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Burris HA, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, Portenoy RK, Storniolo AM, Tarassoff P, Nelson R, Dorr FA, Stephens CD, Von Hoff DD. Improvements in Survival and Clinical Benefit With Gemcitabine as First-Line Therapy for Patients With Advanced Pancreas Cancer: A Randomized Trial. J Clin Oncol 2023; 41:5482-5492. [PMID: 38100992 DOI: 10.1200/jco.22.02777] [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: 12/17/2023] Open
Abstract
PURPOSE Most patients with advanced pancreas cancer experience pain and must limit their daily activities because of tumor-related symptoms. To date, no treatment has had a significant impact on the disease. In early studies with gemcitabine, patients with pancreas cancer experienced an improvement in disease-related symptoms. Based on those findings, a definitive trial was performed to assess the effectiveness of gemcitabine in patients with newly diagnosed advanced pancreas cancer. PATIENTS AND METHODS One hundred twenty-six patients with advanced symptomatic pancreas cancer completed a lead-in period to characterize and stabilize pain and were randomized to receive either gemcitabine 1,000 mg/m2 weekly x 7 followed by 1 week of rest, then weekly x 3 every 4 weeks thereafter (63 patients), or to fluorouracil (5-FU) 600 mg/m2 once weekly (63 patients). The primary efficacy measure was clinical benefit response, which was a composite of measurements of pain (analgesic consumption and pain intensity), Karnofsky performance status, and weight. Clinical benefit required a sustained (> or = 4 weeks) improvement in at least one parameter without worsening in any others. Other measures of efficacy included response rate, time to progressive disease, and survival. RESULTS Clinical benefit response was experienced by 23.8% of gemcitabine-treated patients compared with 4.8% of 5-FU-treated patients (P = .0022). The median survival durations were 5.65 and 4.41 months for gemcitabine-treated and 5-FU-treated patients, respectively (P = .0025). The survival rate at 12 months was 18% for gemcitabine patients and 2% for 5-FU patients. Treatment was well tolerated. CONCLUSION This study demonstrates that gemcitabine is more effective than 5-FU in alleviation of some disease-related symptoms in patients with advanced, symptomatic pancreas cancer. Gemcitabine also confers a modest survival advantage over treatment with 5-FU.
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Affiliation(s)
- H A Burris
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - M J Moore
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - J Andersen
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - M R Green
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - M L Rothenberg
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - M R Modiano
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - M C Cripps
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - R K Portenoy
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - A M Storniolo
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - P Tarassoff
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - R Nelson
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - F A Dorr
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - C D Stephens
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
| | - D D Von Hoff
- Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX 78245, USA
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Andersen J, Caccese J, Esopenko C, Fu A, McKay M, Meyer T, Oxenham V, Peek K. The effect of ball characteristics on head impact magnitude during purposeful heading in adolescent male and female football players. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Falkentoft AC, Andersen J, Malik ME, Selmer C, Gaede PH, Staehr PB, Hlatky MA, Fosboel E, Koeber L, Torp-Pedersen C, Gislason GH, Gerds TA, Shou M, Bruun NE, Ruwald AC. Socioeconomic position and initiation of SGLT-2 inhibitors or GLP-1 receptor agonists in patients with type 2 diabetes – a Danish nationwide observational study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2622] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Between 2015 and 2017, Sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucacon-like-peptide-1 receptor agonists (GLP-1 RA) were shown to reduce cardiovascular events in patients with type 2 diabetes and cardiovascular disease. Thus, in 2018, guidelines were updated to favor these drugs in patients with cardiovascular disease and type 2 diabetes. Lower socioeconomic position may adversely affect use of SGLT-2 inhibitors and GLP-1 RA.
Purpose
We aimed to examine socioeconomic differences in initiation of SGLT-2 inhibitors and GLP-1 RA in a contemporary population of patients with type 2 diabetes.
Methods
Through the Danish nationwide registers, we identified all patients with type 2 diabetes who initiated second-line add-on therapy after metformin monotherapy between December 10, 2012, and December 31, 2018. Patients aged 40–79 years and without a history of end-stage renal disease were included. We measured socioeconomic position according to level of income: Low = 1st quartile; Middle = 2nd and 3rd quartile; High = 4th quartile. Based on multivariable logistic regression models adjusted for age, sex, cohabitation status, duration of type 2 diabetes, comorbidities, and cardiovascular medications, we reported the standardised probabilities of initiating each drug class at time of first intensification according to income group and time period: 2012–2014, 2015–2017, and 2018.
Results
The 33,201 patients had a median age of 63 years (interquartile range 53–69). The probability of initiating a SGLT-2 inhibitor or a GLP-1 RA increased over time in all income-groups. In each time period, the standardised probability of initiating a SGLT-2 inhibitor or a GLP-1 RA at time of first intensification increased with increasing income (Figure): in 2012–2014, from 9.6% (95% confidence interval (CI) 8.4–10.9) in the lowest income group to 14.4% (CI 12.9–15.9) in the highest income group; in 2015–2017, from 19.5% (CI 18.3–20.7) to 24.6% (CI 23.3–25.9); in 2018, from 39.9% (CI 37.5–42.3) to 50.7% (CI 48.2–53.1). The absolute difference between high and low income groups increased over time, reaching 10.8% (CI 7.3–14.3) in 2018. A similar trend was observed in both subgroups of patients with and without established cardiovascular disease (data not shown). Initiation of a dipeptidyl peptidase-4 (DPP-4) inhibitor increased with income in the early time periods, but this trend reversed in 2018 (Figure). Initiation of sulfonylureas (SU) showed a consistent inverse association with income in each time period.
Conclusions
Low socioeconomic position was consistently associated with a lower probability of initiation of a GLP-1 RA or a SLGT-2 inhibitor at time of first intensification of antidiabetic treatment, even after guidelines recommended these drugs to patients with established cardiovascular disease. These disparities may adversely affect cardiovascular outcomes in patients with low socioeconomic position.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - J Andersen
- The Danish Heart Foundation, Copenhagen, Denmark
| | - M E Malik
- Herlev and Gentofte Hospital, Cardiology, Copenhagen, Denmark
| | - C Selmer
- Bispebjerg University Hospital, Endocrinology, Copenhagen, Denmark
| | - P H Gaede
- Slagelse Hospital, Endocrinology, Slagelse, Denmark
| | - P B Staehr
- North Denmark Regional Hospital, Cardiology, Hjørring, Denmark
| | - M A Hlatky
- School of Medicine, Department of medicine, Stanford, United States of America
| | - E Fosboel
- Rigshospitalet - Copenhagen University Hospital, Cardiology, Copenhagen, Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Cardiology, Copenhagen, Denmark
| | | | - G H Gislason
- Herlev and Gentofte Hospital, Cardiology, Copenhagen, Denmark
| | - T A Gerds
- Section of biostatistics, University of, Department of public health, Copenhagen, Denmark
| | - M Shou
- Herlev and Gentofte Hospital, Cardiology, Copenhagen, Denmark
| | - N E Bruun
- Zealand University Hospital, Roskilde, Denmark
| | - A C Ruwald
- Zealand University Hospital, Roskilde, Denmark
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Breidablik H, Johannessen L, Andersen J, Lysebo D, Skare Å, Kleiven OT. Both soap and ozone more effective and better tolerated than alcohol hand disinfection? Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.693] [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: 11/14/2022] Open
Abstract
Abstract
Background
Preventing the transfer of virulent microorganisms is an essential part of infection control programs and clinical practice. Hand disinfection using alcohol from dispensers has become a standard practice worldwide; however, consequent skin irritation is frequently reported. Thus, alternative methods for hand sanitization are needed.
Objectives
We used a modified European Standard procedure (EN 1500:2013) with the aim of comparing the efficiency of alcohol, ozonated water and soap for eradicating transient Escherichia coli from artificially contaminated hands.
Methods
We applied a crossover design for testing alcohol and ozone (20 participants/product; 40 participants in total). The participants were mostly nursing students. We have merged the results from two separate crossover studies with altogether 35 participants, and also included 20 non-crossover participants for soap washing.
Results
Both ozonated tap water and soap & water were more effective than alcohol disinfection; and washing hands with soap the most effective. In some participants, disinfection with alcohol seemed to fail at eradicating transient E. coli from the hands, particularly from one side. The pre-test CFU/mL values were ≥30,000 in 52 of 55 participants. After disinfection of both the hands with 85% alcohol, 0.8 ppm ozonated tap water and soap & water, the mean/median (range) values were 2330/300 (14,000), 538/250 (3450) and 98/50 (450), respectively. The majority of the participants (66%) stated that they would prefer using ozonated tap water if the disinfection effect was the same as that of other agents.
Conclusions
We hypothesize that hand disinfection with alcohol is more difficult, and that the flow rate of water may play a pivotal role in eradicating microorganisms in addition to the choice of disinfectant. Ozonated tap water had no adverse effects on the skin and was preferred by most participants.
Key messages
Ozonized water as hand disinfection. Alcohol hand disinfection problems.
