown for wk 13 endpoints (Table). The groups had similar mean change in Hb from BL to wk 13, with a difference (QW minus EDS) (95% CL) of 0.2 (-0.1, 0.4) g/dL. The % pts who achieved target Hb were also similar (difference [95% CL] = 0 [-7, 6]). At the time of the interim analysis, the incidence and types of adverse events were similar between the groups. Ten (3%) EDS and 15 (4%) QW pts had thromboembolic events, 5 (1%) EDS and 2 (1%) QW pts had cerebrovascular accidents, and 19 (5%) EDS and 22 (6%) QW pts had died. Conclusions: This is the first trial synchronizing DA dosing (Q2W and Q3W) with CTX schedules. The interim results suggest that DA administered once per CTX cycle is well-tolerated and efficacious in these patients. [Table: see text] No significant financial relationships to disclose.
Collapse
Affiliation(s)
- T. Rearden
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - L. Schwartzberg
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - L. Yee
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - B. Mirtsching
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - V. Charu
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - H. Lam
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - T. Lillie
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - R. Burkes
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| | - P. Silberstein
- Hematology and Oncology Consultants, Inc., St Louis, MO; West Clinic, P.C, Memphis, TN; Northwest Medical Specialties, PLLC, Tacoma, WA; Center for Oncology Research and Treatment, Dallas, TX; Pacific Cancer Medical Center, Anaheim, CA; Amgen Inc, Thousand Oaks, CA; Mount Sinai Hospital, Toronto, ON, Canada; Creighton University School of Medicine, Omaha, NE
| |
Collapse
|
34
|
|
35
|
Paquette R, Gabrilove J, Lyons R, Mushtaq C, Sekeres M, Lam H, Dreiling L. Darbepoetin alfa for treating anemia in low-risk myelodysplastic syndrome patients: Interim results after 27/28 weeks. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6564 Background: Patients (pts) with myelodysplastic syndrome (MDS) disorders often develop anemia, resulting in increased transfusions and fatigue. Using the erythropoiesis-stimulating agent (ESA) epoetin alfa to treat anemia in low-risk MDS pts results in an average response rate of 30% (40% when used with G-CSF). Pilot studies suggest that 150 or 300 mcg/week (wk) darbepoetin alfa (DA) can raise hemoglobin (Hb) levels in anemic MDS pts. Methods: This fully enrolled (n = 209), phase 2, single-arm, 52-wk ongoing study is examining DA 500 mcg every 3 weeks (Q3W) for treating anemic pts (Hb ≤ 11 g/dL) with low- or intermediate-risk MDS (IPSS definition). The study’s primary endpoint is the proportion of pts achieving an erythroid response by 13 wks. Other endpoints include the proportion of pts achieving an erythroid response by 27/28 wks and change in both Hb levels and FACT-F scores. Results are stratified by whether pts received ESA therapy before enrollment: ESA-naïve (ESA-N) vs ESA-treated (ESA-T). Results: Previous interim data suggested that low-risk MDS pts can achieve a major erythroid response after 13 wks of DA 500 mcg Q3W. This is the first reported summary of results from a planned interim analysis after 27/28 wks of treatment (n = 129). Of 84 ESA-N pts, 51% were men, 86% were white, and the average (SD) age was 74.1 (9.7) years; the 45 ESA-T pts had similar demographics. During 27/28 wks of treatment, a majority of pts achieved a major erythroid response. ESA-N pts had a mean (SD) 1.2 (1.4) g/dL rise in Hb levels from BL and a clinically significant increase in FACT-F score from BL ( Table ). Of the 129 pts analyzed after 27/28 wks, 83% reported an adverse event (AE) and none reported serious treatment-related AEs or thrombotic events (of 189 pts analyzed after 13 wks, 1 pt reported a serious treatment-related AE). Conclusions: These interim results suggest that DA 500 mcg Q3W is well tolerated and can raise Hb levels in anemic, low-risk MDS pts. Final 27/28-wk data from all enrolled pts (n = 209) will be shown. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- R. Paquette
