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Yu A, Ritenour A, Vincent J, Park C, Rascati K, Godley P. Exploring factors related to clinically advanced fibrosis in patients with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis. Postgrad Med 2024; 136:14-21. [PMID: 38032542 DOI: 10.1080/00325481.2023.2288560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To describe the clinical profile of nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) patients in a Texas integrated delivery network (IDN) and elucidate the local relationship between patient factors and the risk of advanced fibrosis. METHODS This observational, retrospective, cross-sectional study utilized existing data from the electronic health record at a large Texas IDN. Data was collected during the study period from 1 January 2019, to 1 March 2023. Patient characteristics, comorbidities, labs, and medication orders were collected from the most recent encounter in which a Fibrosis-4 (FIB-4) score could be calculated. Chi square tests and analysis of variance (ANOVA) tests were conducted to evaluate differences among the three fibrosis risk categories. Ordinal logistic regression was utilized to assess associations between select variables and a higher risk of advanced fibrosis. RESULTS A total of 56,253 patients were included in the study. 34,839 (61.9%) were Low-Risk 15,578 (27.7%) were Intermediate-Risk, and 5,836 (10.4%) were High-Risk of advanced fibrosis. Results showed that up to 70.4% of patients within a risk group were obese. Only 49.5% of patients in the High-Risk group had at least one gastroenterologist or hepatologist visit. Males, Medicare patients, former smokers, and those with hypertension, type 2 diabetes, and chronic kidney disease were associated with a higher risk of advanced fibrosis. CONCLUSION This study highlights the need for early screening and proactive management of metabolic risk factors for patients with NAFLD/NASH. The findings indicate a notable prevalence of obesity in the study population, a need for specialist referral for those at High-Risk of advanced fibrosis, and the importance of routine labs to evaluate metabolic factors. Primary care providers may be ideal providers to target these interventions and address this care need.
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Affiliation(s)
- Anthony Yu
- Department of Pharmacy, Baylor Scott & White Health, Temple, USA
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, USA
| | | | - Jennifer Vincent
- Division of Gastroenterology, Baylor Scott & White Health, Temple, USA
| | - Chanhyun Park
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, USA
| | - Karen Rascati
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, USA
| | - Paul Godley
- Department of Pharmacy, Baylor Scott & White Health, Temple, USA
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2
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Bussell C, Vincent J, Brust K. Implementation of a multidisciplinary process to improve diagnostic stewardship of hospital-onset Clostridioides difficile infections. Am J Infect Control 2023; 51:1329-1333. [PMID: 37295677 DOI: 10.1016/j.ajic.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Testing inappropriate stool samples for Clostridioides (Clostridium) difficile can lead to the identification of the patient colonized with C difficile and erroneous diagnosis of an active infection. We hypothesized that a multidisciplinary process to improve diagnostic stewardship could reduce our numbers of hospital-onset C difficile infection (HO-CDI). METHODS We created an algorithm describing appropriate stool specimens for polymerase chain reaction testing. The algorithm was converted into "ticket to test" checklist cards designed to accompany each specimen. Rejection of a specimen could occur via nursing staff or laboratory staff. RESULTS A baseline period of comparison was established from January 1, 2017 to June 30, 2017. Following implementation of all improvement strategies, a retrospective analysis was done, and the total number of HO-CDI cases in a 6-month period dropped from 57 to 32 cases. During the initial 3 months, the percentage of appropriate samples sent to the lab ranged from 41% to 65%. After the interventions were in place, the percentages improved between 71% and 91%. CONCLUSIONS A multidisciplinary approach led to improved diagnostic stewardship to identify true CDI cases. This, in turn, reduced the number of reported HO-CDIs, and resulted in potentially more than $1,080,000 in patient care savings.
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Affiliation(s)
- Charles Bussell
- Department of Internal Medicine, Baylor Scott & White Medical Center-Temple, Temple, TX; Division of Gastroenterology, Department of Internal Medicine, Baylor Scott & White Medical Center-Temple, Temple, TX.
| | - Jennifer Vincent
- Division of Gastroenterology, Department of Internal Medicine, Baylor Scott & White Medical Center-Temple, Temple, TX
| | - Karen Brust
- Division of Infectious Diseases, Department of Internal Medicine, Baylor Scott & White Medical Center-Temple, Temple, TX
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Hillege L, Waelen J, Ziemons J, Aarnoutse R, De Vos-Geelen J, De Boer M, Van Riet Y, Vincent J, Venema K, Rensen S, Simpson J, Redinbo M, Penders J, Smidt M. Bacterial β-glucuronidase activity in postmenopausal breast cancer patients: a pilot study. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01578-7] [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: 11/19/2022]
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4
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van den Berg K, Schaap DP, Voogt ELK, Buffart TE, Verheul HMW, de Groot JWB, Verhoef C, Melenhorst J, Roodhart JML, de Wilt JHW, van Westreenen HL, Aalbers AGJ, van 't Veer M, Marijnen CAM, Vincent J, Simkens LHJ, Peters NAJB, Berbée M, Werter IM, Snaebjornsson P, Peulen HMU, van Lijnschoten IG, Roef MJ, Nieuwenhuijzen GAP, Bloemen JG, Willems JMWE, Creemers GJM, Nederend J, Rutten HJT, Burger JWA. Neoadjuvant FOLFOXIRI prior to chemoradiotherapy for high-risk ("ugly") locally advanced rectal cancer: study protocol of a single-arm, multicentre, open-label, phase II trial (MEND-IT). BMC Cancer 2022; 22:957. [PMID: 36068495 PMCID: PMC9446695 DOI: 10.1186/s12885-022-09947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/29/2022] [Indexed: 11/14/2022] Open
Abstract
Background The presence of mesorectal fascia (MRF) invasion, grade 4 extramural venous invasion (EMVI), tumour deposits (TD) or extensive or bilateral extramesorectal (lateral) lymph nodes (LLN) on MRI has been suggested to identify patients with indisputable, extensive locally advanced rectal cancer (LARC), at high risk of treatment failure. The aim of this study is to evaluate whether or not intensified chemotherapy prior to neoadjuvant chemoradiotherapy improves the complete response (CR) rate in these patients. Methods This multicentre, single-arm, open-label, phase II trial will include 128 patients with non-metastatic high-risk LARC (hr-LARC), fit for triplet chemotherapy. To ensure a study population with indisputable, unfavourable prognostic characteristics, hr-LARC is defined as LARC with on baseline MRI at least one of the following characteristics; MRF invasion, EMVI grade 4, enlarged bilateral or extensive LLN at high risk of an incomplete resection, or TD. Exclusion criteria are the presence of a homozygous DPD deficiency, distant metastases, any chemotherapy within the past 6 months, previous radiotherapy within the pelvic area precluding standard chemoradiotherapy, and any contraindication for the planned treatment. All patients will be planned for six two-weekly cycles of FOLFOXIRI (5-fluorouracil, leucovorin, oxaliplatin and irinotecan) prior to chemoradiotherapy (25 × 2 Gy or 28 × 1.8 Gy with concomitant capecitabine). A resection will be performed following radiological confirmation of resectable disease after the completion of chemoradiotherapy. A watch and wait strategy is allowed in case of a clinical complete response. The primary endpoint is the CR rate, described as a pathological CR or a sustained clinical CR one year after chemoradiotherapy. The main secondary objectives are long-term oncological outcomes, radiological and pathological response, the number of resections with clear margins, treatment-related toxicity, perioperative complications, health-related costs, and quality of life. Discussion This trial protocol describes the MEND-IT study. The MEND-IT study aims to evaluate the CR rate after intensified chemotherapy prior to concomitant chemoradiotherapy in a homogeneous group of patients with locally advanced rectal cancer and indisputably unfavourable characteristics, defined as hr-LARC, in order to improve their prognosis. Trial registration Clinicaltrials.gov: NCT04838496, registered on 02–04-2021 Netherlands Trial Register: NL9790. Protocol version Version 3 dd 11–4-2022.