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Affiliation(s)
- H Breidablik
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
| | - L Johannessen
- Microbiology Department, Thelma Indoor Air & Working Environment, Trondheim, Norway
| | - J Andersen
- Western Norway University of Applied Sciences, Centre of Health Research, Førde, Norway
| | - D Lysebo
- Haukeland University Hospital, Haukeland University Hospital, Bergen, Norway
| | - Å Skare
- Førde Hospital Trust, Department for Infection Control, Førde Hospital Trust, Førde, Norway
| | - O T Kleiven
- Western Norway University of Applied Sciences, Førde, Norway
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Oliveira M, Saura C, Nuciforo P, Calvo I, Andersen J, Passos-Coelho JL, Gil Gil M, Bermejo B, Patt DA, Ciruelos E, de la Peña L, Xu N, Wongchenko M, Shi Z, Singel SM, Isakoff SJ. FAIRLANE, a double-blind placebo-controlled randomized phase II trial of neoadjuvant ipatasertib plus paclitaxel for early triple-negative breast cancer. Ann Oncol 2020; 30:1289-1297. [PMID: 31147675 DOI: 10.1093/annonc/mdz177] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND This hypothesis-generating trial evaluated neoadjuvant ipatasertib-paclitaxel for early triple-negative breast cancer (TNBC). PATIENTS AND METHODS In this randomized phase II trial, patients with early TNBC (T ≥ 1.5 cm, N0-2) were randomized 1 : 1 to receive weekly paclitaxel 80 mg/m2 with ipatasertib 400 mg or placebo (days 1-21 every 28 days) for 12 weeks before surgery. Co-primary end points were pathologic complete response (pCR) rate (ypT0/TisN0) in the intention-to-treat (ITT) and immunohistochemistry phosphatase and tensin homolog (PTEN)-low populations. Secondary end points included pCR rate in patients with PIK3CA/AKT1/PTEN-altered tumors and pre-surgery response rates by magnetic resonance imaging (MRI). RESULTS pCR rates with ipatasertib versus placebo were 17% versus 13%, respectively, in the ITT population (N = 151), 16% versus 13% in the immunohistochemistry PTEN-low population (N = 35), and 18% versus 12% in the PIK3CA/AKT1/PTEN-altered subgroup (N = 62). Rates of overall and complete response (CR) by MRI favored ipatasertib in all three populations (CR rate 39% versus 9% in the PIK3CA/AKT1/PTEN-altered subgroup). Ipatasertib was associated with more grade ≥3 adverse events (32% versus 16% with placebo), especially diarrhea (17% versus 1%). Higher cycle 1 day 8 (C1D8) immune score was significantly associated with better response only in placebo-treated patients. All ipatasertib-treated patients with low immune scores and a CR had PIK3CA/AKT1/PTEN-altered tumors. CONCLUSIONS Adding ipatasertib to 12 weeks of paclitaxel for early TNBC did not clinically or statistically significantly increase pCR rate, although overall response rate by MRI was numerically higher with ipatasertib. The antitumor effect of ipatasertib was most pronounced in biomarker-selected patients. Safety was consistent with prior experience of ipatasertib-paclitaxel. A T-cell-rich environment at C1D8 had a stronger association with improved outcomes in paclitaxel-treated patients than seen for baseline tumor-infiltrating lymphocytes. This dependency may be overcome with the addition of AKT inhibition, especially in patients with PIK3CA/AKT1/PTEN-altered tumors. CLINICALTRIALS.GOV NCT02301988.
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Affiliation(s)
- M Oliveira
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona; Breast Cancer Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona; SOLTI Breast Cancer Research Group, Barcelona.
| | - C Saura
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona; Breast Cancer Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona; SOLTI Breast Cancer Research Group, Barcelona
| | - P Nuciforo
- Molecular Oncology Group, VHIO, Barcelona
| | - I Calvo
- Breast Cancer Unit, Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain
| | - J Andersen
- Medical Oncology and Hematology, Compass Oncology and US Oncology, Portland, USA
| | | | - M Gil Gil
- SOLTI Breast Cancer Research Group, Barcelona; Medical Oncology Service, Institut Català d'Oncologia, L'Hospitalet, Barcelona; Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Barcelona
| | - B Bermejo
- Hospital Clinico Universitario, Valencia, Spain
| | - D A Patt
- Texas Oncology Cancer Center, US Oncology, Austin, USA
| | - E Ciruelos
- SOLTI Breast Cancer Research Group, Barcelona; Medical Oncology Department, University Hospital 12 de Octubre, Madrid, Spain
| | | | - N Xu
- Product Development Oncology, Genentech Inc., South San Francisco
| | - M Wongchenko
- Oncology Biomarker Department, Genentech Inc., South San Francisco
| | - Z Shi
- Oncology Biomarker Department, Genentech Inc., South San Francisco
| | - S M Singel
- Product Development Oncology, Genentech Inc., South San Francisco
| | - S J Isakoff
- Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center, Boston, USA
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Bihlet A, Byrjalsen I, Nielsen HB, Andersen J, Delpy L, Derne C, Carrara D. AB0856 A PLACEBO-CONTROLLED, DOUBLE-BLIND, RANDOMIZED, TRIAL OF AMZ001 – A NOVEL DICLOFENAC SODIUM 3.06% GEL - FOR THE TREATMENT OF KNEE OSTEOARTHRITIS SYMPTOMS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1984] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Development of improved topical treatments of painful joints is warranted. A novel diclofenac sodium gel formulation, AMZ001, has been developed with the purpose of improving 1) The onset and duration of pain relief, and 2) The ease of use by reducing the required daily frequency of gel application. Previous trials in human subjects have confirmed improved permeability of a reduced volume of AMZ001 gel as compared to approved diclofenac topical products with a comparable safety and tolerability profile, supporting trials to evaluate the efficacy and safety of AMZ001 in painful joint conditions.Objectives:The current abstract reports the main results of a randomized trial of AMZ001 once or twice daily application versus placebo in symptomatic knee osteoarthritis.Methods:The trial was a placebo-controlled, parallel group, double-blind, randomized trial to evaluate the efficacy and safety of AMZ001 or placebo in subjects with knee osteoarthritis. The main inclusion criteria were Kellgren-Lawrence radiographic severity of 1-3, and pain ≥40 and ≤90 out of 100 using the WOMAC pain subscale (5 questions) at the time of screening. The subjects were randomized to apply AMZ001 gel once (QD) or twice (BID) daily or placebo twice daily per OA knee for a period of 28 days, or to apply Voltaren® Gel 1 % four times daily (QID) in a single-blind fashion for exploratory comparison. The primary endpoint was change from baseline at week 4 in WOMAC pain (5 questions). The main secondary endpoints included WOMAC subscales, Patient Global Assessment (PGA) and quality of life using the EQ-5D. In addition to the main analysis, a post-hoc subgroup analysis of subjects meeting the pain criterion at both screening and baseline was performed.Results:A total of 444 subjects were randomized. The main baseline characteristics were well balanced between treatment groups.AMZ001 QD and BID led to statistically significant reductions in pain compared to baseline with an estimated difference (95% CI) normalized to 0-100 at week 4 of -27.33 (-30.50, -24.17), and -26.49 (-29.60, -23.38), respectively. Reduction in pain at week 4 was statistically significantly superior to placebo for AMZ001 QD (p=0.04), and borderline significant for AMZ001 BID (p<0.10) as shown in Figure 1.Both AMZ001 QD and BID led to statistically significant improvements in PGA at week 4 compared to placebo (p<0.05 for both), and AMZ001 BID led to significantly improved quality of life (p<0.05) compared to placebo. There were no statistically significant differences between AMZ001 QD or BID in any of the endpoints. In the post-hoc analysis of subjects meeting the pain criterion at both screening and baseline the differentiation to placebo was strengthened for all efficacy endpoints, as shown in Figure 2.While the study design and differences in sample sizes does not allow formal comparisons between the double- and single blinded groups, the exploratory comparator, Voltaren QID, did not reach statistically significant differences to placebo or AMZ001 in any of the endpoints, in neither the ITT nor the subgroup analyses.The safety and tolerability of AMZ001 was favorable, as the frequency of AEs leading to discontinuation of treatment was similarly low (ranging between 2.8 % to 6.6 %) between AMZ001 once or twice daily and placebo or Voltaren Gel 1%. The most common treatment-emergent AEs were application site dryness, and application site erythema. No serious adverse events were reported during the trial.Conclusion:AMZ001, a novel topical diclofenac formulation, either once or twice daily was efficacious in the treatment of knee OA pain with a good tolerability and safety profile, suggesting AMZ001 may be a promising alternative to existing pain-relieving treatments in knee OA.References:NADisclosure of Interests:Asger Bihlet Shareholder of: Nordic Bioscience, Consultant of: Amzell BV, Medivir AB, Xintela AB, Merck KGaA, Employee of: Nordic Bioscience, Inger Byrjalsen Employee of: Nordic Bioscience, Henning Bay Nielsen: None declared, Jeppe Andersen Shareholder of: Minor shareholder of Nordic Bioscience, Consultant of: Medivir AB, Xintela AB, Employee of: Nordic Bioscience, Laetitia Delpy Employee of: Amzell BV, Caroline Derne Employee of: Amzell BV, Dario Carrara Employee of: Amzell BV
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Andersen J, Larsen RW, Ceponkus J, Uvdal P, Nelander B. Far-Infrared Investigation of the Benzene–Water Complex: The Identification of Large-Amplitude Motion and Tunneling Pathways. J Phys Chem A 2019; 124:513-519. [DOI: 10.1021/acs.jpca.9b01497] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Andersen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kgs. Lyngby, Denmark
| | - R. Wugt Larsen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kgs. Lyngby, Denmark
| | - J. Ceponkus
- Department of General Physics and Spectroscopy, Vilnius University, Sauletekio 9, LT-10007 Vilnius, Lithuania
| | - P. Uvdal
- Chemical Physics, Department of Chemistry, Lund University, P.O. Box 124, SE-22100 Lund, Sweden
| | - B. Nelander
- Chemical Physics, Department of Chemistry, Lund University, P.O. Box 124, SE-22100 Lund, Sweden
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Madelaire C, Gustafsson F, Kristensen SL, Stevenson LW, Koeber L, Torp-Pedersen C, D'Souza M, Andersen J, Gislason G, Biering-Sorensen T, Andersson C, Schou M. P765One-year mortality risk after intensification of outpatient diuretics. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0365] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Mortality is increased following a hospitalization for heart failure (HF). It is not clear whether outpatient intensification of diuretic confers the same increased risk in the general population with heart failure
Purpose
This study sought to assess 1-year mortality risk after worsening HF, defined either as hospitalization due to HF or as intensified diuretic therapy in an outpatient setting, in a complete nationwide cohort of patients with HF on angiotensin converting enzyme inhibitors/ angiotensin receptor blocker and beta blockers.