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - J. Gabrilove
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - R. Lyons
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - C. Mushtaq
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - M. Sekeres
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - H. Lam
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - L. Dreiling
- UCLA Oncology Center, Los Angeles, CA; Mt. Sinai School of Medicine, New York, NY; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| |
Collapse
|
36
|
Wong C, Chan W, Lam H, Chan W, Wang L, Ma E. Spectrum of EGFR mutations associated with non-small cell lung cancer in an Asian Chinese population. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.20055] [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
20055 Background: Somatic mutations in tyrosine kinase (TK) domain of the EGFR gene, predicting for sensitivity to TK inhibition therapy, are over-represented in lung cancer with adenocarcinoma or bronchioloalveolar histology, non-smokers, female gender and East Asian ethnicity. Methods: We prospectively screened for EGFR mutations at exons 19–21 on micro-dissected specimen enriched for tumor cells by direct nucleotide sequencing in Hong Kong Chinese patients. Results: From May 2005 onwards, a total of 27 patients were analyzed. They comprised 11 males and 16 females with a median age of 67 years. Histological diagnoses were adenocarcinoma (n = 22), bronchioloalveolar carcinoma (n = 4) and squamous cell carcinoma (n = 1). Samples included primary tumor (n = 20) as well as metastatic lesions (n = 7). EGFR mutations were detected in 17 patients (63%), the most common being L858R at exon 21 (n = 7) followed by exon 19 deletions (del(746–750) = 3, del(747–751) = 1, del(747–753) = 3) and G719C at exon 18 (n = 1). Two patients showed novel EGFR mutations, namely 4-base pair insertion deletion at exon 19 leading to substitution of Glu746-Leu747 by Val746-Pro747 and three base pair deletion at exon 18 leading to replacement of Glu709-Thr710 by Asp. Furthermore, two patients showed double mutations, including novel S768I at exon 20 in combination with G719C, and novel K860I at exon 21 in combination with L858R. Finally, one patient showed homozygous del(747–753) as detected by sequencing in both primary lung tumor and brain secondary, which might represent loss of heterozygosity. Conclusions: Similar to other series, two hotspots i.e. exon 19 deletion and L858 account for the majority (82%) of detectable EGFR mutations in our patient population. For the rare and novel variants, it would be of interest to document the clinical responsiveness to TK inhibitors gefitinib and erlotinib, so that a more complete picture of cancer genotype phenotype correlation can be achieved. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- C. Wong
- Hong Kong Sanatorium & Hospital, Hong Kong SAR, Hong Kong Special Administrative Region of China
| | - W. Chan
- Hong Kong Sanatorium & Hospital, Hong Kong SAR, Hong Kong Special Administrative Region of China
| | - H. Lam
- Hong Kong Sanatorium & Hospital, Hong Kong SAR, Hong Kong Special Administrative Region of China
| | - W. Chan
- Hong Kong Sanatorium & Hospital, Hong Kong SAR, Hong Kong Special Administrative Region of China
| | - L. Wang
- Hong Kong Sanatorium & Hospital, Hong Kong SAR, Hong Kong Special Administrative Region of China
| | - E. Ma
- Hong Kong Sanatorium & Hospital, Hong Kong SAR, Hong Kong Special Administrative Region of China
| |
Collapse
|
37
|
Glaspy J, Henry D, Canon JL, Lam H, Lillie T. Darbepoetin alfa administered at varying intervals compared with weekly epoetin alfa for treating chemotherapy-induced anemia: A pooled analysis of 20 clinical trials. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.18508] [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