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Affiliation(s)
- K van den Berg
- Department of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands.,Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - D P Schaap
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - E L K Voogt
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - T E Buffart
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Medical Oncology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | - H M W Verheul
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - J W B de Groot
- Department of Medical Oncology, Isala Oncology Centre, Zwolle, the Netherlands
| | - C Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - J Melenhorst
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - J M L Roodhart
- Department of Medical Oncology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - J H W de Wilt
- Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | | | - A G J Aalbers
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - M van 't Veer
- Department of Research and Education, Catharina Hospital, Eindhoven, the Netherlands
| | - C A M Marijnen
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - J Vincent
- Department of Medical Oncology, Elkerliek Hospital, Helmond, the Netherlands
| | - L H J Simkens
- Department of Medical Oncology, Maxima Medical Centre, Veldhoven, the Netherlands
| | - N A J B Peters
- Department of Medical Oncology, St. Jans Hospital, Weert, the Netherlands
| | - M Berbée
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - I M Werter
- Department of Medical Oncology, Rijnstate Hospital, Arnhem, the Netherlands
| | - P Snaebjornsson
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - H M U Peulen
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands
| | - I G van Lijnschoten
- Department of Pathology, PAMM Laboratory for Pathology and Medical Microbiology, Eindhoven, the Netherlands
| | - M J Roef
- Department of Nuclear Medicine, Catharina Hospital, Eindhoven, the Netherlands
| | | | - J G Bloemen
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
| | - J M W E Willems
- Department of Medical Oncology, Anna Hospital, Geldrop, the Netherlands
| | - G J M Creemers
- Department of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands
| | - J Nederend
- Department of Radiology, Catharina Hospital, Eindhoven, the Netherlands
| | - H J T Rutten
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.,GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
| | - J W A Burger
- Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
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Li J, Lu M, Zhou Y, Bowlus CL, Lindor K, Rodriguez-Watson C, Romanelli RJ, Haller IV, Anderson H, VanWormer JJ, Boscarino JA, Schmidt MA, Daida YG, Sahota A, Vincent J, Wu KHH, Trudeau S, Rupp LB, Melkonian C, Gordon SC. Dynamic Risk Prediction of Response to Ursodeoxycholic Acid Among Patients with Primary Biliary Cholangitis in the USA. Dig Dis Sci 2022; 67:4170-4180. [PMID: 34499271 DOI: 10.1007/s10620-021-07219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/05/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Ursodeoxycholic acid (UDCA) remains the first-line therapy for primary biliary cholangitis (PBC); however, inadequate treatment response (ITR) is common. The UK-PBC Consortium developed the modified UDCA Response Score (m-URS) to predict ITR (using alkaline phosphatase [ALP] > 1.67 times the upper limit of normal [*ULN]) at 12 months post-UDCA initiation). Using data from the US-based Fibrotic Liver Disease Consortium, we assessed the m-URS in our multi-racial cohort. We then used a dynamic modeling approach to improve prediction accuracy. METHODS Using data collected at the time of UDCA initiation, we assessed the m-URS using the original formula; then, by calibrating coefficients to our data, we also assessed whether it remained accurate when using Paris II criteria for ITR. Next, we developed and validated a dynamic risk prediction model that included post-UDCA initiation laboratory data. RESULTS Among 1578 patients (13% men; 8% African American, 9% Asian American/American Indian/Pacific Islander; 25% Hispanic), the rate of ITR was 27% using ALP > 1.67*ULN and 45% using Paris II criteria. M-URS accuracy was "very good" (AUROC = 0.87, sensitivity = 0.62, and specificity = 0.82) for ALP > 1.67*ULN and "moderate" (AUROC = 0.74, sensitivity = 0.57, and specificity = 0.70) for Paris II. Our dynamic model significantly improved accuracy for both definitions of ITR (ALP > 1.67*ULN: AUROC = 0.91; Paris II: AUROC = 0.81); specificity approached 100%. Roughly 9% of patients in our cohort were at the highest risk of ITR. CONCLUSIONS Early identification of patients who will not respond to UDCA treatment using a dynamic prediction model based on longitudinal, repeated risk factor measurements may facilitate earlier introduction of adjuvant treatment.
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Affiliation(s)
- Jia Li
- Department of Public Health Sciences, Henry Ford Health System, 3E One Ford Place, Detroit, MI, 48202, USA.
| | - Mei Lu
- Department of Public Health Sciences, Henry Ford Health System, 3E One Ford Place, Detroit, MI, 48202, USA
| | - Yueren Zhou
- Department of Public Health Sciences, Henry Ford Health System, 3E One Ford Place, Detroit, MI, 48202, USA
| | | | - Keith Lindor
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Carla Rodriguez-Watson
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA
- Innovation in Medical Evidence Development and Surveillance, The Reagan-Udall Foundation for the FDA, Washington, DC, USA
| | | | - Irina V Haller
- Essentia Institute of Rural Health, Essentia Health, Duluth, MN, USA
| | - Heather Anderson
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA
| | | | - Joseph A Boscarino
- Department of Epidemiology and Health Services Research, Geisinger Clinic, Danville, PA, USA
| | - Mark A Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Yihe G Daida
- Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
| | - Amandeep Sahota
- Department of Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, CA, USA
| | | | - Kuan-Han Hank Wu
- Department of Public Health Sciences, Henry Ford Health System, 3E One Ford Place, Detroit, MI, 48202, USA
| | - Sheri Trudeau
- Department of Public Health Sciences, Henry Ford Health System, 3E One Ford Place, Detroit, MI, 48202, USA
| | - Loralee B Rupp
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Christina Melkonian
- Department of Public Health Sciences, Henry Ford Health System, 3E One Ford Place, Detroit, MI, 48202, USA
| | - Stuart C Gordon
- Department of Gastroenterology and Hepatology, Henry Ford Health System, and Wayne State University School of Medicine, Detroit, MI, USA
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Beige A, Ghiringhelli F, Vincent J, Lecuelle J, Truntzer C, Farah W, Borsotti F, Mazilu I, Ilie S. 361P Efficacy of chemotherapy plus bevacizumab in recurrent multiforme glioblastoma: A real-life study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.025] [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: 11/16/2022] Open
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Kelly CR, Yen EF, Grinspan AM, Kahn SA, Atreja A, Lewis JD, Moore TA, Rubin DT, Kim AM, Serra S, Nersesova Y, Fredell L, Hunsicker D, McDonald D, Knight R, Allegretti JR, Pekow J, Absah I, Hsu R, Vincent J, Khanna S, Tangen L, Crawford CV, Mattar MC, Chen LA, Fischer M, Arsenescu RI, Feuerstadt P, Goldstein J, Kerman D, Ehrlich AC, Wu GD, Laine L. Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry. Gastroenterology 2021; 160:183-192.e3. [PMID: 33011173 PMCID: PMC8034505 DOI: 10.1053/j.gastro.2020.09.038] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/26/2020] [Accepted: 09/24/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Fecal microbiota transplantation (FMT) is used commonly for treatment of Clostridioides difficile infections (CDIs), although prospective safety data are limited and real-world FMT practice and outcomes are not well described. The FMT National Registry was designed to assess FMT methods and both safety and effectiveness outcomes from North American FMT providers. METHODS Patients undergoing FMT in clinical practices across North America were eligible. Participating investigators enter de-identified data into an online platform, including FMT protocol, baseline patient characteristics, CDI cure and recurrence, and short and long-term safety outcomes. RESULTS Of the first 259 participants enrolled at 20 sites, 222 had completed short-term follow-up at 1 month and 123 had follow-up to 6 months; 171 (66%) were female. All FMTs were done for CDI and 249 (96%) used an unknown donor (eg, stool bank). One-month cure occurred in 200 patients (90%); of these, 197 (98%) received only 1 FMT. Among 112 patients with initial cure who were followed to 6 months, 4 (4%) had CDI recurrence. Severe symptoms reported within 1-month of FMT included diarrhea (n = 5 [2%]) and abdominal pain (n = 4 [2%]); 3 patients (1%) had hospitalizations possibly related to FMT. At 6 months, new diagnoses of irritable bowel syndrome were made in 2 patients (1%) and inflammatory bowel disease in 2 patients (1%). CONCLUSIONS This prospective real-world study demonstrated high effectiveness of FMT for CDI with a good safety profile. Assessment of new conditions at long-term follow-up is planned as this registry grows and will be important for determining the full safety profile of FMT.