Methods
From nationwide administrative registers, we identified all patients in Denmark diagnosed with HF in 2001–2016 and prescribed angiotensin converting enzyme inhibitor/ angiotensin receptor blocker and beta blocker within 120 days. During follow-up we defined worsening HF by the following events: Inpatient worsening (HF readmission) and outpatient worsening (intensified diuretic therapy, defined as the first event of new addition or doubled dosage of loop diuretic therapy or new onset addition of thiazide to loop diuretic therapy). Patients with a worsening event were risk set matched to two HF controls each at time of the event – based on age, sex and calendar year. One-year mortality risk was estimated with Kaplan-Meier and multivariable Cox regression models.
Results
We included 74,990 patients, median age 71 years (interquartile range: 62–79), 36% women. During five years of follow up, 8,727 patients had an inpatient worsening event, and 12,290 had an outpatient worsening event as first event. Absolute risk of 1-year mortality was 22.6% (95%-confidence interval (95%-CI): 21.7%-23.5%) after inpatient worsening, 18.0% (95%-CI: 17.3%-18.7%) after outpatient worsening compared to 9.8% (95%-CI: 9.5%-10.1%) for the matched controls. In a multivariable Cox model adjusted ischemic heart disease, atrial fibrillation, chronic obstructive pulmonary disease and diabetes, the hazard ratio for mortality among patients experiencing inpatient worsening was 2.46 (95%-CI: 2.33–2.60) and for outpatient worsening was 1.87 (95%-CI: 1.77–1.97), compared with the matched HF controls as reference (figure 1). Among patients who had an outpatient worsening as first event, 1,245 (10.1%) had a subsequent HF readmission within one year.
Conclusion
In a nationwide cohort of patients with HF, outpatient worsening defined by a diuretic intensification was associated with almost 2-fold risk of mortality during the next year. Although HF hospitalization is associated with a higher risk, the need to intensify diuretics in the outpatient setting is a signal to review and intensify efforts to improve HF outcomes.
Acknowledgement/Funding
The Danish Heart Foundation, (grant number 17-R116-A7610-22048)
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Affiliation(s)
- C Madelaire
- Gentofte University Hospital, department of cardiology, the cardiovascular research center, Copenhagen, Denmark
| | - F Gustafsson
- Rigshospitalet - Copenhagen University Hospital, Department of cardiology, Copenhagen, Denmark
| | - S L Kristensen
- Rigshospitalet - Copenhagen University Hospital, Department of cardiology, Copenhagen, Denmark
| | - L W Stevenson
- Vanderbilt University, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, United States of America
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of cardiology, Copenhagen, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Department of cardiology, Aalborg, Denmark
| | - M D'Souza
- Gentofte University Hospital, department of cardiology, the cardiovascular research center, Copenhagen, Denmark
| | - J Andersen
- The Danish Heart Foundation, Copenhagen, Denmark
| | - G Gislason
- Gentofte University Hospital, department of cardiology, the cardiovascular research center, Copenhagen, Denmark
| | - T Biering-Sorensen
- Gentofte University Hospital, department of cardiology, the cardiovascular research center, Copenhagen, Denmark
| | - C Andersson
- Herlev Hospital, Department of cardiology, Herlev, Denmark
| | - M Schou
- Herlev Hospital, Department of cardiology, Herlev, Denmark
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Wongchenko MJ, Oliveira M, Saura C, Nuciforo P, Calvo I, Andersen J, Passos Coelho JI, Gil Gil M, Bermejo B, Patt DA, Ciruelos E, Singel SM, Maslyar DJ, Xu N, de la Peña L, Baselga J, Gendreau S, Isakoff SJ. Abstract P2-08-19: Exploratory biomarker analyses of FAIRLANE, a double-blind placebo (PBO)-controlled randomized phase II trial of neoadjuvant ipatasertib (IPAT) + paclitaxel (PAC) for early triple-negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The oral AKT inhibitor IPAT is being evaluated in cancers with a high prevalence of PI3K/AKT pathway activation. In the PBO-controlled randomized phase II FAIRLANE trial (NCT02301988), adding IPAT to PAC as neoadjuvant therapy for TNBC led to a numerical increase in pathologic complete response (pCR) in unselected patients (17.1% vs 13.3%), with a greater treatment effect in patients with PIK3CA/AKT1/PTEN-altered tumors (17.9% vs 11.8%). The addition of IPAT also led to an increase in complete response (CR) by MRI (27.6% vs 13.3%) that was enhanced in patients with PIK3CA/AKT1/PTEN-altered tumors (39.3% vs 8.8%) [Oliveira, AACR 2018]. We report an exploratory analysis performed to provide better understanding of potential biomarkers for response.
Methods: Pretreatment tumor samples were evaluated for genomic alterations using the FoundationOne® (Foundation Medicine) assay (n=144) and gene expression by RNA-Seq (n=92). Samples were classified into TNBC subtypes based on the method developed by Lehmann and Pietenpol [Lehmann, J Clin Invest 2011]. Tumor-infiltrating lymphocytes (TILs) were quantified using the Salgado method [Salgado, Ann Oncol 2015] (n=135).
Results: Of 62 patients (43%) with PIK3CA/AKT1/PTEN-altered tumors, 21 had an activating mutation in PIK3CA or AKT1 and 47 had an alteration in PTEN (6 [3 in each arm] had both PIK3CA mutation and PTEN alteration). Although only 3 patients with PIK3CA/AKT1-mutant tumors achieved a pCR, there was an increased rate of MRI CR with the addition of IPAT to PAC [Table]. In patients with PTEN alterations, both pCR rate and MRI CR rate were increased with IPAT. In patients treated with PBO + PAC, all 4 pCR patients evaluable by RNA-Seq were of the immunomodulatory (IM) subtype. However, in the IPAT + PAC arm, pCRs were also seen in patients with basal-like 1 (BL-1), mesenchymal (M), and mesenchymal stem-like (MSL) subtypes. Consistent with this observation, in the PBO + PAC arm, samples from patients achieving a pCR had significantly higher levels of stromal TILs than those from patients who did not have a pCR, while no difference was observed in the IPAT + PAC arm.
Response, n (%)PIK3CA/AKT mutation (n=21)PTEN alteration (n=47) IPAT + PAC (n=11)PBO + PAC (n=10)IPAT + PAC (n=21)PBO + PAC (n=26)pCR1 (9%)2 (20%)4 (19%)3 (12%)CR by MRI5 (45%)1 (10%)8 (38%)2 (8%)
Conclusions: This retrospective exploratory biomarker analysis of the phase II FAIRLANE trial of neoadjuvant IPAT for TNBC provides insight into the potential heterogeneity of response and resistance to taxane therapy. The results also hint that response to PAC alone is dependent on baseline immune infiltration and that this dependency might be relieved with the addition of AKT inhibition.
Citation Format: Wongchenko MJ, Oliveira M, Saura C, Nuciforo P, Calvo I, Andersen J, Passos Coelho JI, Gil Gil M, Bermejo B, Patt DA, Ciruelos E, Singel SM, Maslyar DJ, Xu N, de la Peña L, Baselga J, Gendreau S, Isakoff SJ. Exploratory biomarker analyses of FAIRLANE, a double-blind placebo (PBO)-controlled randomized phase II trial of neoadjuvant ipatasertib (IPAT) + paclitaxel (PAC) for early triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-19.