18508 Background: Cancer patients (pts) often develop chemotherapy-induced anemia (CIA), resulting in an increased risk for transfusions and fatigue. The erythropoiesis-stimulating agents (ESAs) epoetin alfa (EA) and darbepoetin alfa (DA) can reduce transfusion requirements, raise hemoglobin (Hb) levels, and decrease fatigue in pts with CIA. The 74-hour half-life of DA allows for flexible dosing with weekly (QW), every-2-week (Q2W), or every-3-week (Q3W) administration. This study evaluated if the dosing interval used to administer DA affected its efficacy. Methods: Data from 20 clinical trials in the CIA setting were pooled, including single-arm, active-controlled, and placebo-controlled trials (a full description of these studies will be presented). Six studies contributed data for DA QW, 7 studies for DA Q2W, and 5 studies for DA Q3W. Controlled studies used either a placebo or EA as the comparator. Logistic regression with treatment as a random effect was used to analyze the clinical trials. Endpoints included the percentage of pts requiring transfusions (from week 1 to end of the treatment period [EOTP] and from week 5 to EOTP), reaching a target Hb of ≥ 11 g/dL, and achieving ≥ 3 point change in FACT-F score from baseline (BL). Percentages were adjusted for BL Hb levels (< 10 vs ≥ 10 g/dL), whether pts received platinum chemotherapy (no vs yes), and for dosage adjustments. Results: The type of ESA used (EA or DA) did not appear to affect the percentage of study pts who achieved clinically meaningful endpoints (see Table ). The results from these analyses also suggest that the dosing interval at which DA was administered did not affect its efficacy in study pts (see Table ). Conclusions: DA administered at dosing intervals of QW, Q2W, or Q3W has comparable efficacy to EA QW. This flexibility allows DA administration to be synchronized with common chemotherapy schedules, which may increase pt convenience by reducing the number of clinic visits. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- J. Glaspy
- UCLA Medical Center, Los Angeles, CA; Pennsylvania Oncology/Hematology Associates, Philadelphia, PA; Centre Hospitalier Notre Dame et Reine Fabiola, Charleroi, Belgium; Amgen, Inc., Thousand Oaks, CA
| | - D. Henry
- UCLA Medical Center, Los Angeles, CA; Pennsylvania Oncology/Hematology Associates, Philadelphia, PA; Centre Hospitalier Notre Dame et Reine Fabiola, Charleroi, Belgium; Amgen, Inc., Thousand Oaks, CA
| | - J. L. Canon
- UCLA Medical Center, Los Angeles, CA; Pennsylvania Oncology/Hematology Associates, Philadelphia, PA; Centre Hospitalier Notre Dame et Reine Fabiola, Charleroi, Belgium; Amgen, Inc., Thousand Oaks, CA
| | - H. Lam
- UCLA Medical Center, Los Angeles, CA; Pennsylvania Oncology/Hematology Associates, Philadelphia, PA; Centre Hospitalier Notre Dame et Reine Fabiola, Charleroi, Belgium; Amgen, Inc., Thousand Oaks, CA
| | - T. Lillie
- UCLA Medical Center, Los Angeles, CA; Pennsylvania Oncology/Hematology Associates, Philadelphia, PA; Centre Hospitalier Notre Dame et Reine Fabiola, Charleroi, Belgium; Amgen, Inc., Thousand Oaks, CA
| |
Collapse
|
38
|
Gabrilove J, Paquette R, Lyons R, Mushtaq C, Sekeres M, Lam H, Dreiling L. Darbepoetin alfa for treating anemia in patients with low-risk myelodysplastic syndromes: Exploratory analysis of baseline predictors of response. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.6579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6579 Background: Patients (pts) with myelodysplastic syndromes (MDS) often develop anemia, resulting in fatigue and increased transfusions. The erythropoiesis-stimulating agents (ESAs) epoetin alfa and darbepoetin alfa (DA) can raise hemoglobin (Hb) levels in low-risk MDS pts. Baseline (BL) endogenous erythropoietin (eEPO) levels, transfusion history, and FAB sub-type can be predictive factors of response to ESAs (Hellström-Lindberg et al., 2003). Methods: This is an ongoing, fully enrolled (n = 209), phase 2, single-arm, 52-week (wk) study of DA 500 mcg every three weeks (Q3W) for treating anemia (Hb ≤ 11 g/dL) in low- or intermediate-risk MDS pts. A planned interim analysis was done after 13 wks (n = 189). The