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Affiliation(s)
- Colleen R. Kelly
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Eugene F. Yen
- Division of Gastroenterology, NorthShore University HealthSystem, Evanston, Illinois
| | - Ari M. Grinspan
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Stacy A. Kahn
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children’s Hospital, Boston, Massachusetts
| | - Ashish Atreja
- Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - James D. Lewis
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - David T. Rubin
- Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, Illinois
| | - Alison M. Kim
- American Gastroenterological Association, Bethesda, Maryland
| | - Sonya Serra
- American Gastroenterological Association, Bethesda, Maryland
| | | | - Lydia Fredell
- American Gastroenterological Association, Bethesda, Maryland
| | | | - Daniel McDonald
- Department of Pediatrics, University of California San Diego, La Jolla, California
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, California,Center for Microbiome Innovation, University of California San Diego, La Jolla, California,Department of Computer Science and Engineering, University of California San Diego, La Jolla, California,Department of Bioengineering, University of California San Diego, La Jolla, California
| | | | - Joel Pekow
- Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago Medicine, Chicago, Illinois
| | - Imad Absah
- Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Ronald Hsu
- Sutter Health, Sutter Institute for Medical Research and Division of Gastroenterology, School of Medicine, University of California, Davis, California
| | - Jennifer Vincent
- Division of Gastroenterology, Baylor Scott and White Research Institute, Temple, Texas
| | - Sahil Khanna
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Lyn Tangen
- Carle Foundation Hospital, Urbana, Illinois
| | - Carl V. Crawford
- Division of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Mark C. Mattar
- Division of Gastroenterology, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Lea Ann Chen
- Division of Gastroenterology and Hepatology, New York University Grossman School of Medicine, New York, New York
| | - Monika Fischer
- Division of Gastroenterology, Indiana University, Indianapolis, Indiana
| | - Razvan I. Arsenescu
- Atlantic Inflammatory Bowel Disease Center of Excellence, Atlantic Digestive Health Institute, Morristown, New Jersey
| | | | | | - David Kerman
- Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, Florida
| | - Adam C. Ehrlich
- Section of Gastroenterology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Gary D. Wu
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Loren Laine
- Yale School of Medicine, New Haven, Connecticut,Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
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8
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Lu M, Bowlus CL, Lindor K, Rodriguez-Watson CV, Romanelli RJ, Haller IV, Anderson H, VanWormer JJ, Boscarino JA, Schmidt MA, Daida YG, Sahota A, Vincent J, Li J, Trudeau S, Rupp LB, Gordon SC. Validity of an Automated Algorithm to Identify Cirrhosis Using Electronic Health Records in Patients with Primary Biliary Cholangitis. Clin Epidemiol 2020; 12:1261-1267. [PMID: 33204167 PMCID: PMC7666983 DOI: 10.2147/clep.s262558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022] Open
Abstract
Background Biopsy remains the gold standard for determining fibrosis stage in patients with primary biliary cholangitis (PBC), but it is unavailable for most patients. We used data from the 11 US health systems in the FibrOtic Liver Disease Consortium to explore a combination of biochemical markers and electronic health record (EHR)-based diagnosis/procedure codes (DPCs) to identify the presence of cirrhosis in PBC patients. Methods Histological fibrosis staging data were obtained from liver biopsies. Variables considered for the model included demographics (age, gender, race, ethnicity), total bilirubin, alkaline phosphatase, albumin, aspartate aminotransferase (AST) to platelet ratio index (APRI), Fibrosis 4 (FIB4) index, AST to alanine aminotransferase (ALT) ratio, and >100 DPCs associated with cirrhosis/decompensated cirrhosis, categorized into ten clusters. Using least absolute shrinkage and selection operator regression (LASSO), we derived and validated cutoffs for identifying cirrhosis. Results Among 4328 PBC patients, 1350 (32%) had biopsy data; 121 (9%) were staged F4 (cirrhosis). DPC clusters (including codes related to cirrhosis and hepatocellular carcinoma diagnoses/procedures), Hispanic ethnicity, ALP, AST/ALT ratio, and total bilirubin were retained in the final model (AUROC=0.86 and 0.83 on learning and testing data, respectively); this model with two cutoffs divided patients into three categories (no cirrhosis, indeterminate, and cirrhosis) with specificities of 81.8% (for no cirrhosis) and 80.3% (for cirrhosis). A model excluding DPCs retained ALP, AST/ALT ratio, total bilirubin, Hispanic ethnicity, and gender (AUROC=0.81 and 0.78 on learning and testing data, respectively). Conclusion An algorithm using laboratory results and DPCs can categorize a majority of PBC patients as cirrhotic or noncirrhotic with high accuracy (with a small remaining group of patients' cirrhosis status indeterminate). In the absence of biopsy data, this EHR-based model can be used to identify cirrhosis in cohorts of PBC patients for research and/or clinical follow-up.
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Affiliation(s)
- Mei Lu
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | | | - Keith Lindor
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Carla V Rodriguez-Watson
- Center for Health Research Kaiser Permanente Mid-Atlantic Research Institute, Rockville, MD; Reagan-Udall Foundation for the FDA, Washington, DC, USA
| | | | - Irina V Haller
- Essentia Institute of Rural Health, Essentia Health, Duluth, MN, USA
| | - Heather Anderson
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Joseph A Boscarino
- Department of Population Health Sciences, Geisinger Clinic, Danville, PA, USA
| | - Mark A Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Yihe G Daida
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | - Amandeep Sahota
- Department of Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, CA, USA
| | | | - Jia Li
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Sheri Trudeau
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA
| | - Loralee B Rupp
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Stuart C Gordon
- Division of Gastroenterology and Hepatology, Henry Ford Health System; and Wayne State University School of Medicine, Detroit, MI, USA
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Parikh U, Lamba H, Vincent J, Civitello A, Nair A, Taimeh Z, Loor G, Shafii A, Liao K, Chatterjee S. Pre-Operative Hyponatremia as a Risk Factor for Mortality in Patients after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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Toupin April K, Bisaillon J, Welch V, Maxwell LJ, Jüni P, Rutjes AWS, Husni ME, Vincent J, El Hindi T, Wells GA, Tugwell P. Tramadol for osteoarthritis. Cochrane Database Syst Rev 2019; 5:CD005522. [PMID: 31132298 PMCID: PMC6536297 DOI: 10.1002/14651858.cd005522.pub3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Tramadol is often prescribed to treat pain and is associated physical disability in osteoarthritis (OA). Due to the pharmacologic mechanism of tramadol, it may lead to fewer associated adverse effects (i.e. gastrointestinal bleeding or renal problems) compared to non-steroidal anti-inflammatory drugs (NSAIDs). This is an update of a Cochrane Review originally published in 2006. OBJECTIVES To determine the benefits and harms of oral tramadol or tramadol combined with acetaminophen or NSAIDs in people with osteoarthritis. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase databases, as well as the US National Institutes of Health and World Health Organization trial registries up to February 2018. We searched the LILACS database up to August 2015. SELECTION CRITERIA We included randomized controlled trials (RCTs) that evaluated the effect of tramadol, or tramadol in combination with acetaminophen (paracetamol) or NSAIDs versus placebo or any comparator in people with osteoarthritis. DATA COLLECTION AND ANALYSIS We used standard methodologic procedures expected by Cochrane. MAIN RESULTS We included 22 RCTs (11 more than the previous review) of which 21 RCTs were included in meta-analyses for 3871 participants randomized to tramadol alone or tramadol in combination with another analgesic and 2625 participants randomized to placebo or active control. Seventeen studies evaluated tramadol alone and five evaluated tramadol plus acetaminophen. Thirteen studies used placebo controls and eleven studies used active controls (two trials had both placebo and active arms). The dose of tramadol ranged from 37.5 mg to 400 mg daily; all doses were pooled. Most trials were multicenter with a mean duration of two months. Participants were predominantly women with hip or knee osteoarthritis, with a mean age of 63 years and moderate to severe pain. There was a high risk of selection bias as only four trials reported both adequate sequence generation and allocation concealment. There was a low risk for performance bias as most studies blinded participants. There was a high risk of attrition bias as 10/22 trials showed incomplete outcome data. Most of the trials were funded by the pharmaceutical industry.Moderate quality evidence (downgraded due to risk of bias) indicated that tramadol alone and in combination with acetaminophen had no important benefit on pain reduction compared to placebo control (tramadol alone: 4% absolute improvement, 95% confidence interval (CI) 3% to 5%; 8 studies, 3972 participants; tramadol in combination with acetaminophen: 4% absolute improvement, 95% CI 2% to 6%; 2 studies, 614 participants).Fifteen out of 100 people in the tramadol group improved by 20% (which corresponded to a clinically important difference in pain) compared to 10/100 in the placebo group (5% absolute improvement). Twelve out of 100 people improved by 20% in the tramadol in combination with acetaminophen group compared to 7/100 in the placebo group (5% absolute improvement).Moderate quality evidence (downgraded due to risk of bias) indicated that tramadol alone and in combination with acetaminophen led to no important benefit in physical function compared to placebo (tramadol alone: 4% absolute improvement, 95% CI 2% to 6%; 5 studies, 2550 participants; tramadol in combination with acetaminophen: 4% absolute improvement, 95% CI 2% to 7%; 2 studies, 614 participants).Twenty-one out of 100 people in the tramadol group improved by 20% (which corresponded to a clinically important difference in physical function) compared to 16/100 in the placebo group (5% absolute improvement). Fifteen out of 100 people improved by 20% in the tramadol in combination with acetaminophen group compared to 10/100 in the placebo group (5% absolute improvement).Moderate quality evidence (downgraded due to risk of bias) indicated that, compared to placebo, there was a greater risk of developing adverse events with tramadol alone (risk ratio (RR) 1.34, 95% CI 1.24 to 1.46; 4 studies, 2039 participants) and tramadol in combination with acetaminophen compared to placebo (RR 1.91, 95% CI 1.32 to 2.76; 1 study, 308 participants). This corresponded to a 17% increase (95% CI 12% to 23%) with tramadol alone and 22% increase (95% CI 8% to 41%) with tramadol in combination with acetaminophen.The three most frequent adverse events were nausea, dizziness and tiredness. Moderate quality evidence (downgraded due to risk of bias) indicated that there was a greater risk of withdrawing from the study because of adverse events with tramadol alone compared to placebo (RR 2.64, 95% CI 2.17 to 3.20; 9 studies, 4533 participants), which corresponded to a 12% increase (95% CI 9% to 16%).Low quality evidence (downgraded due to risk of bias and inconsistency) indicated that there was a greater risk of withdrawing from the study because of adverse events with tramadol in combination with acetaminophen compared to placebo (RR 2.78, 95% CI 1.50 to 5.16; 2 studies, 614 participants), which corresponded to a 8% absolute improvement (95% CI 2% to 19%).Low quality evidence (downgraded due to risk of bias and imprecision) indicated that there was a greater risk of developing serious adverse events with tramadol alone compared to placebo (110/2459 participants with tramadol compared to 22/1153 participants with placebo; RR 1.78, 95% CI 1.11 to 2.84; 7 studies, 3612 participants), which corresponded to a 1% increase (95% CI 0% to 4%). There were no serious adverse events reported in one small study (15 participants) of tramadol with acetaminophen compared to placebo. AUTHORS' CONCLUSIONS Moderate quality evidence indicates that compared to placebo, tramadol alone or in combination with acetaminophen probably has no important benefit on mean pain or function in people with osteoarthritis, although slightly more people in the tramadol group report an important improvement (defined as 20% or more). Moderate quality evidence shows that adverse events probably cause substantially more participants to stop taking tramadol. The increase in serious adverse events with tramadol is less certain, due to the small number of events.
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Affiliation(s)
- Karine Toupin April
- Children's Hospital of Eastern Ontario Research InstituteOttawaCanada
- University of OttawaDepartment of Pediatrics and School of Rehabilitation SciencesOttawaCanada
| | | | - Vivian Welch
- Bruyère Research InstituteMethods CentreOttawaONCanada
- University of OttawaSchool of Epidemiology and Public HealthOttawaCanada
- Ottawa Hospital Research InstituteClinical Epidemiology ProgramOttawaCanada
| | - Lara J Maxwell
- University of OttawaCochrane MusculoskeletalOttawaONCanada
| | - Peter Jüni
- University of BernInstitute of Primary Health Care (BIHAM)Gesellschaftsstrasse 49BernSwitzerland3012
| | - Anne WS Rutjes
- University of BernInstitute of Social and Preventive Medicine (ISPM)Mittelstrasse 43BernBernSwitzerland3012
- University of BernCTU BernBernSwitzerland
| | - M Elaine Husni
- Cleveland Clinic: Orthopedic and Rheumatologic InstituteDepartment of Rheumatic and Immunologic Diseases9500 Euclid Ave‐ A50ClevelandOHUSA44195
| | - Jennifer Vincent
- Children's Hospital of Eastern Ontario Research InstituteOttawaCanada
| | - Tania El Hindi
- Children's Hospital of Eastern Ontario Research InstituteOttawaCanada
| | - George A Wells
- University of OttawaSchool of Epidemiology and Public HealthOttawaCanada
| | - Peter Tugwell
- University of OttawaSchool of Epidemiology and Public HealthOttawaCanada
- Ottawa Hospital Research InstituteClinical Epidemiology ProgramOttawaCanada
- University of OttawaDepartment of Medicine, Faculty of MedicineOttawaONCanadaK1H 8M5
- Bruyère Research InstituteWHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health EquityOttawaCanadaK1R 7G5
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Toupin April K, Bisaillon J, Welch V, Maxwell LJ, Jüni P, Rutjes AW, Husni ME, Vincent J, El Hindi T, Wells GA, Tugwell P. Tramadol for osteoarthritis. Cochrane Database Syst Rev 2019. [PMID: 31132298 DOI: 10.1002/14651858.cd005522.pub3/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Tramadol is often prescribed to treat pain and is associated physical disability in osteoarthritis (OA). Due to the pharmacologic mechanism of tramadol, it may lead to fewer associated adverse effects (i.e. gastrointestinal bleeding or renal problems) compared to non-steroidal anti-inflammatory drugs (NSAIDs). This is an update of a Cochrane Review originally published in 2006. OBJECTIVES To determine the benefits and harms of oral tramadol or tramadol combined with acetaminophen or NSAIDs in people with osteoarthritis. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and Embase databases, as well as the US National Institutes of Health and World Health Organization trial registries up to February 2018. We searched the LILACS database up to August 2015. SELECTION CRITERIA We included randomized controlled trials (RCTs) that evaluated the effect of tramadol, or tramadol in combination with acetaminophen (paracetamol) or NSAIDs versus placebo or any comparator in people with osteoarthritis. DATA COLLECTION AND ANALYSIS We used standard methodologic procedures expected by Cochrane. MAIN RESULTS We included 22 RCTs (11 more than the previous review) of which 21 RCTs were included in meta-analyses for 3871 participants randomized to tramadol alone or tramadol in combination with another analgesic and 2625 participants randomized to placebo or active control. Seventeen studies evaluated tramadol alone and five evaluated tramadol plus acetaminophen. Thirteen studies used placebo controls and eleven studies used active controls (two trials had both placebo and active arms). The dose of tramadol ranged from 37.5 mg to 400 mg daily; all doses were pooled. Most trials were multicenter with a mean duration of two months. Participants were predominantly women with hip or knee osteoarthritis, with a mean age of 63 years and moderate to severe pain. There was a high risk of selection bias as only four trials reported both adequate sequence generation and allocation concealment. There was a low risk for performance bias as most studies blinded participants. There was a high risk of attrition bias as 10/22 trials showed incomplete outcome data. Most of the trials were funded by the pharmaceutical industry.Moderate quality evidence (downgraded due to risk of bias) indicated that tramadol alone and in combination with acetaminophen had no important benefit on pain reduction compared to placebo control (tramadol alone: 4% absolute improvement, 95% confidence interval (CI) 3% to 5%; 8 studies, 3972 participants; tramadol in combination with acetaminophen: 4% absolute improvement, 95% CI 2% to 6%; 2 studies, 614 participants).Fifteen out of 100 people in the tramadol group improved by 20% (which corresponded to a clinically important difference in pain) compared to 10/100 in the placebo group (5% absolute improvement). Twelve out of 100 people improved by 20% in the tramadol in combination with acetaminophen group compared to 7/100 in the placebo group (5% absolute