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Affiliation(s)
- MJ Wongchenko
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - M Oliveira
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - C Saura
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - P Nuciforo
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - I Calvo
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - J Andersen
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - JI Passos Coelho
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - M Gil Gil
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - B Bermejo
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - DA Patt
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - E Ciruelos
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - SM Singel
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - DJ Maslyar
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - N Xu
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - L de la Peña
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - J Baselga
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - S Gendreau
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
| | - SJ Isakoff
- Genentech Inc, South San Francisco, CA; Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO) and SOLTI Breast Cancer Research Group, Barcelona, Spain; Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Centro Integral Oncologico Clara Campal (CIOCC), Madrid, Spain; Compass Oncology and US Oncology, Portland, OR; Hospital Beatriz Angelo, Loures, Portugal; Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain; Hospital Clinico Universitario, Valencia, Spain; Texas Oncology Cancer Center, US Oncology, Austin, TX; University Hospital 12 de October and SOLTI Breast Cancer Research Group, Madrid, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain; Memorial Sloan Kettering Cancer Center, New York, NY; Massachusetts General Hospital, Boston, MA
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Mihrin D, Andersen J, Jakobsen PW, Wugt Larsen R. Highly localized H 2O librational motion as a far-infrared spectroscopic probe for microsolvation of organic molecules. Phys Chem Chem Phys 2019; 21:1717-1723. [PMID: 30623967 DOI: 10.1039/c8cp05985c] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The most prominent spectroscopic observable for the hydrogen bonding between individual molecules in liquid water is the broad absorption band detected in the spectral region between 300 and 900 cm-1. The present work demonstrates how the associated large-amplitude out-of-plane OH librational motion of H2O molecules also directly reflects the microsolvation of organic compounds. This highly localized OH librational motion of the first solvating H2O molecule causes a significant change of dipole moment and gives rise to a strong characteristic band in the far-infrared spectral region, which is correlated quantitatively with the complexation energy. The out-of-plane OH librational band origins ranging from 324.5 to 658.9 cm-1 have been assigned experimentally for a series of four binary hydrogen-bonded H2O complexes embedded in solid neon involving S-, O- and N-containing compounds with increasing hydrogen bond acceptor capability. The hydrogen bond energies for altogether eight binary H2O complexes relative to the experimental value of 13.2 ± 0.12 kJ mol-1 for the prototypical (H2O)2 system [Rocher-Casterline et al., J. Chem. Phys., 2011, 134, 211101] are revealed directly by these far-infrared spectroscopic observables. The far-infrared spectral signatures are able to capture even minor differences in the hydrogen bond acceptor capability of O atoms with slightly different alkyl substituents in the order H-O-C(CH3)3 > CH3-O-CH3 > H-O-CH(CH3)2 > H-O-CH2CH3.
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Affiliation(s)
- D Mihrin
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kgs. Lyngby, Denmark.
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11
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Hansen C, Andersen J, Kjelmann K, Lund T. Labour market trajectories over the life-course - the importance of childhood negative life events? Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Hansen
- Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
| | - J Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland—University Research Clinic, Herning, Denmark
| | - K Kjelmann
- Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
| | - T Lund
- Unit of Social Medicine, Department of Occupational and Environmental Medicine, Frederiksberg Hospital, Frederiksberg, Denmark
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12
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Kjaer A, Jensen W, Dyrby T, Andreasen L, Andersen J, Andreassen S, Nielsen KD. Causal Probabilistic Network and Power Spectral Estimation Used in Sleep Stage Classification. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636853] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract.A new method for sleep-stage classification using a causal probabilistic network as automatic classifier has been implemented and validated. The system uses features from the primary sleep signals from the brain (EEG) and the eyes (AOG) as input. From the EEG, features are derived containing spectral information which is used to classify power in the classical spectral bands, sleep spindles and K-complexes. From AOG, information on rapid eye movements is derived. Features are extracted every 2 seconds. The CPN-based sleep classifier was implemented using the HUGIN system, an application tool to handle causal probabilistic networks. The results obtained using different training approaches show agreements ranging from 68.7 to 70.7% between the system and the two experts when a pooled agreement is computed over the six subjects. As a comparison, the interrater agreement between the two experts was found to be 71.4%, measured also over the six subjects.
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13
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Saussaye L, van Veen E, Rollinson G, Boutouil M, Andersen J, Coggan J. Geotechnical and mineralogical characterisations of marine-dredged sediments before and after stabilisation to optimise their use as a road material. Environ Technol 2017; 38:3034-3046. [PMID: 28118789 DOI: 10.1080/09593330.2017.1287220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 01/22/2017] [Indexed: 06/06/2023]
Abstract
Dredging activities to extend, deepen and maintain access to harbours generate significant volumes of waste dredged material. Some ways are investigated to add value to these sediments. One solution described here is their use in road construction following treatment with hydraulic binders. This paper presents the characterisation of four sediments, in their raw state and after 90 days of curing following stabilisation treatment with lime and cement, using a combination of novel and established analytical techniques to investigate subsequent changes in mineralogy. These sediments are classified as fine, moderately to highly organic and highly plastic and their behaviour is linked to the presence of smectite clays. The main minerals found in the sediments using X-ray diffraction (XRD) and automated mineralogy are quartz, calcite, feldspars, aluminium silicates, pyrite and halite. Stabilisation was found to improve the mechanical performances of all the sediments. The formation of cementitious hydrates was not specifically detected using automated mineralogy or XRD. However, a decrease in the percentage volume of aluminium silicates and aluminium-iron silicates and an increase of the percentage volume of feldspars and carbonates was observed.
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Affiliation(s)
- L Saussaye
- a Ecole Supérieure d'Ingénierie et des Travaux de la Construction de Caen (ESITC Caen) Epron , France
| | - E van Veen
- b Camborne School of Mines (CSM), College of Engineering, Mathematics and Physical Sciences (CEMPS), Tremough Campus, University of Exeter , Penryn , UK
| | - G Rollinson
- b Camborne School of Mines (CSM), College of Engineering, Mathematics and Physical Sciences (CEMPS), Tremough Campus, University of Exeter , Penryn , UK
| | - M Boutouil
- a Ecole Supérieure d'Ingénierie et des Travaux de la Construction de Caen (ESITC Caen) Epron , France
| | - J Andersen
- b Camborne School of Mines (CSM), College of Engineering, Mathematics and Physical Sciences (CEMPS), Tremough Campus, University of Exeter , Penryn , UK
| | - J Coggan
- b Camborne School of Mines (CSM), College of Engineering, Mathematics and Physical Sciences (CEMPS), Tremough Campus, University of Exeter , Penryn , UK
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14
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Hoory E, Budassi J, Pfeffer E, Cho N, Thalappillil J, Andersen J, Rafailovich M, Sokolov J. Discrimination of Adsorbed Double-Stranded and Single-Stranded DNA Molecules on Surfaces by Fluorescence Emission Spectroscopy Using Acridine Orange Dye. J Fluoresc 2017; 27:2153-2158. [DOI: 10.1007/s10895-017-2154-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 07/31/2017] [Indexed: 10/19/2022]
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15
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Affiliation(s)
- M. Chamoli
- Buck Institute for Research on Aging, Novato, California,
| | - S. Chinta
- Buck Institute for Research on Aging, Novato, California,
- Touro University California, Vallejo, California
| | - M. Schmidt
- Buck Institute for Research on Aging, Novato, California,
| | - G.J. Lithgow
- Buck Institute for Research on Aging, Novato, California,
| | - J. Andersen
- Buck Institute for Research on Aging, Novato, California,
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16
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Melov S, Evans D, Andersen J, Kapahi P, Lithgow G. PHARMACOLOGICALLY TARGETING AGING SLOWS AGE-RELATED BONE LOSS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4485] [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)
- S. Melov
- Buck Institute for Research on Aging, Novato, California,
| | - D. Evans
- California Pacific Medical Center, San Francisco, California
| | - J. Andersen
- Buck Institute for Research on Aging, Novato, California,
| | - P. Kapahi
- Buck Institute for Research on Aging, Novato, California,
| | - G.J. Lithgow
- Buck Institute for Research on Aging, Novato, California,
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17
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Andersen J, Voute A, Mihrin D, Heimdal J, Berg RW, Torsson M, Wugt Larsen R. Probing the global potential energy minimum of (CH2O)2: THz absorption spectrum of (CH2O)2 in solid neon and para-hydrogen. J Chem Phys 2017; 146:244311. [DOI: 10.1063/1.4990042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J. Andersen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - A. Voute
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - D. Mihrin
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - J. Heimdal
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - R. W. Berg
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - M. Torsson
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - R. Wugt Larsen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
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18
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Andersen J, Heimdal J, Nelander B, Wugt Larsen R. Competition between weak OH⋯π and CH⋯O hydrogen bonds: THz spectroscopy of the C2H2—H2O and C2H4—H2O complexes. J Chem Phys 2017; 146:194302. [PMID: 28527443 DOI: 10.1063/1.4983293] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- J Andersen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - J Heimdal
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - B Nelander
- MAX-IV Laboratory, Lund University, P.O. Box 118, 22100 Lund, Sweden
| | - R Wugt Larsen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
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Furin J, Alirol E, Allen E, Fielding K, Merle C, Abubakar I, Andersen J, Davies G, Dheda K, Diacon A, Dooley KE, Dravnice G, Eisenach K, Everitt D, Ferstenberg D, Goolam-Mahomed A, Grobusch MP, Gupta R, Harausz E, Harrington M, Horsburgh CR, Lienhardt C, McNeeley D, Mitnick CD, Nachman S, Nahid P, Nunn AJ, Phillips P, Rodriguez C, Shah S, Wells C, Thomas-Nyang'wa B, du Cros P. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults. Int J Tuberc Lung Dis 2017; 20:290-4. [PMID: 27046707 DOI: 10.5588/ijtld.15.0490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.