primary endpoint is the proportion of pts with an erythroid response by 13 wks. Other endpoints include change in Hb levels and in FACT-F score from BL. Results are stratified by whether pts received an ESA before enrollment: ESA-naïve (ESA-N) pts vs ESA-treated (ESA-T) pts. Exploratory analyses of the percentage of pts with an erythroid response adjusted by BL eEPO or FAB category were done. Results: Of 130 ESA-N pts, 52% were women, 86% were white, 58% had refractory anemia (RA), 34% had RA with ringed sideroblasts (RARS), 8% had RA with excess blasts (RAEB), and the mean (SD) age was 74.8 (10.1) years. The 59 ESA-T pts had similar demographics. A majority of ESA-N pts had an erythroid response, achieved a target Hb of 11 g/dL, and had a clinically significant rise in FACT-F score; ESA-N pts with lower BL eEPO levels were more likely to have a major erythroid response ( Table ). A major erythroid response was seen in 50% of pts with RA (n = 111), in 30% of pts with RARS (n = 64), and in 23% of pts with RAEB (n = 13). Of all 189 pts, 78% had an adverse event (AE), 1 had a serious treatment-related AE (hypertension), and none had thrombotic events. Conclusions: These interim results suggest that FAB sub-type and BL eEPO may affect response. Final 13-wk data from all enrolled pts (n = 209) will be shown. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- J. Gabrilove
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - R. Paquette
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - R. Lyons
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - C. Mushtaq
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - M. Sekeres
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - H. Lam
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| | - L. Dreiling
- Mount Sinai School of Medicine, New York, NY; UCLA Oncology Center, Los Angeles, CA; Cancer Care Centers of South Texas, San Antonio, TX; South Carolina Oncology Associates, Columbia, SC; Cleveland Clinic Foundation, Cleveland, OH; Amgen, Inc., Thousand Oaks, CA
| |
Collapse
|
39
|
Peng Z, Xu W, Lam H, Cheng L, James AA, Simons FER. A new recombinant mosquito salivary allergen, rAed a 2: allergenicity, clinical relevance, and cross-reactivity. Allergy 2006; 61:485-90. [PMID: 16512811 DOI: 10.1111/j.1398-9995.2006.00985.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [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: 11/27/2022]
Abstract
BACKGROUND Mosquito salivary proteins cause allergic reactions in humans. The allergenicity, clinical relevance, and species cross-reactivity of a new 37-kDa recombinant mosquito (Aedes aegypti) salivary allergen, rAed a 2, were evaluated. METHODS rAed a 2 was expressed using a baculovirus/insect cell system and purified. Its allergenicity was examined using an enzyme-linked immunosorbent assay (ELISA), ELISA inhibition tests, immunoblots, and skin tests. Epicutaneous tests with the allergen, mosquito whole body extracts, and mosquito bite tests were performed on 48 volunteers. Serum rAed a 2-specific immunoglobulin E (IgE) was measured in individuals with positive mosquito saliva-specific IgE and negative controls. RESULTS Both immunoblots and ELISAs demonstrated that rAed a 2 bound to the IgE of mosquito-allergic individuals. The binding could be inhibited by the addition of a natural mosquito preparation. Furthermore, rAed a 2 induced immediate and delayed skin reactions. Ten per cent of 31 participants with a positive mosquito bite test had positive skin reactions to rAed a 2, compared with 32% for mosquito whole body extract. None of the participants with a negative bite test showed positive reactions to either of the two extracts. Forty-three per cent of individuals with positive saliva-IgE had positive rAed a 2-IgE. rAed a 2 was a species-shared allergen, being present in the saliva of the 11 species studied. CONCLUSIONS rAed a 2 has identical antigenicity and biologic activity to its native form. It can be used in the diagnosis of mosquito allergy, and is an important species-shared antigen.