improvement).Moderate quality evidence (downgraded due to risk of bias) indicated that tramadol alone and in combination with acetaminophen led to no important benefit in physical function compared to placebo (tramadol alone: 4% absolute improvement, 95% CI 2% to 6%; 5 studies, 2550 participants; tramadol in combination with acetaminophen: 4% absolute improvement, 95% CI 2% to 7%; 2 studies, 614 participants).Twenty-one out of 100 people in the tramadol group improved by 20% (which corresponded to a clinically important difference in physical function) compared to 16/100 in the placebo group (5% absolute improvement). Fifteen out of 100 people improved by 20% in the tramadol in combination with acetaminophen group compared to 10/100 in the placebo group (5% absolute improvement).Moderate quality evidence (downgraded due to risk of bias) indicated that, compared to placebo, there was a greater risk of developing adverse events with tramadol alone (risk ratio (RR) 1.34, 95% CI 1.24 to 1.46; 4 studies, 2039 participants) and tramadol in combination with acetaminophen compared to placebo (RR 1.91, 95% CI 1.32 to 2.76; 1 study, 308 participants). This corresponded to a 17% increase (95% CI 12% to 23%) with tramadol alone and 22% increase (95% CI 8% to 41%) with tramadol in combination with acetaminophen.The three most frequent adverse events were nausea, dizziness and tiredness. Moderate quality evidence (downgraded due to risk of bias) indicated that there was a greater risk of withdrawing from the study because of adverse events with tramadol alone compared to placebo (RR 2.64, 95% CI 2.17 to 3.20; 9 studies, 4533 participants), which corresponded to a 12% increase (95% CI 9% to 16%).Low quality evidence (downgraded due to risk of bias and inconsistency) indicated that there was a greater risk of withdrawing from the study because of adverse events with tramadol in combination with acetaminophen compared to placebo (RR 2.78, 95% CI 1.50 to 5.16; 2 studies, 614 participants), which corresponded to a 8% absolute improvement (95% CI 2% to 19%).Low quality evidence (downgraded due to risk of bias and imprecision) indicated that there was a greater risk of developing serious adverse events with tramadol alone compared to placebo (110/2459 participants with tramadol compared to 22/1153 participants with placebo; RR 1.78, 95% CI 1.11 to 2.84; 7 studies, 3612 participants), which corresponded to a 1% increase (95% CI 0% to 4%). There were no serious adverse events reported in one small study (15 participants) of tramadol with acetaminophen compared to placebo. AUTHORS' CONCLUSIONS Moderate quality evidence indicates that compared to placebo, tramadol alone or in combination with acetaminophen probably has no important benefit on mean pain or function in people with osteoarthritis, although slightly more people in the tramadol group report an important improvement (defined as 20% or more). Moderate quality evidence shows that adverse events probably cause substantially more participants to stop taking tramadol. The increase in serious adverse events with tramadol is less certain, due to the small number of events.
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John S, Sharma N, Sborov DW, Williams N, Jones D, Benson DM, Efebera YA, Rosko AE, Vincent J, Hofmeister CC. Most multiple myeloma patients have low testosterone. Leuk Lymphoma 2018; 60:836-838. [PMID: 30277092 DOI: 10.1080/10428194.2018.1508664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sonya John
- a College of Medicine , The Ohio State University , Columbus , OH , USA
| | - Nidhi Sharma
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Douglas W Sborov
- c Division of Hematology & Hematologic Malignancies, Department of Internal Medicine , Huntsman Cancer Institute University of Utah , Salt Lake City , UT , USA
| | - Nita Williams
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Desirée Jones
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Don M Benson
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Yvonne A Efebera
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Ashley E Rosko
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Jennifer Vincent
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
| | - Craig C Hofmeister
- b Division of Hematology, Department of Internal Medicine , The Ohio State University , Columbus , OH , USA
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van Kleef J, van de Poll-Franse L, Verhoeven R, Slingerland M, Ruurda J, Heisterkamp J, Rosman C, de Groot J, Kouwenhoven E, van Dijk M, de Graaf E, van Voorthuizen T, Daams F, Lagarde S, Nieuwenhuijzen G, Vincent J, van Berge Henegouwen M, van Oijen M, Sprangers M, van Laarhoven H. Prospective observational cohort study of oesophagogastric cancer patients (POCOP): A Dutch nationwide cohort. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.079] [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: 11/13/2022] Open
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Ferreira JP, Abreu P, McMurray JJV, Van Veldhuisen DJ, Swedberg K, Pocock S, Vincent J, Lins K, Pitt B, Zannad F. P910Beware of making dose comparisons for efficacy in post-hoc analyses of achieved dose in up-titrating studies: lessons from the EMPHASIS trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p910] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J P Ferreira
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
| | - P Abreu
- Cardiovascular Research Foundation, New York, United States of America
| | - J J V McMurray
- Cardiovascular Research Centre of Glasgow, Glasgow, United Kingdom
| | | | | | - S Pocock
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J Vincent
- Cardiovascular Research Foundation, New York, United States of America
| | - K Lins
- Cardiovascular Research Foundation, New York, United States of America
| | - B Pitt
- University of Michigan, Ann Arbor, United States of America
| | - F Zannad
- Clinical Investigation Centre Pierre Drouin (CIC-P), Nancy, France
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Lu M, Zhou Y, Haller IV, Romanelli RJ, VanWormer JJ, Rodriguez CV, Anderson H, Boscarino JA, Schmidt MA, Daida YG, Sahota A, Vincent J, Bowlus CL, Lindor K, Zhang T, Trudeau S, Li J, Rupp LB, Gordon SC. Increasing Prevalence of Primary Biliary Cholangitis and Reduced Mortality With Treatment. Clin Gastroenterol Hepatol 2018; 16:1342-1350.e1. [PMID: 29277621 DOI: 10.1016/j.cgh.2017.12.033] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/08/2017] [Accepted: 12/12/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS There are few data from longitudinal studies of trends in primary biliary cholangitis (PBC) among patients under routine clinical care in the United States. We collected data from the Fibrotic Liver Disease consortium to investigate changes in the incidence and prevalence of PBC and the effects of patient demographics, clinical features, and treatment on mortality. METHODS We collected demographic and clinical data for the general patient population as well as PBC patients receiving care from 11 health systems in different regions of the United States (Northeast, Midwest, Northwest, and South) from January 1, 2003, through December 31, 2014. Annual percentage changes in PBC prevalence and incidence were estimated using join-point Poisson regression. Differences based on race, age, and gender were calculated with rate ratios. All-cause mortality was estimated using Cox regression with adjustment for patient characteristics and treatment with ursodeoxycholic acid (UDCA). Propensity scores were used to adjust for treatment selection bias. Analyses were adjusted by geographic regions. RESULTS In our racially diverse cohort of 3488 patients with PBC (21% Hispanic, 8% African American, 7% Asian American), 70% had ever received UDCA. From 2006 through 2014, the prevalence of PBC increased from 21.7 to 39.2 per 100,000 persons. Adjusted annual percentage changes in prevalence differed among age groups (≤40 y, 41-50 y, 51-60 y, 61-70 y, and >70 y), ranging from 3.0% to 7.5% (P < .05). Incidence did not change significantly during the study period (4.2 vs 4.3 per 100,000 person-years in 2006 and 2014, respectively; P = .98). Ratios of prevalence for women vs men (3.9:1) and incidence for women vs men (3.2:1) were consistent over the study period. Among African Americans, the prevalence of PBC increased from 16.9 to 30.8 per 100,000 during the study period, and annual incidence ranged from 2.6 to 6.6 per 100,000 person-years. In adjusted analyses, an increased level of alkaline phosphatase at baseline was associated with significantly higher mortality (adjusted hazard ratios [aHR], 1.24; 95% CI, 1.04-1.48 for patients with levels 1-2 times the upper limit of normal and aHR, 2.27; 95% CI, 1.88-2.73 for patients with levels more than 3 times the upper limit of normal). UDCA treatment was associated with significantly reduced mortality (aHR, 0.57; 95% CI, 0.52-0.64). CONCLUSIONS In an analysis of data from patients receiving routine clinical care in Fibrotic Liver Disease Consortium health systems, we found that the prevalence of PBC increased from 2004 through 2014, despite steady incidence. Patient demographic and clinical characteristics, as well as UDCA treatment, affected mortality.