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Affiliation(s)
- J Furin
- TB Research Unit, Case Western Reserve University School of Medicine, Room E-202, 2210 Circle Dr, Cleveland, OH 44149, USA.
| | - E Alirol
- Manson Unit Médicins Sans Frontières, London, UK
| | - E Allen
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - K Fielding
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - C Merle
- Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - I Abubakar
- Department of Infection and Population Health, University College of London, London, UK
| | - J Andersen
- Statistical and Data Analysis Center, Harvard School of Public Health, Boston, Massachusetts, USA
| | - G Davies
- Institutes of Infection and Global Health and of Translational Medicine, University of Liverpool, Liverpool, UK
| | - K Dheda
- Department of Medicine, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - A Diacon
- Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa
| | - K E Dooley
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - G Dravnice
- Tuberculosis Foundation, KNCV, Amsterdam, The Netherlands
| | - K Eisenach
- Pathology and Microbiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - D Everitt
- Global Alliance for TB Drug Development, New York, New York, USA
| | | | | | - M P Grobusch
- Department of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Gupta
- Otsuka USA, Rockville, Maryland, USA
| | - E Harausz
- TB Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - M Harrington
- Treatment Action Group, New York City, New York, USA
| | - C R Horsburgh
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - C Lienhardt
- Stop TB Partnership & Stop TB Department, World Health Organization, Geneva, Switzerland
| | - D McNeeley
- Medical Service Corp International, Arlington, Virginia, USA
| | - C D Mitnick
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - S Nachman
- Department of Pediatrics, Stony Brook School of Medicine, Stony Brook, New York, USA
| | - P Nahid
- Curry International Tuberculosis Center, San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA
| | - A J Nunn
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - P Phillips
- Medical Research Council Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - C Rodriguez
- Department of Respiratory Medicine, P D Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | - S Shah
- Department of Global Health & Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - C Wells
- Otsuka USA, Rockville, Maryland, USA
| | | | - P du Cros
- Manson Unit Médicins Sans Frontières, London, UK
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Hansen R, Andersen J, Vinther A, Pielmeier U, Larsen R. Breaking up Prolonged Sitting does not Alter Postprandial Glycemia in Young, Normal-Weight Men and Women. Int J Sports Med 2016; 37:e1. [DOI: 10.1055/s-0036-1597544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- R. Hansen
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - J. Andersen
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - A. Vinther
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - U. Pielmeier
- Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - R. Larsen
- Health Science and Technology, Aalborg University, Aalborg, Denmark
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21
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Andersen J. OP0152-PARE Starting A Disease Specific Youth Group on A National Level. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Andersen J, Stones S, Balazova P, Van Nieuwkoop L, Papastavrou T, Caeyers N, Klett F. PARE0017 Eular Young Pare: The Voice of Young People with Rheumatic Diseases across Europe. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Andersen J, Heimdal J, Wugt Larsen R. Spectroscopic identification of ethanol-water conformers by large-amplitude hydrogen bond librational modes. J Chem Phys 2016; 143:224315. [PMID: 26671383 DOI: 10.1063/1.4937482] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The far-infrared absorption spectra have been recorded for hydrogen-bonded complexes of water with ethanol embedded in cryogenic neon matrices at 2.8 K. The partial isotopic H/D-substitution of the ethanol subunit enabled by a dual inlet deposition procedure enables the observation and unambiguous assignment of the intermolecular high-frequency out-of-plane and the low-frequency in-plane donor OH librational modes for two different conformations of the mixed binary ethanol/water complex. The resolved donor OH librational bands confirm directly previous experimental evidence that ethanol acts as the O⋯HO hydrogen bond acceptor in the two most stable conformations. In the most stable conformation, the water subunit forces the ethanol molecule into its less stable gauche configuration upon dimerization owing to a cooperative secondary weak O⋯HC hydrogen bond interaction evidenced by a significantly blue-shift of the low-frequency in-plane donor OH librational band origin. The strong correlation between the low-frequency in-plane donor OH librational motion and the secondary intermolecular O⋯HC hydrogen bond is demonstrated by electronic structure calculations. The experimental findings are further supported by CCSD(T)-F12/aug-cc-pVQZ calculations of the conformational energy differences together with second-order vibrational perturbation theory calculations of the large-amplitude donor OH librational band origins.
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Affiliation(s)
- J Andersen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
| | - J Heimdal
- MAX-IV Laboratory, Lund University, P.O. Box 118, 22100 Lund, Sweden
| | - R Wugt Larsen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kongens Lyngby, Denmark
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Saura C, Isakoff SJ, Calvo I, Patt D, Andersen J, Gonzalez-Martin A, Fisher J, Ciruelos E, Gil-Gil M, De la Peña L, Choi Y, Jia S, Singel S, Patel PH, Baselga J, Oliveira M. Abstract OT1-03-09: FAIRLANE: A phase II randomized, double-blind, study of the Akt inhibitor ipatasertib (Ipat, GDC-0068) in combination with paclitaxel (Pac) as neoadjuvant treatment for early stage triple-negative breast cancer (TNBC). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot1-03-09] [Citation(s) in RCA: 1] [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: 11/16/2022]
Abstract
Abstract
Background: TNBC often exhibits activation of PI3K/Akt signaling, associated with loss of PTEN expression, low INPP4B expression, and/or increased AKT3 amplification. Inhibition of the PI3K/Akt pathway in diverse cancers leads to radiosensitization and/or chemosensitization. Ipat is an oral, potent ATP-competitive small molecule inhibitor of all three isoforms of Akt. The combination of ipat with taxanes in preclinical models resulted in enhanced efficacy relative to either ipat or chemotherapy alone. In a Phase Ib clinical study, the combination of ipat with diverse chemotherapy regimens was well-tolerated and resulted in RECIST responses, particularly pts with tumors having PI3K/Akt activation.
Methods: FAIRLANE is a randomized, double-blind, placebo controlled, multicenter, neoadjuvant Phase II study designed to estimate the efficacy of ipat combined with pac versus placebo combined with pac in women with Stage Ia IIIa TNBC. Approximately 150 pts (Pts) will be enrolled, randomized in a 1:1 ratio, and stratified by PTEN status, node involvement, and tumor size. Pts will receive 3 cycles of ipat 400 mg or placebo orally once daily on Days 1 to 21 of each 28-day cycle, along with pac 80 mg/m2 every 7 days for a total of 12 doses. All pts will undergo pretreatment and Day 8 tumor tissue acquisition to evaluate pathway biomarkers. Following three cycles of treatment, pts will undergo surgery. The primary efficacy endpoint, pCR within the breast and axilla (ypT0/Tis ypN0) in all pts and in pts with PTEN low tumors, will be assessed by local pathology evaluation following completion of neoadjuvant therapy and surgery. Additional endpoints include objective response rate, safety, BCS rate, pharmacokinetics, and pathway biomarkers. Following surgical resection of primary tumor, pts are expected to continue post-operative treatment with a standard adjuvant chemotherapy regimen at physician's discretion. The study is open for accrual. Clinical trial information: NCT02301988.
Citation Format: Saura C, Isakoff SJ, Calvo I, Patt D, Andersen J, Gonzalez-Martin A, Fisher J, Ciruelos E, Gil-Gil M, De la Peña L, Choi Y, Jia S, Singel S, Patel PH, Baselga J, Oliveira M. FAIRLANE: A phase II randomized, double-blind, study of the Akt inhibitor ipatasertib (Ipat, GDC-0068) in combination with paclitaxel (Pac) as neoadjuvant treatment for early stage triple-negative breast cancer (TNBC). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT1-03-09.
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Affiliation(s)
- C Saura
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - SJ Isakoff
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - I Calvo
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - D Patt
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - J Andersen
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - A Gonzalez-Martin
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - J Fisher
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - E Ciruelos
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - M Gil-Gil
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - L De la Peña
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - Y Choi
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - S Jia
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - S Singel
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - PH Patel
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - J Baselga
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
| | - M Oliveira
- Vall d'Hebron Institute of Oncology (VHIO); SOLTI Breast Cancer Research Group; Massachusetts General Hospital Cancer Center; Centro Integral Oncológico Clara Campal; Texas Oncology Center; Compass Oncology; MD Anderson Cancer Center; Carolinas Healthcare System; Hospital Universitario 12 de Octubre; ICO L'Hospitalet, Barcelona; Genentech; Memorial Sloan-Kettering Cancer Center
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Heger M, Andersen J, Suhm MA, Wugt Larsen R. The donor OH stretching–libration dynamics of hydrogen-bonded methanol dimers in cryogenic matrices. Phys Chem Chem Phys 2016; 18:3739-45. [DOI: 10.1039/c5cp07387a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
FTIR spectra of the methanol dimer trapped in neon matrices are presented.
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Affiliation(s)
- M. Heger
- Institut für Physikalische Chemie
- Universität Göttingen
- D-37077 Göttingen
- Germany
| | - J. Andersen
- Department of Chemistry
- Technical University of Denmark
- DK-2800 Kgs. Lyngby
- Denmark
| | - M. A. Suhm
- Institut für Physikalische Chemie
- Universität Göttingen
- D-37077 Göttingen
- Germany
| | - R. Wugt Larsen
- Department of Chemistry
- Technical University of Denmark
- DK-2800 Kgs. Lyngby
- Denmark
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Ricci MF, Andersen J, Joffe A, Dinu I, Moez E, Garcia Guerra G, Robertson C. 186: Frequency and Potentially Modifiable Predictors of Major Neuromotor Disability Following Complex Cardiac Surgery in Early Infancy. Paediatr Child Health 2015. [DOI: 10.1093/pch/20.5.e100a] [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: 11/12/2022] Open
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Wohl DA, Kendall MA, Owens S, Holland G, Nokta M, Spector SA, Schrier R, Fiscus S, Davis M, Jacobson MA, Currier JS, Squires K, Alston-Smith B, Andersen J, Freeman WR, Higgins M, Torriani FJ. The Safety of Discontinuation of Maintenance Therapy for Cytomegalovirus (CMV) Retinitis and Incidence of Immune Recovery Uveitis Following Potent Antiretroviral Therapy. HIV Clinical Trials 2015; 6:136-46. [PMID: 16192248 DOI: 10.1310/4j65-4yx1-4et6-e5kr] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Reconstitution of immune function during potent antiretroviral therapy can prompt discontinuation of maintenance cytomegalovirus (CMV) therapy but has also been associated with sight-threatening inflammatory conditions including immune recovery uveitis (IRU). METHOD Patients with inactive CMV retinitis and a CD4+ cell count above 100/mm3, receiving CMV therapy and stable combination antiretroviral therapy, were assigned to one of two groups based on willingness to discontinue CMV therapy. RESULTS Thirty-eight participants were enrolled: 28 discontinued anti-CMV therapy (Group 1) and 10 continued CMV treatment (Group 2). Median on-study follow-up was 16 months. One Group 1 participant who experienced an increase in plasma HIV viral load and a decline in CD4+ cell count developed confirmed progression of CMV retinitis. Progression or reactivation CMV retinitis was not observed among Group 2. IRU was present at study entry in 3 participants. Six participants in Group 1 and 3 participants in Group 2 developed IRU on-study. CMV viremia was not detected in any participants, and urinary shedding of CMV was intermittent. CONCLUSION Recurrence of CMV retinitis following discontinuation of anti-CMV therapy among patients with antiretroviral-induced increases in CD4+ cell count was rare. However, IRU was common in both those who maintained and discontinued anti-CMV therapy.