Collapse
Affiliation(s)
- Z Peng
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | | | | | | | | | | |
Collapse
|
40
|
Hung W, Chan C, Chan L, Mak K, Fung A, Iu P, Lam H, Lau Y, Yip A. Measurement of residual tumour size after neo-adjuvant chemotherapy for locally advanced breast cancer: accuracy of clinical examination, mammography, ultrasound and magnetic resonance imaging. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80399-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
41
|
Walwyn WM, Matsuka Y, Arai D, Bloom DC, Lam H, Tran C, Spigelman I, Maidment NT. HSV-1-mediated NGF delivery delays nociceptive deficits in a genetic model of diabetic neuropathy. Exp Neurol 2006; 198:260-70. [PMID: 16427624 DOI: 10.1016/j.expneurol.2005.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Revised: 10/19/2005] [Accepted: 12/07/2005] [Indexed: 01/11/2023]
Abstract
A previous phase III clinical trial failed to show significant therapeutic benefit of repeated subcutaneous nerve growth factor (NGF) administration in the treatment of diabetic neuropathy. Animal studies have since shown that site-specific viral-mediated expression of NGF in the lumbar dorsal root ganglia prevents peripheral nerve dysfunction associated with chemically induced neuropathy. Using a Herpes simplex virus expression vector, we have investigated the effect of localized NGF expression in a genetic mouse model of progressive diabetic neuropathy, the +/+ Leprdb mouse. We found that site-specific delivery of NGF initially delayed the appearance of hypoalgesia, assessed by the Hargreaves test, by 1 month and effectively attenuated this deficit for 2 months over the approximately 10 months normal life-span of these animals. Once the disease progressed into its more severe stages, NGF, although still capable of altering the electrophysiological profile of the sensory A- and C-fibers and influencing the expression of p75 and substance P in the dorsal root ganglia, could no longer maintain normal nociception. These data suggest that maximal therapeutic benefit in future NGF-based gene therapy trials will be gained from early applications of such viral-mediated neurotrophin delivery.
Collapse
Affiliation(s)
- W M Walwyn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA 90024-1759, USA.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Qin YX, Lam H, Orzechowski L. Anabolic fluid flow stimulation is responsible for trabecular and cortical bone formation as a manner of specific frequency and magnitude. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)82927-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Lam H, Leung WC, Lee CP, Lao TT. The use of fetal Doppler cerebroplacental blood flow and amniotic fluid volume measurement in the surveillance of postdated pregnancies. Acta Obstet Gynecol Scand 2005; 84:844-8. [PMID: 16097973 DOI: 10.1111/j.0001-6349.2005.00741.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 11/28/2022]
Abstract
BACKGROUND This prospective observational study aims at determining the distribution of fetal cerebro-placental Doppler indices and amniotic fluid volume in a homogenous group of uncomplicated postdated pregnancies at 41 weeks. The correlation with incidence of passage of thick meconium-stained liquor in labor was analyzed to decide which parameter would be useful in the surveillance of postdated pregnancies. METHODS The amniotic fluid volume, middle cerebral artery pulsatility index, umbilical artery pulsatility index, and cerebroplacental ratio were measured and distribution determined in 118 well-dated singleton pregnancies admitted for routine induction of labor at 41 weeks. The 10th centile and the 90th centile in each Doppler parameter and amniotic fluid volume were chosen to divide each parameter into three centile groups. The prevalence of thick meconium-stained liquor in labor in different Doppler and amniotic fluid volume centile groups was compared using Chi-square test for trend with P < 0.05 taken as statistically significant. RESULTS The prevalence of thick meconium-stained liquor in labor was significantly inversely correlated with the middle cerebral artery pulsatility index (P = 0.008), with significant difference across different middle cerebral artery pulsatility index centile groups (P = 0.02). There was no significant difference in the prevalence of thick meconium-stained liquor in labor or oligohydramnios across different umbilical artery pulsatility index centile groups. Neither was there significant difference in the prevalence of thick meconium-stained liquor in labor and oligohydramnios across different cerebroplacental ratio and amniotic fluid volume centile groups. Logistic regression using the 10th centile of middle cerebral artery pulsatility index confirmed that it was a significant independent predicting factor for risk of thick meconium-stained liquor in labor with adjusted odds ratio (95th CI) of 6.14 (1.6-24.1). CONCLUSION Middle cerebral artery pulsatility index is better than amniotic fluid volume or umbilical artery pulsatility index in predicting the risk of thick meconium-stained liquor in labor in uncomplicated postdated pregnancy at 41 weeks.