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Affiliation(s)
- Mei Lu
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
| | - Yueren Zhou
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Irina V Haller
- Essentia Institute of Rural Health, Essentia Health, Duluth, Minnesota
| | | | | | - Carla V Rodriguez
- Center for Health Research, Kaiser Permanente Mid-Atlantic Research Institute, Rockville, Maryland
| | - Heather Anderson
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado
| | - Joseph A Boscarino
- Department of Epidemiology and Health Services Research, Geisinger Clinic, Danville, Pennsylvania
| | - Mark A Schmidt
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Yihe G Daida
- Center for Health Research Hawai'i, Kaiser Permanente, Honolulu, Hawaii
| | - Amandeep Sahota
- Department of Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, California
| | | | | | - Keith Lindor
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Talan Zhang
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Sheri Trudeau
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Jia Li
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Loralee B Rupp
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan
| | - Stuart C Gordon
- Department of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, Michigan
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Ramalli L, Noël H, Chiappini JD, Vincent J, Barré-Cardi H, Malfait P, Normand G, Busato F, Gendrin V, Mulero S, Allienne JF, Fillaux J, Boissier J, Berry A. A persistent risk of urogenital schistosomiasis transmission linked to the Cavu River in Southern Corsica since 2013. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Aparicio T, Ducreux M, Faroux R, Barbier E, Manfredi S, Lecomte T, Etienne PL, Bedenne L, Bennouna J, Phelip JM, François E, Michel P, Legoux JL, Gasmi M, Breysacher G, Rougier P, De Gramont A, Lepage C, Bouché O, Seitz JF, Adenis A, Alessio A, Aouakli A, Azzedine A, Bedjaoui A, Bidault A, Blanchi A, Botton A, Cadier-Lagnes A, Fatisse A, Gagnaire A, Gilbert A, Gueye A, Hollebecque A, Lemaire A, Mahamat A, Marre A, Patenotte A, Rotenberg A, Roussel A, Thirot-Bidault A, Votte A, Weber A, Zaanan A, Dupont-Gossart A, Villing A, Queuniet A, Coudert B, Denis B, Garcia B, Lafforgue B, Landi B, Leduc B, Linot B, Paillot B, Rhein B, Winkfield B, Barberis C, Becht C, Belletier C, Berger C, Bineau C, Borel C, Brezault C, Buffet C, Cornila C, Couffon C, De La Fouchardière C, Giraud C, Lecaille C, Lepere C, Lobry C, Locher C, Lombard-Bohas C, Paoletti C, Platini C, Rebischung C, Sarda C, Vilain C, Briac-Levaché C, Auby D, Baudet-Klepping D, Bechade D, Besson D, Cleau D, Festin D, Gargot D, Genet D, Goldfain D, Luet D, Malka D, Peré-Vergé D, Pillon D, Sevin-Robiche D, Smith D, Soubrane D, Tougeron D, Zylberait D, Carola E, Cuillerier E, Dorval Danquechin E, Echinard E, Janssen E, Maillard E, Mitry E, Norguet-Monnereau E, Suc E, Terrebonne E, Zrihen E, Pariente E, Almaric F, Audemar F, Bonnetain F, Desseigne F, Dewaele F, Di Fiore F, Ghiringhelli F, Husseini F, Khemissa F, Kikolski F, Morvan F, Petit-Laurent F, Riot F, Subtil F, Zerouala-Boussaha F, Caroli-Bosc F, Boilleau-Jolimoy G, Bordes G, Cavaglione G, Coulanjon G, Deplanque G, Gatineau-Saillant G, Goujon G, Medinger G, Roquin G, Brixi-Benmansour H, Castanie H, Lacroix H, Maechel H, Perrier H, Salloum H, Senellart H, Baumgaertner I, Cumin I, Graber I, Trouilloud I, Boutin J, Butel J, Charneau J, Cretin J, Dauba J, Deguiral J, Egreteau J, Ezenfis J, Forestier J, Goineau J, Lacourt J, Lafon J, Martin J, Meunier J, Moreau J, Provencal J, Taieb J, Thaury J, Tuaillon J, Vergniol J, Villand J, Vincent J, Volet J, Bachet J, Barbare J, Souquet J, Grangé J, Dor J, Paitel J, Jouve J, Raoul J, Cheula J, Gornet J, Sabate J, Vantelon J, Vaillant J, Aucouturier J, Barbieux J, Herr J, Lafargue J, Lagasse J, Latrive J, Plachot J, Ramain J, Robin J, Spano J, Douillard J, Beerblock K, Bouhier-Leporrier K, Slimane Fawzi K, Cany L, Chone L, Dahan L, Gasnault L, Rob L, Stefani L, Wander L, Baconnier M, Ben Abdelghani M, Benchalal M, Blasquez M, Carreiro M, Charbit M, Combe M, Duluc M, Fayolle M, Gignoux M, Giovannini M, Glikmanas M, Mabro M, Mignot M, Mornet M, Mousseau M, Mozer M, Pauwels M, Pelletier M, Porneuf M, Ramdani M, Schnee M, Tissot M, Zawadi M, Clavero-Fabri M, Gouttebel M, Kaminsky M, Galais M, Abdelli N, Barrière N, Bouaria N, Bouarioua N, Delas N, Gérardin N, Hess-Laurens N, Stremsdoerfer N, Berthelet O, Boulat O, Capitain O, Favre O, Amoyal P, Bergerault P, Burtin P, Cassan P, Chatrenet P, Chiappa P, Claudé P, Couzigou P, Feydy P, Follana P, Geoffroy P, Godeau P, Hammel P, Laplaige P, Lehair P, Martin P, Novello P, Pantioni P, Pienkowski P, Pouderoux P, Prost P, Ruszniewski P, Souillac P, Texereau P, Thévenet P, Haineaux P, Benoit R, Coriat R, Lamy R, Mackiewicz R, Beorchia S, Chaussade S, Hiret S, Jacquot S, Lavau Denes S, Montembault S, Nahon S, Nasca S, Nguyen S, Oddou-Lagraniere S, Pesque-Penaud S, Fratte S, Chatellier T, Mansourbakht T, Morin T, Walter T, Boige V, Bourgeois V, Derias V, Guérin-Meyer V, Hautefeuille V, Jestin Le Tallec V, Lorgis V, Quentin V, Sebbagh V, Veuillez V, Adhoute X, Coulaud X, Becouarn Y, Coscas Y, Courouble Y, Le Bricquir Y, Molin Y, Rinaldi Y, Lam Y, Ladhib Z. Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials. Eur J Cancer 2018; 98:1-9. [DOI: 10.1016/j.ejca.2018.03.031] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 02/07/2023]
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Karlin J, Allen J, Ahmad SF, Hughes G, Sheridan V, Odedra R, Farrington P, Cadogan EB, Riches LC, Garcia-Trinidad A, Thomason AG, Patel B, Vincent J, Lau A, Pike KG, Hunt TA, Sule A, Valerie NCK, Biddlestone-Thorpe L, Kahn J, Beckta JM, Mukhopadhyay N, Barlaam B, Degorce SL, Kettle J, Colclough N, Wilson J, Smith A, Barrett IP, Zheng L, Zhang T, Wang Y, Chen K, Pass M, Durant ST, Valerie K. Orally Bioavailable and Blood-Brain Barrier-Penetrating ATM Inhibitor (AZ32) Radiosensitizes Intracranial Gliomas in Mice. Mol Cancer Ther 2018; 17:1637-1647. [PMID: 29769307 DOI: 10.1158/1535-7163.mct-17-0975] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/18/2018] [Accepted: 05/03/2018] [Indexed: 11/16/2022]
Abstract
Inhibition of ataxia-telangiectasia mutated (ATM) during radiotherapy of glioblastoma multiforme (GBM) may improve tumor control by short-circuiting the response to radiation-induced DNA damage. A major impediment for clinical implementation is that current inhibitors have limited central nervous system (CNS) bioavailability; thus, the goal was to identify ATM inhibitors (ATMi) with improved CNS penetration. Drug screens and refinement of lead compounds identified AZ31 and AZ32. The compounds were then tested in vivo for efficacy and impact on tumor and healthy brain. Both AZ31 and AZ32 blocked the DNA damage response and radiosensitized GBM cells in vitro AZ32, with enhanced blood-brain barrier (BBB) penetration, was highly efficient in vivo as radiosensitizer in syngeneic and human, orthotopic mouse glioma model compared with AZ31. Furthermore, human glioma cell lines expressing mutant p53 or having checkpoint-defective mutations were particularly sensitive to ATMi radiosensitization. The mechanism for this p53 effect involves a propensity to undergo mitotic catastrophe relative to cells with wild-type p53. In vivo, apoptosis was >6-fold higher in tumor relative to healthy brain after exposure to AZ32 and low-dose radiation. AZ32 is the first ATMi with oral bioavailability shown to radiosensitize glioma and improve survival in orthotopic mouse models. These findings support the development of a clinical-grade, BBB-penetrating ATMi for the treatment of GBM. Importantly, because many GBMs have defective p53 signaling, the use of an ATMi concurrent with standard radiotherapy is expected to be cancer-specific, increase the therapeutic ratio, and maintain full therapeutic effect at lower radiation doses. Mol Cancer Ther; 17(8); 1637-47. ©2018 AACR.