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Affiliation(s)
- D A Wohl
- University of North Carolina, Chapel Hill, North Carolina 27516-7215, USA.
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Andersen J, Heimdal J, Wugt Larsen R. The influence of large-amplitude librational motion on the hydrogen bond energy for alcohol–water complexes. Phys Chem Chem Phys 2015; 17:23761-9. [DOI: 10.1039/c5cp04321b] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The intermolecular large-amplitude OH librational modes for mixed hydrogen-bonded complexes of water with methanol and t-butanol are unambiguously assigned for the first time.
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Affiliation(s)
- J. Andersen
- Department of Chemistry
- Technical University of Denmark
- 2800 Kgs. Lyngby
- Denmark
| | - J. Heimdal
- MAX-IV Laboratory
- Lund University
- 22100 Lund
- Sweden
| | - R. Wugt Larsen
- Department of Chemistry
- Technical University of Denmark
- 2800 Kgs. Lyngby
- Denmark
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Andersen J, Gjengedal E, Sandberg S, Råheim M. A skin disease, a blood disease or something in between? An exploratory focus group study of patients' experiences with porphyria cutanea tarda. Br J Dermatol 2014; 172:223-9. [PMID: 24958197 PMCID: PMC4303989 DOI: 10.1111/bjd.13198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2014] [Indexed: 01/04/2023]
Abstract
Background Porphyria cutanea tarda (PCT) is characterized by fragile skin with blistering on sun-exposed areas. Symptoms typically develop in late adulthood and can be triggered by iron overload, alcohol intake, oestrogens and various liver diseases. Treatment consists of phlebotomy to reduce iron, or increasing urinary porphyrin excretion by administering chlorochin. To optimize patient care, health personnel need to understand the subjective experiences of PCT. Objectives To explore the experiences of persons with PCT with regard to symptoms, treatment, follow-up and prevention of the disease. Methods Interpretive description was used as a qualitative approach. Twenty-one participants attended three focus groups. All participants had experienced PCT symptoms during the last 5 years. Results Participants' experiences varied from trivializing symptoms and fragile skin to what was described as a desperate situation, with huge blisters, skin falling off and feeling as if one was in a ‘horror movie’. For some, itching was very troublesome, preventing sleep and delaying skin healing. In managing PCT a shift in focus from skin to blood was described. PCT was perceived as a chronic and systemic disease causing a range of health problems. Strategies for preventing symptoms ranged from doing nothing to frequent controls and check-ups. Conclusions Participants had a systemic perception of PCT, and a tendency to attribute a range of health problems to the condition. This study adds insight into the experiences patients have with PCT.
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Affiliation(s)
- J Andersen
- Laboratory for Clinical Biochemistry, Norwegian Porphyria Centre (NAPOS), Haukeland University Hospital, Bergen, Norway; Department of Global Health and Primary Health Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway
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Kollipost F, Andersen J, Mahler DW, Heimdal J, Heger M, Suhm MA, Wugt Larsen R. The effect of hydrogen bonding on torsional dynamics: A combined far-infrared jet and matrix isolation study of methanol dimer. J Chem Phys 2014; 141:174314. [DOI: 10.1063/1.4900922] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F. Kollipost
- Institut für Physikalische Chemie, Universität Göttingen, Tammannstr. 6, D-37077 Göttingen, Germany
| | - J. Andersen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, DK-2800 Kgs. Lyngby, Denmark
| | - D. W. Mahler
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, DK-2800 Kgs. Lyngby, Denmark
| | - J. Heimdal
- MAX-IV Laboratory, Lund University, P. O. Box 118, SE-22100 Lund, Sweden
| | - M. Heger
- Institut für Physikalische Chemie, Universität Göttingen, Tammannstr. 6, D-37077 Göttingen, Germany
| | - M. A. Suhm
- Institut für Physikalische Chemie, Universität Göttingen, Tammannstr. 6, D-37077 Göttingen, Germany
| | - R. Wugt Larsen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, DK-2800 Kgs. Lyngby, Denmark
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Andersen J, Heimdal J, Mahler DW, Nelander B, Larsen RW. Communication: THz absorption spectrum of the CO2-H2O complex: observation and assignment of intermolecular van der Waals vibrations. J Chem Phys 2014; 140:091103. [PMID: 24606346 DOI: 10.1063/1.4867901] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Terahertz absorption spectra have been recorded for the weakly bound CO2-H2O complex embedded in cryogenic neon matrices at 2.8 K. The three high-frequency van der Waals vibrational transitions associated with out-of-plane wagging, in-plane rocking, and torsional motion of the isotopic H2O subunit have been assigned and provide crucial observables for benchmark theoretical descriptions of this systems' flat intermolecular potential energy surface. A (semi)-empirical value for the zero-point energy of 273 ± 15 cm(-1) from the class of intermolecular van der Waals vibrations is proposed and the combination with high-level quantum chemical calculations provides a value of 726 ± 15 cm(-1) for the dissociation energy D0.
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Affiliation(s)
- J Andersen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kgs. Lyngby, Denmark
| | - J Heimdal
- MAX-IV Laboratory, Lund University, P. O. Box 118, 22100 Lund, Sweden
| | - D W Mahler
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kgs. Lyngby, Denmark
| | - B Nelander
- MAX-IV Laboratory, Lund University, P. O. Box 118, 22100 Lund, Sweden
| | - R Wugt Larsen
- Department of Chemistry, Technical University of Denmark, Kemitorvet 206, 2800 Kgs. Lyngby, Denmark
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Moller P, Goplen F, Vassbotn F, Lund Johansen M, Myrseth E, Finnkirk M, Breivik C, Andersen J, Nilsen K. Vestibular Schwannoma and Dizziness. Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Duale N, Steffensen IL, Andersen J, Brevik A, Brunborg G, Lindeman B. Impaired sperm chromatin integrity in obese mice. Andrology 2014; 2:234-43. [DOI: 10.1111/j.2047-2927.2013.00178.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 11/29/2013] [Accepted: 12/02/2013] [Indexed: 12/27/2022]
Affiliation(s)
- N. Duale
- Division of Environmental Medicine; Norwegian Institute of Public Health; Oslo Norway
| | - I.-L. Steffensen
- Division of Environmental Medicine; Norwegian Institute of Public Health; Oslo Norway
| | - J. Andersen
- Division of Environmental Medicine; Norwegian Institute of Public Health; Oslo Norway
| | - A. Brevik
- Faculty of Health Sciences; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - G. Brunborg
- Division of Environmental Medicine; Norwegian Institute of Public Health; Oslo Norway
| | - B. Lindeman
- Division of Environmental Medicine; Norwegian Institute of Public Health; Oslo Norway
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Knoop AS, Lænkholm AV, Jensen MB, Nielsen KV, Andersen J, Nielsen D, Ejlertsen B. Abstract P1-13-03: ER, PR, HER2, and Ki67 index and responsiveness to adjuvant tamoxifen in postmenopausal high-risk breast cancer patients enrolled in the DBCG 77C trial. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-13-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
PURPOSE: The DBCG 77C trial compared one year of tamoxifen in postmenopausal, steroid-receptor unknown, high-risk breast cancer patients to no adjuvant systemic therapy. After a potential follow-up of 30 years we report overall efficacy for the study and results according to subtypes subsequently assessed by immunohistochemistry and FISH.
METHODS: Between 1977 and 1982, 1716 postmenopausal patients with tumors larger than 5 cm or positive axillary nodes were randomly assigned to no systemic therapy or tamoxifen 30 mg daily for one year. The main study is reported as an ITT analysis with the predefined DFS and BCM as endpoint. For multivariate analysis the Cox proportional hazards regression model was applied to assess the adjusted hazard ratio of treatment regimen, and to explore interactions. Formalin-fixed, paraffin-embedded primary breast tumor tissue blocks were available from 1548 (90%) of the 1716 participants enrolled and 1428 were assessable for ER, PR, HER2 and Ki67. The hormone receptor positive (ER and/or PR) cancers were defined as luminal A if Ki67 low and HER2-negative; as luminal B if Ki67 high or HER2-positive; and otherwise as HER2 positive or triple negative.