Collapse
Affiliation(s)
- H Lam
- Department of Obstetrics and Gynecology, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.
| | | | | | | |
Collapse
|
44
|
Massé M, Martinez-Mir A, Lam H, Geraghty MT, Christiano AM. Identification of a recurrent mutation in the human hairless gene underlying atrichia with papular lesions. Clin Exp Dermatol 2005; 30:363-5. [PMID: 15953070 DOI: 10.1111/j.1365-2230.2005.01762.x] [Citation(s) in RCA: 7] [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: 11/29/2022]
Abstract
Identification of mutations in the hairless (HR) gene in patients with atrichia with papular lesions (APL) has proven of critical importance, as it provides a basis for the differentiation between APL and alopecia universalis. The establishment of the diagnostic criteria for APL has triggered the identification of a large number of APL patients among those suspected to suffer from alopecia universalis. This advancement has resulted in the discovery of an increasing number of hairless mutations in both consanguineous and nonconsanguineous APL families. Here, we report the identification of a homozygous mutation, 3434delC, in an APL patient of Arab-Palestinian descent. The proband is a 23-year-old female with generalized scalp and body alopecia. To confirm the diagnosis of APL and to identify the specific mutation, we sequenced the hairless gene. Sequencing of all exons of the hairless gene revealed a homozygous frameshift mutation, 3434delC, in exon 18. Interestingly, the same mutation was previously identified in an Arab-Israeli family. Our data suggest that the 3434delC mutation most likely represents a founder mutation in this geographical region.
Collapse
Affiliation(s)
- M Massé
- Department of Dermatology, Columbia University, New York, USA
| | | | | | | | | |
Collapse
|
45
|
Lam H, Leung WC, Lee CP, Lao TT. Relationship between cerebroplacental Doppler ratio and birth weight in postdates pregnancies. Ultrasound Obstet Gynecol 2005; 25:265-269. [PMID: 15717288 DOI: 10.1002/uog.1794] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVES To explore the relationship between cerebroplacental Doppler impedance index and birth weight in postdates pregnancies, and to evaluate the use of a combination of Doppler parameters and ultrasound biometry in the prediction of large-for-gestational age (LGA) fetuses at 41 weeks of gestation. METHODS The pulsatility indices of the umbilical (UA-PI) and middle cerebral (MCA-PI) arteries, the cerebroplacental pulsatility index ratio (CPR) and the estimated fetal weight (EFW) were obtained in a cohort of 181 ultrasound-dated pregnancies at 41 weeks' gestation, 2 days before induction of delivery. A regression equation was established and the correlation between umbilical artery impedance and different birth-weight centile groups was determined. A receiver-operating characteristics (ROC) curve was used to compare prediction of LGA fetuses using biometry alone with that using biometry and UA-PI. RESULTS UA-PI was inversely related to EFW (Spearson's correlation coefficient rho = -0.28, P < 0.001). Logistic regression showed an independent contribution of UA-PI to the birth-weight estimation (birth weight = 1356.8 - 232.0 x UA-PI + 0.65 x EFW). On ROC curve analysis, the prediction of LGA with the regression equation was comparable to that using ultrasound biometry alone. CONCLUSION UA-PI was inversely correlated to EFW, but the combination of ultrasound biometry and UA-PI compared with biometry alone showed similar prediction of LGA fetuses in postdates pregnancies. Further prospective trials on larger populations or groups with a higher prevalence of LGA fetuses would be needed to validate the use of the new formula.