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Affiliation(s)
- Jeremy Karlin
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Jasmine Allen
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Syed F Ahmad
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Gareth Hughes
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Victoria Sheridan
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Rajesh Odedra
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Paul Farrington
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Elaine B Cadogan
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Lucy C Riches
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Antonio Garcia-Trinidad
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Andrew G Thomason
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Bhavika Patel
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Jennifer Vincent
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Alan Lau
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Kurt G Pike
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Thomas A Hunt
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Amrita Sule
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Nicholas C K Valerie
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Laura Biddlestone-Thorpe
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Jenna Kahn
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Jason M Beckta
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Nitai Mukhopadhyay
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Bernard Barlaam
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Sebastien L Degorce
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Jason Kettle
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Nicola Colclough
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Joanne Wilson
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Aaron Smith
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Ian P Barrett
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Li Zheng
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Tianwei Zhang
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Yingchun Wang
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Kan Chen
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Martin Pass
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Stephen T Durant
- AstraZeneca - Bioscience, DMPK, Chemistry, Discovery Sciences and Projects-Oncology, IMED Biotech Unit, Alderley Park, Cambridge, United Kingdom; and DizalPharma, Shanghai, China
| | - Kristoffer Valerie
- Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia.
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Dvirnik N, Belley-Cote E, Hanif H, Devereaux P, Lamy A, Dieleman J, Vincent J, Whitlock R. Steroids in cardiac surgery: a systematic review and meta-analysis. Br J Anaesth 2018; 120:657-667. [DOI: 10.1016/j.bja.2017.10.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 10/16/2017] [Accepted: 10/26/2017] [Indexed: 11/27/2022] Open
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Tugwell P, Petkovic J, Welch V, Vincent J, Bhutta ZA, Churchill R, deSavigny D, Mbuagbaw L, Pantoja T. Setting priorities for knowledge translation of Cochrane reviews for health equity: Evidence for Equity. Int J Equity Health 2017; 16:208. [PMID: 29197403 PMCID: PMC5712153 DOI: 10.1186/s12939-017-0697-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/08/2017] [Indexed: 11/10/2022] Open
Abstract
Background A focus on equity in health can be seen in many global development goals and reports, research and international declarations. With the development of a relevant framework and methods, the Campbell and Cochrane Equity Methods Group has encouraged the application of an ‘equity lens’ to systematic reviews, and many organizations publish reviews intended to address health equity. The purpose of the Evidence for Equity (E4E) project was to conduct a priority-setting exercise and apply an equity lens by developing a knowledge translation product comprising summaries of systematic reviews from the Cochrane Library. E4E translates evidence from systematic reviews into ‘friendly front end’ summaries for policy makers. Methods The following topic areas with high burdens of disease globally, were selected for the pilot: diabetes/obesity, HIV/AIDS, malaria, nutrition, and mental health/depression. For each topic area, a “stakeholder panel” was assembled that included policymakers and researchers. A systematic search of Cochrane reviews was conducted for each area to identify equity-relevant interventions with a meaningful impact. Panel chairs developed a rating sheet which was used by all panels to rank the importance of these interventions by: 1) Ease of Implementation; 2) Health System Requirements; 3)Universality/Generalizability/Share of Burden; and 4) Impact on Inequities/Effect on equity. The ratings of panel members were averaged for each intervention and criterion, and interventions were ordered according to the average overall ratings. Results Stakeholder panels identified the top 10 interventions from their respective topic areas. The evidence on these interventions is being summarized with an equity focus and the results posted online, at http://methods.cochrane.org/equity/e4e-series. Conclusions This method provides an explicit approach to setting priorities by systematic review groups and funders for providing decision makers with evidence for the most important equity-relevant interventions. Electronic supplementary material The online version of this article (10.1186/s12939-017-0697-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter Tugwell
- Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. .,WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Canada.
| | | | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Jennifer Vincent
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Zulfiqar A Bhutta
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Don deSavigny
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Tomas Pantoja
- Department of Family Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Centro Medico San Joaquin, Santiago, Chile
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Battaglia A, Sellal J, Magnin-Poull I, Voilliot D, Vincent J, Baruffaldi F, De Chillou C. 4987Ventricular tachycardia critical isthmus detection through pacemapping technique guided by a robotic magnetic navigation system. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx495.4987] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Guimon C, Pfister-Guillouzo G, Salmona G, Vincent J. Étude de la structure électronique du benzothiazole et de ses homologues azoté, oxygéné et sélénié par spectroscopie photoélectronique (HeI, HeII). ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1978750859] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Sathya C, Wayne C, Gotsch A, Vincent J, Sullivan KJ, Nasr A. Laparoscopic versus open pyloromyotomy in infants: a systematic review and meta-analysis. Pediatr Surg Int 2017; 33:325-333. [PMID: 27942806 DOI: 10.1007/s00383-016-4030-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE To determine whether open or laparoscopic pyloromyotomy is superior for the treatment of hypertrophic pyloric stenosis in infants. METHODS We searched MEDLINE, EMBASE, and CENTRAL for articles comparing laparoscopic and open procedures. We conducted meta-analyses when possible and described other results narratively. RESULTS Our meta-analyses revealed no significant difference in our primary outcome of major complications [risk difference (RD) 0.03, 95% confidence interval (CI) -0.03 to 0.08, P = 0.35, I 2 = 55%], or in our secondary outcomes of all perioperative complications (RD -0.01, 95% CI -0.06 to 0.04, P = 0.74, I 2 = 0%), operative time [mean difference (MD) 0.68, 95% CI -3.60 to 4.79, P = 0.76, I 2 = 86%], and length of stay (MD -2.60, 95% CI -6.05 to 0.86, P = 0.14, I 2 = 0%). Laparoscopy was associated with a shorter time to full feeds (standardized mean difference -0.25, 95% CI -0.43 to -0.06, P = 0.009, I 2 = 8%) and a slightly higher rate of inadequate pyloromyotomy (RD 0.04, 95% CI 0.00-0.08, P = 0.03, I 2 = 0%). Results from one randomized controlled trial indicate a better cosmetic outcome after laparoscopy compared to open procedure. CONCLUSION There is no strong evidence to support a recommendation of one procedure over the other; therefore, the choice of laparoscopic or open procedure should be left to the discretion of the surgeon.
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Affiliation(s)
- Chethan Sathya
- Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Carolyn Wayne
- Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Anna Gotsch
- Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Jennifer Vincent
- Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Katrina J Sullivan
- Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Ahmed Nasr
- Department of Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. .,University of Ottawa, Ottawa, ON, Canada.