RESULTS: In the intent-to-treat (ITT) population one year of tamoxifen improved the disease-free-survival (DFS) (Hazard ratio (HR) = 0.87; 95% CI 0.77-0.98), the recurrence-free-survival (RFS) (HR = 0.79; 0.69-0.90) and reduced the breast-cancer-specific-mortality (BCM) (HR = 0.83; 0.73-0.93). Recurrence-free survivals were improved significantly by tamoxifen in luminal A (HR = 0.66; 0.53-0.84) and luminal B/HER2- (HR = 0.54; 0.39-0.74) but not in the other subsets, and with similar results for BCM with 30 years follow-up.
CONCLUSION: One year of treatment with tamoxifen significantly improves RFS and BCM in postmenopausal patients with ER positive breast cancers. The benefit from tamoxifen was not significantly different in luminal A and B subtypes.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-13-03.
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Affiliation(s)
- AS Knoop
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
| | - A-V Lænkholm
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
| | - M-B Jensen
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
| | - KV Nielsen
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
| | - J Andersen
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
| | - D Nielsen
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
| | - B Ejlertsen
- Rigshospitalet, Copenhagen, Denmark; Slagelse Hospital, Slagelse, Denmark; Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen, Denmark; Dako Denmark A/S, Glostrup, Denmark; Aarhus University Hospital, Aarhus, Denmark; Herlev University Hospital, Herlev, Denmark; Department of Oncology, Odense, Denmark
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Saha P, Aksan N, Andersen J, Yan J, Simoneau J, Leung L, Bertrand F, Aoto K, Kamide H. Issues and future direction of thermal-hydraulics research and development in nuclear power reactors. Nuclear Engineering and Design 2013. [DOI: 10.1016/j.nucengdes.2012.07.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Swindells S, Komarow L, Tripathy S, Cain KP, MacGregor RR, Achkar JM, Gupta A, Veloso VG, Asmelash A, Omoz-Oarhe AE, Gengiah S, Lalloo U, Allen R, Shiboski C, Andersen J, Qasba SS, Katzenstein DK. Screening for pulmonary tuberculosis in HIV-infected individuals: AIDS Clinical Trials Group Protocol A5253. Int J Tuberc Lung Dis 2013; 17:532-9. [PMID: 23485388 DOI: 10.5588/ijtld.12.0737] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [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
BACKGROUND Improved tuberculosis (TB) screening is urgently needed for human immunodeficiency virus (HIV) infected patients. METHODS An observational, multi-country, cross-sectional study of HIV-infected patients to compare a standardized diagnostic evaluation (SDE) for TB with standard of care (SOC). SOC evaluations included TB symptom review (current cough, fever, night sweats and/or weight loss), sputum Ziehl-Neelsen staining and chest radiography. SDE screening added extended clinical signs and symptoms and fluorescent microscopy (FM). All participants underwent all evaluations. Mycobacterium tuberculosis on sputum culture was the primary outcome. RESULTS A total of 801 participants were enrolled from Botswana, Malawi, South Africa, Zimbabwe, India, Peru and Brazil. The median age was 33 years; 37% were male, and median CD4 count was 275 cells/mm(3). Thirty-one participants (4%) had a positive culture on Löwenstein-Jensen media and 54 (8%) on MGIT. All but one positive culture came from sub-Saharan Africa, where the prevalence of TB was 54/445 (12%). SOC screening had 54% sensitivity (95%CI 40-67) and 76% specificity (95%CI 72-80). Positive and negative predictive values were respectively 24% and 92%. No elements of the SDE improved the predictive values of SOC. CONCLUSIONS Symptom-based screening with smear microscopy was insufficiently sensitive. More sensitive diagnostic testing is required for HIV-infected patients.
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Affiliation(s)
- S Swindells
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198-8106, USA.
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Chang LH, Shibata K, Yotsumoto Y, Andersen J, Sasaki Y, Watanabe T. When is old better? Task Irrelevant Perceptual Learning with older people. J Vis 2013. [DOI: 10.1167/13.9.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Tjon Pian Gi REA, Ilmarinen T, van den Heuvel ER, Aaltonen LM, Andersen J, Brunings JW, Chirila M, Dietz A, Ferran Vilà F, Friedrich G, de Gier HHW, Golusinski W, Graupp M, Hantzakos A, Horcasitas R, Jackowska J, Koelmel JC, Lawson G, Lindner F, Remacle M, Sittel C, Weichbold V, Wierzbicka M, Dikkers FG. Safety of intralesional cidofovir in patients with recurrent respiratory papillomatosis: an international retrospective study on 635 RRP patients. Eur Arch Otorhinolaryngol 2013; 270:1679-87. [PMID: 23377227 DOI: 10.1007/s00405-013-2358-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/10/2013] [Indexed: 12/27/2022]
Abstract
Intralesional use of cidofovir (Vistide(®)) has been one of the mainstays of adjuvant therapy in patients with recurrent respiratory papillomatosis (RRP) since 1998. In 2011, a communication provided by the producer of cidofovir addressed very serious side effects concerning its off-label use. As this was a general warning, it was inconclusive whether this would account for its use in RRP. The aim of this study is to determine whether nephrotoxic, neutropenic, or oncogenic side effects have occurred after intralesional use of cidofovir in patients with RRP. Update of recent developments in RRP, a multicentre questionnaire and a multicentre retrospective chart review. Sixteen hospitals from eleven countries worldwide submitted records of 635 RRP patients, of whom 275 were treated with cidofovir. RRP patients received a median of three intralesional injections (interquartile range 2-6). There were no statistical differences in occurrence of neutropenia or renal dysfunction before and after cidofovir. There was no statistical difference in occurrence of upper airway and tracheal malignancies between the cidofovir and the non-cidofovir group. In this retrospective patient chart review, no clinical evidence was found for more long-term nephrotoxicity, neutropenia or laryngeal malignancies after the administration of intralesional cidofovir in RRP patients.
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Affiliation(s)
- R E A Tjon Pian Gi
- Department of Otorhinolaryngology Head and Neck Surgery, University of Groningen, University Medical Center Groningen, PO box 30001, 9700 RB Groningen, The Netherlands.
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Langer L, Clark L, Gress J, Patt D, Denduluri N, Wang Y, Andersen J, Solti M, Wheeler A, Delamelena T, Smith JW, Sandbach J. Abstract P4-11-04: A Structured Genetic Risk Evaluation and Testing Program in the Community Oncology Practice Increases Identification of Individuals at Risk for BRCA Mutations. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p4-11-04] [Citation(s) in RCA: 1] [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: 11/16/2022]
Abstract
Abstract
Background: Genetic risk assessment is an important component of the care of the community oncology breast cancer patient. However, identification of at-risk patients is largely an ad-hoc process and practices lack a systematic approach to genetic risk evaluation. The US Oncology Network Genetic Risk Evaluation and Testing (USON GREAT) Program provides a structured approach to implementation of genetic risk evaluation, testing, and triage for appropriate intervention.
Methods: In 2009, our multi-disciplinary community oncology practice implemented the USON GREAT Program. The practice's program has a single dedicated nurse practitioner and physician lead, trained in part through a core educational curriculum and utilizing US Oncology Network-wide genetics resources (web-based MD, midlevel, and genetic counselor conferencing; discussion Portal; published guidelines and office procedures). NCCN guidelines were used to guide testing recommendations. Sequential risk evaluations were documented prospectively. We retrospectively analyzed how evaluation patterns changed over a 4 year time period. We also sought to capture descriptive characteristics of the evaluated population.
Results: Overall, between 2008 and 2011, our practice evaluated 1018 patients at potential risk for a BRCA mutation (mut), based on personal history of breast cancer under age 50; ovarian, fallopian or peritoneal cancer; known family history of malignancy; or known BRCA mutation in the family.
In 2008, 6% of potential at-risk individuals were identified vs 35% in 2011. NCCN guideline exclusions for BRCA testing in invasive breast cancer were 8% in 2008 and 3% in 2010.
150 deleterious mut and variants of uncertain significance (VUS) were identified. There was an 14.7% overall identification rate for BRCA1/2 (B1, B2) mut and VUS. Among mut and VUS identified by cancer type, B1 mut was more commonly identified in patients with a gynecologic malignancy (53% B1 vs 30% B2, 17% VUS); mut in invasive breast cancer were more likely to be in B2 (42% B2 vs 32% B1, 26% VUS). 7% of all tests for individuals with malignancy were declined or cancelled due to insurance or finances, vs 37% for unaffecteds, despite their high risk of mutation carrier status.
Conclusions: We report a single practice's four-year experience with implementation of the USON GREAT Program. The results from this experience demonstrate that the USON GREAT Program results in higher rates of identification of at-risk individuals, and promotes more appropriate guidelines-based testing in the community oncology setting. The relative frequency of BRCA2 vs BRCA1 in invasive breast cancer is of unclear significance at this time and warrants further analysis. Cost of testing remains a barrier to appropriate utilization.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-11-04.