Collapse
Affiliation(s)
- H Lam
- Department of Obstetrics and Gynaecology, University of Hong Kong, HKSAR, China.
| | | | | | | |
Collapse
|
46
|
Leung WC, Lam H, Lee CP, Lao TT. Doppler study of the umbilical and fetal middle cerebral arteries in women with gestational diabetes mellitus. Ultrasound Obstet Gynecol 2004; 24:534-537. [PMID: 15386601 DOI: 10.1002/uog.1730] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To investigate the correlation between Doppler parameters in the umbilical and fetal middle cerebral arteries and pregnancy outcome in women with gestational diabetes mellitus (GDM). METHODS A prospective study was performed on 169 singleton GDM pregnancies in a university teaching hospital from January to December 2002. Umbilical artery (UA) pulsatility index (PI) and middle cerebral artery (MCA) PI and peak systolic velocity (Vmax) were measured every 4 weeks until delivery from the time of diagnosis of GDM. The pregnancy outcome was obtained from the hospital database. Using linear or quadratic regression, lines of best fit were drawn to compare the Doppler measurements between the two groups with normal and abnormal pregnancy outcomes. RESULTS One hundred and thirty-eight women with known pregnancy outcome completed the study. A total of 305 Doppler examinations were performed with one to four examinations for each woman. Thirty-eight women (27.5%) had one or more abnormal pregnancy outcomes: placental abruption, pre-eclampsia, preterm delivery, small-for-gestational age (SGA) infants, low Apgar scores, neonatal jaundice requiring treatment, sepsis, birth trauma, meconium aspiration syndrome, respiratory and neurological complications. There was extensive overlap of the UA-PI, MCA-PI and MCA-Vmax measurements between the two groups. CONCLUSION A Doppler study of the UA-PI, MCA-PI and MCA-Vmax was not useful in the prediction of abnormal pregnancy outcome in GDM.
Collapse
Affiliation(s)
- W C Leung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
| | | | | | | |
Collapse
|
47
|
Lam H, Tang OS, Lee CP, Ho PC. A pilot-randomized comparison of sublingual misoprostol with syntometrine on the blood loss in third stage of labor. Acta Obstet Gynecol Scand 2004; 83:647-50. [PMID: 15225189 DOI: 10.1111/j.0001-6349.2004.00572.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND To compare sublingual misoprostol with intravenous syntometrine use during third stage of labor by measuring the blood loss. METHODS Sixty women were randomized to receive either 600 micro g misoprostol sublingually or 1 ml syntometrine intravenously during the third stage of labor after spontaneous vaginal delivery. For those with risk factors of postpartum hemorrhage such as medical induction or augmentation of labor, previous third stage complications were excluded. The blood loss in labor was measured by the alkaline-hematin method, and differences in hemoglobin before and after delivery were compared. RESULTS There was no significant difference in the median measured blood loss between the misoprostol group and the syntometrine group (280 versus 226 ml, p = 0.45). The change in hemoglobin was comparable between the two groups. There were more women in the misoprostol group who required additional oxytocics, but the difference was not statistically significant. A major complication occurred in one patient in the misoprostol group with blood loss in excess of 1000 ml. The incidence of side effects such as shivering and pyrexia in women receiving misoprostol was significantly higher than that in the syntometrine group. CONCLUSION The use of sublingual misoprostol or intravenous syntometrine in spontaneous vaginal delivery resulted in a comparable amount of blood loss. Transient side effect such as fever and shivering which resolved within a day occurred more frequent to those who received sublingual misoprostol.
Collapse
Affiliation(s)
- H Lam
- Department of Obstetrics and Gynecology, Queen Mary Hospital, Hong Kong SAR, China.
| | | | | | | |
Collapse
|
48
|
Narayanan S, Lam H, Christian L, Levine MS, Grandy D, Rubinstein M, Maidment NT. Endogenous opioids mediate basal hedonic tone independent of dopamine D-1 or D-2 receptor activation. Neuroscience 2004; 124:241-6. [PMID: 14960355 DOI: 10.1016/j.neuroscience.2003.11.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2003] [Indexed: 10/26/2022]
Abstract
Exogenously administered opiates are recognized as rewarding and the involvement of dopamine systems in mediating their apparent pleasurable effects is contentious. The aversive response to naloxone administration observed in animal studies suggests the presence of an endogenous opioid tone regulating hedonic state. We sought evidence for the requirement for dopamine systems in mediating this action of endogenous opioids by determining whether mice deficient in dopamine D-1 or D-2 receptors were able to display conditioned place aversion to naloxone. Mice received saline in the morning in one chamber and either saline or naloxone (10 mg/kg, s.c.) in the afternoon in another chamber, each day for 3 days. On the test day they were given free access to the testing chambers in the afternoon. Similar to their wild-type littermates, D-1 and D-2 receptor knockout mice receiving naloxone in the afternoon spent significantly less time on the test day in the compartment in which they previously received naloxone, compared with animals receiving saline in the afternoon. The persistence of naloxone-conditioned place aversion in D-1 and D-2 knockout mice suggests that endogenous opioid peptides maintain a basal level of positive affect that is not dependent on downstream activation of dopamine systems involving D-1 or D-2 receptors.
Collapse
Affiliation(s)
- S Narayanan
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles Neuropsychiatric Institute, 760 Westwood Plaza, Los Angeles, CA 90024, USA
| | | | | | | | | | | | | |
Collapse
|
49
|
Lam H, Pun TC, Lam PW. Successful conservative management of placenta previa accreta during cesarean section. Int J Gynaecol Obstet 2004; 86:31-2. [PMID: 15207668 DOI: 10.1016/j.ijgo.2003.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2003] [Revised: 12/22/2003] [Accepted: 12/24/2003] [Indexed: 11/21/2022]
Affiliation(s)
- H Lam
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, HKSAR, China.
| | | | | |
Collapse
|
50
|
Jensen DM, Cotler SJ, Lam H, Harb G, Shillington A. A comparison of hepatitis C treatment and outcomes at academic, private and Veterans' Affairs treatment centres. Aliment Pharmacol Ther 2004; 19:69-77. [PMID: 14687168 DOI: 10.1046/j.1365-2036.2003.01817.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Currently, there is a lack of published data examining hepatitis C treatment practices in different care settings. AIM To provide data describing treatment practices for patients with hepatitis C virus infection in actual clinical practice, and to examine clinical outcomes in patients treated with interferon alpha-2b/ribavirin combination therapy in academically affiliated centres, private treatment centres and Veterans' Affairs treatment centres. METHODS This multi-centre, retrospective, cohort study of 231 patients examined hepatitis C virus treatment practices in patients receiving interferon alpha-2b from January 1997 to May 2001 and explored outcomes in academically affiliated, private and Veterans' Affairs centres. RESULTS Differences in treatment practice and use of diagnostic procedures were found. Genotype testing was under-utilized in non-academic sites (academic centres, 79.2%; private centres, 33.7%; Veterans' Affairs centres, 35.9%; P<0.001). Liver biopsies were performed less often in private sites (academic centres, 95.8%; private centres, 80.0%; Veterans' Affairs centres, 92.2%; P<0.01). End-of-treatment viral response (academic centres, 40.0%; private centres, 31.3%; Veterans' Affairs centres, 17.2%; P<0.05) was lower than that found in published trial data. Multivariate analysis revealed genotype 1 as the single significant predictor of treatment failure (P<0.01). CONCLUSIONS Outside of the academic setting, there is significantly less diagnostic work-up performed prior to the initiation of hepatitis C virus therapy. This suggests a need for a standardization of care across treatment settings.
Collapse
Affiliation(s)
- D M Jensen
- Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA
| | | | | | | | | |
Collapse
|