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Affiliation(s)
- L Langer
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - L Clark
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - J Gress
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - D Patt
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - N Denduluri
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - Y Wang
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - J Andersen
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - M Solti
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - A Wheeler
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - T Delamelena
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - JW Smith
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
| | - J Sandbach
- Compass Oncology, Portland, OR; Texas Oncology, Austin, TX; Virginia Cancer Specialists, Arlington, VA; McKesson Specialty Health/The US Oncology Network, The Woodlands, TX
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Jakobsen L, Schrøder JM, Vanselow K, Nigg EA, Lundberg E, Andersen J. Identification and functional analysis of novel centrosomal proteins to study their implication in human disease. Cilia 2012. [PMCID: PMC3555804 DOI: 10.1186/2046-2530-1-s1-p28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Baumgartner S, Doesburg P, Scherr C, Andersen J. P01.17. Development of a biocrystallisation method for examining effects of homeopathic preparations on germinating cress seeds. BMC Complement Altern Med 2012. [PMCID: PMC3373524 DOI: 10.1186/1472-6882-12-s1-p17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Andersen J, Christensen H, Pachler JH, Hallin M, Thaysen HV, Kehlet H. Effect of the laxative magnesium oxide on gastrointestinal functional recovery in fast-track colonic resection: a double-blind, placebo-controlled randomized study. Colorectal Dis 2012; 14:776-82. [PMID: 21883811 DOI: 10.1111/j.1463-1318.2011.02796.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM A double-blind randomized controlled study was conducted to compare the effect of magnesium oxide (1 g 12-h) with placebo given within an evidence-based multimodal rehabilitation programme on gastrointestinal recovery, pain, mobilization and hospital stay after open colonic resection. METHOD Of 62 potentially eligible patients, 13 were excluded, leaving 22 in the magnesium oxide group and 27 in the placebo group. The main outcome measure was time to normalization of bowel function. Secondary outcome measures included postoperative nausea, vomiting, pain, fatigue, mobilization and length of postoperative hospital stay. RESULTS The median times to first flatus and defaecation in the laxative and placebo groups were 18.0 vs 14.0 h and 42 vs 50 h (P > 0.15). Early intake of liquids, protein drinks and solid food, nausea and vomiting, pain, fatigue and mobilization were similar in the groups (P > 0.3). The median postoperative hospital stay was 3 days in both groups (P > 0.65). CONCLUSION Magnesium oxide does not enhance the recovery of gastrointestinal function within the context of an evidence-based multimodal rehabilitation programme after open colonic surgery.
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Affiliation(s)
- J Andersen
- Department of Surgical Gastroenterology, Hvidovre University Hospital, Copenhagen, Denmark.
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Darrah J, Wiart L, Magill-Evans J, Ray L, Andersen J. Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy? Child Care Health Dev 2012; 38:41-7. [PMID: 21083684 DOI: 10.1111/j.1365-2214.2010.01160.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. METHODS Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. RESULTS All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. CONCLUSION Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite attending the same programme. Standardized programme processes and policies may provide a starting point to ensure that all families have equitable opportunities to participate in their child's rehabilitation programme.
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Affiliation(s)
- J Darrah
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada T6G 2G4.
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Haastrup E, Andersen J, Ostrowski SR, Høyer-Hansen G, Jacobsen N, Heilmann C, Ullum H, Müller K. Soluble Urokinase Plasminogen Activator Receptor During Allogeneic Stem Cell Transplantation. Scand J Immunol 2011; 73:325-9. [DOI: 10.1111/j.1365-3083.2011.02511.x] [Citation(s) in RCA: 7] [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: 11/29/2022]
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Petersen A, Bergström A, Andersen J, Hansen M, Lahtinen S, Wilcks A, Licht T. Analysis of the intestinal microbiota of oligosaccharide fed mice exhibiting reduced resistance to Salmonella infection. Benef Microbes 2010; 1:271-81. [DOI: 10.3920/bm2010.0016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Certain indigestible carbohydrates, known as prebiotics, are claimed to be beneficial for gut health through a selective stimulation of certain gut microbes including bifidobacteria. However, stimulation of such microbes does not necessarily imply a preventive effect against pathogen infection. We recently demonstrated a reduced resistance to Salmonella infection in mice fed diets containing fructo-oligosaccharides (FOS) or xylo-oligosaccharides (XOS). In the present study, faecal and caecal samples from the same mice were analysed in order to study microbial changes potentially explaining the observed effects on the pathogenesis of Salmonella. Denaturing gradient gel electrophoresis revealed that the microbiota in faecal samples from mice fed FOS or XOS were different from faecal samples collected before the feeding trial as well as from faecal profiles generated from control animals. This difference was not seen for caecal profiles. Further analysis of faecal samples by real-time PCR demonstrated a significant increase in the Bacteroidetes phylum, the Bacteroides fragilis group and in Bifidobacterium spp. in mice fed FOS or XOS. The observed bifidogenic effect was more pronounced for XOS than for FOS. The Firmicutes phylum and the Clostridium coccoides group were reduced by both FOS and XOS. Surprisingly, no significant differences were detected between faecal samples collected before and after pathogen challenge in any of the groups. Furthermore, no effect of diets on caecal concentrations of short-chain fatty acids was recorded. In conclusion, diets supplemented with FOS or XOS induced a number of microbial changes in the faecal microbiota of mice. The observed effects of XOS were qualitatively similar to those of FOS, but the most prominent bifidogenic effect was seen for XOS. An increased level of bifidobacteria is thus not in itself preventive against Salmonella infection, since the same XOS or FOS-fed mice were previously reported to be more severely affected by Salmonella than control animals.
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Affiliation(s)
- A. Petersen
- National Food Institute, Division of Microbiology and Risk Assessment, Technical University of Denmark, Moerkhoej Bygade 19, 2860 Soeborg, Denmark
| | - A. Bergström
- National Food Institute, Division of Microbiology and Risk Assessment, Technical University of Denmark, Moerkhoej Bygade 19, 2860 Soeborg, Denmark
| | - J. Andersen
- National Food Institute, Division of Microbiology and Risk Assessment, Technical University of Denmark, Moerkhoej Bygade 19, 2860 Soeborg, Denmark
| | - M. Hansen
- National Food Institute, Division of Toxicology and Risk Assessment, Technical University of Denmark, Moerkhoej Bygade 19, 2860 Soeborg, Denmark
| | - S. Lahtinen
- Danisco Health & Nutrition, Sokeritehtaantie 20, 02460 Kantvik, Finland
| | - A. Wilcks
- National Food Institute, Division of Microbiology and Risk Assessment, Technical University of Denmark, Moerkhoej Bygade 19, 2860 Soeborg, Denmark
| | - T. Licht
- National Food Institute, Division of Microbiology and Risk Assessment, Technical University of Denmark, Moerkhoej Bygade 19, 2860 Soeborg, Denmark
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Bower J, Zheng B, Andersen J. Aging, retinal eccentricity, and global motion perception. J Vis 2010. [DOI: 10.1167/9.8.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ni R, Bian Z, Andersen J. Age-related differences in the use of optical flow and landmark information in steering control. J Vis 2010. [DOI: 10.1167/9.8.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Iversen MD, Lee B, Connell P, Andersen J, Anderson AF, Kocher MS. Validity and comprehensibility of the International Knee Documentation Committee Subjective Knee Evaluation form in Children. Scand J Med Sci Sports 2010; 20:e87-95. [DOI: 10.1111/j.1600-0838.2009.00917.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vasan S, Hurley A, Schlesinger SJ, Hannaman D, Gardiner DF, Dugin DP, Boente-Carrera MM, Vittorino RM, Caskey M, Andersen J, Huang Y, Cox J, Tarragona T, Gill DK, Cheeseman H, Clark L, Dally L, Smith C, Schmidt C, Park H, Sayeed E, Gilmour J, Fast P, Bernard R, Ho DD. OA05-01. In vivo electroporation enhances the immunogenicity of ADVAX, a DNA-based HIV-1 vaccine candidate, in healthy volunteers. Retrovirology 2009. [PMCID: PMC2767553 DOI: 10.1186/1742-4690-6-s3-o31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wohl DA, Kendall MA, Andersen J, Crumpacker C, Spector SA, Feinberg J, Alston-Smith B, Owens S, Chafey S, Marco M, Maxwell S, Lurain N, Jabs D, Benson C, Keiser P, Jacobson MA. Low rate of CMV end-organ disease in HIV-infected patients despite low CD4+ cell counts and CMV viremia: results of ACTG protocol A5030. HIV Clin Trials 2009; 10:143-52. [PMID: 19632953 DOI: 10.1310/hct1003-143] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To describe cytomegalovirus (CMV) end-organ disease (EOD) rate in AIDS patients with low CD4+ cell count despite HAART who were enrolled in a randomized, placebo-controlled trial of preemptive valganciclovir (VGCV) to prevent CMV EOD in those with CMV viremia. METHODS Subjects (N = 338) were HIV-infected with CD4+ count <100 cells/mm3, plasma HIV RNA >400 copies/mL, and on stable or no HAART. All underwent plasma CMV DNA PCR testing every 8 weeks (Step 1); those with detectable CMV DNA were randomized to VGCV or placebo (Step 2). RESULTS Plasma CMV DNA was detected in 68 (20%), of whom 4 developed CMV EOD. During Step 1, 53 died. Of the 47 who entered Step 2 (24 VGCV, 23 placebo), CMV EOD was diagnosed in 10 (4 VGCV, 6 placebo) and 15 died (7 VGCV, 8 placebo). Of those randomized to placebo, 14% were diagnosed with CMV EOD at 12 months. CONCLUSIONS We observed a lower CMV EOD rate among subjects receiving HAART than predicted based on published literature. However, mortality was high in this study. Our findings suggest that preemptive anti-CMV therapy in patients with persistently low CD4+ cell counts in the current treatment era may not be warranted given the low incidence of CMV EOD and high all-cause mortality observed in this study population.
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Affiliation(s)
- D A Wohl
- University of North Carolina, Chapel Hill, North Carolina, USA.
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