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Olivier A, Girerd N, Michel JB, Ketelslegers JM, Fay R, Vincent J, Bramlage P, Pitt B, Zannad F, Rossignol P. Combined baseline and one-month changes in big endothelin-1 and brain natriuretic peptide plasma concentrations predict clinical outcomes in patients with left ventricular dysfunction after acute myocardial infarction: Insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) study. Int J Cardiol 2017; 241:344-350. [PMID: 28284500 DOI: 10.1016/j.ijcard.2017.02.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/14/2017] [Accepted: 02/03/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Increased levels of neuro-hormonal biomarkers predict poor prognosis in patients with acute myocardial infarction (AMI) complicated by left ventricular systolic dysfunction (LVSD). The predictive value of repeated (one-month interval) brain natriuretic peptides (BNP) and big-endothelin 1 (BigET-1) measurements were investigated in patients with LVSD after AMI. METHODS In a sub-study of the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS trial), BNP and BigET-1 were measured at baseline and at 1month in 476 patients. RESULTS When included in the same Cox regression model, baseline BNP (p=0.0003) and BigET-1 (p=0.026) as well as the relative changes (after 1month) from baseline in BNP (p=0.049) and BigET-1 (p=0.045) were predictive of the composite of cardiovascular death or hospitalization for worsening heart failure. Adding baseline and changes in BigET-1 to baseline and changes in BNP led to a significant increase in prognostic reclassification as assessed by integrated discrimination improvement index (5.0%, p=0.01 for the primary endpoint). CONCLUSIONS Both increased baseline and changes after one month in BigET-1 concentrations were shown to be associated with adverse clinical outcomes, independently from BNP baseline levels and one month changes, in patients after recent AMI complicated with LVSD. This novel result may be of clinical interest since such combined biomarker assessment could improve risk stratification and open new avenues for biomarker-guided targeted therapies. KEY MESSAGES In the present study, we report for the first time in a population of patients with reduced LVEF after AMI and signs or symptoms of congestive HF, that increased baseline values of BNP and BigET-1 as well as a further rise of these markers over the first month after AMI, were independently predictive of future cardiovascular events. This approach may therefore be of clinical interest with the potential of improving risk stratification after AMI with reduced LVEF while further opening new avenues for biomarker-guided targeted therapies.
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Affiliation(s)
- A Olivier
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France; Department of Cardiovascular Disease, Institut Lorrain du Coeur et des Vaisseaux, Nancy University Hospital, Nancy, France.
| | - N Girerd
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
| | - J B Michel
- Inserm, UMRS 1148 University Paris Diderot, Paris, France
| | | | - R Fay
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
| | | | - P Bramlage
- Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow, Germany
| | - B Pitt
- University of Michigan, School of Medicine, Ann Arbor, MI, USA
| | - F Zannad
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France; Department of Cardiovascular Disease, Institut Lorrain du Coeur et des Vaisseaux, Nancy University Hospital, Nancy, France
| | - P Rossignol
- Inserm, CIC-P 14-33, U 116, CHU Nancy, France; University of Lorraine, France; F-CRIN INI-CRCT, Nancy, France
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Abstract
CONTEXT Postoperative emesis is common after pyloromyotomy. Although postoperative feeding is likely to be an influencing factor, there is no consensus on optimal feeding. OBJECTIVE To compare the effect of feeding regimens on clinical outcomes of infants after pyloromyotomy. DATA SOURCES Cumulative Index to Nursing and Allied Health Literature, The Cochrane Central Register of Controlled Trials, Embase, and Medline. STUDY SELECTION Two reviewers independently assessed studies for inclusion based on a priori inclusion criteria. DATA EXTRACTION Data were extracted on methodological quality, general study and intervention characteristics, and clinical outcomes. RESULTS Fourteen studies were included. Ad libitum feeding was associated with significantly shorter length of stay (LOS) when compared with structured feeding (mean difference [MD] -4.66; 95% confidence interval [CI], -8.38 to -0.95; P = .01). Although gradual feeding significantly decreased emesis episodes (MD -1.70; 95% CI, -2.17 to -1.23; P < .00001), rapid feeding led to significantly shorter LOS (MD 22.05; 95% CI, 2.18 to 41.93; P = .03). Late feeding resulted in a significant decrease in number of patients with emesis (odds ratio 3.13; 95% CI, 2.26 to 4.35; P < .00001). LIMITATIONS Exclusion of non-English studies, lack of randomized controlled trials, insufficient number of studies to perform publication bias or subgroup analysis for potential predictors of emesis. CONCLUSIONS Ad libitum feeding is recommended for patients after pyloromyotomy as it leads to decreased LOS. If physicians still prefer structured feeding, early rapid feeds are recommended as they should lead to a reduced LOS.
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Affiliation(s)
- Katrina J Sullivan
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and
| | - Emily Chan
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and
| | - Jennifer Vincent
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and
| | - Mariam Iqbal
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and
| | - Carolyn Wayne
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and
| | - Ahmed Nasr
- Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; and Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Narayanasamy G, Pyakuryal AP, Pandit S, Vincent J, Lee C, Mavroidis P, Papanikolaou N, Kudrimoti M, Sio TT. Radiobiological evaluation of intensity modulated radiation therapy treatments of patients with head and neck cancer: A dual-institutional study. J Med Phys 2015; 40:165-9. [PMID: 26500403 PMCID: PMC4594386 DOI: 10.4103/0971-6203.165075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
In clinical practice, evaluation of clinical efficacy of treatment planning stems from the radiation oncologist's experience in accurately targeting tumors, while keeping minimal toxicity to various organs at risk (OAR) involved. A more objective, quantitative method may be raised by using radiobiological models. The purpose of this work is to evaluate the potential correlation of OAR-related toxicities to its radiobiologically estimated parameters in simultaneously integrated boost (SIB) intensity modulated radiation therapy (IMRT) plans of patients with head and neck tumors at two institutions. Lyman model for normal tissue complication probability (NTCP) and the Poisson model for tumor control probability (TCP) models were used in the Histogram Analysis in Radiation Therapy (HART) analysis. In this study, 33 patients with oropharyngeal primaries in the head and neck region were used to establish the correlation between NTCP values of (a) bilateral parotids with clinically observed rates of xerostomia, (b) esophagus with dysphagia, and (c) larynx with dysphagia. The results of the study indicated a strong correlation between the severity of xerostomia and dysphagia with Lyman NTCP of bilateral parotids and esophagus, respectively, but not with the larynx. In patients without complications, NTCP values of these organs were negligible. Using appropriate radiobiological models, the presence of a moderate to strong correlation between the severities of complications with NTCP of selected OARs suggested that the clinical outcome could be estimated prior to treatment.
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Affiliation(s)
- G Narayanasamy
- Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - A P Pyakuryal
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - S Pandit
- Department of Radiation Oncology, BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - J Vincent
- Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - C Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - P Mavroidis
- Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - N Papanikolaou
- Department of Radiation Oncology, University of Texas Health Science Center, San Antonio, TX, USA
| | - M Kudrimoti
- Department of Radiation Medicine, University of Kentucky, Lexington, KY, USA
| | - T T Sio
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
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Belley-Cote E, Lamy A, Vincent J, Kavsak P, Ou Y, Zhang M, Devereaux P, Whitlock R. AN EVENT DRIVEN MYOCARDIAL INFARCTION DEFINITION USING TROPONINS AFTER CORONARY ARTERY BYPASS SURGERY IN THE CORONARY TRIAL. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Belley-Cote E, Lamy A, Tagarakis G, Ou Y, Vincent J, Kavsak P, Zhang M, Devereaux P, Whitlock R. AN EVALUATION OF THE INCIDENCE AND PROGNOSIS OF POST CORONARY ARTERY BYPASS GRAFTING MYOCARDIAL INFARCTION ACCORDING TO DIFFERENT DEFINITIONS IN THE CORONARY TRIAL. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.346] [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: 11/15/2022] Open
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Jurkovic I, Stathakis S, Li Y, Patel A, Vincent J, Papanikolaou N, Mavroidis P. SU-E-J-160: Motion Analysis and 3D Plane Fit Through the Tumor Center of Mass Positions in the 4DCT Data Set. Med Phys 2015. [DOI: 10.1118/1.4924245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Carter J, Orzechowski M, Roettger D, Vincent J, Hinton M, Kubassova O, Boesen M. SAT0322 A Post-Hoc Analysis of the Synovial-Based Inflammation During Inter-Critical Gout Using A Novel Semi-Automatic Quantitative MRI Tool. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3910] [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: 11/03/2022]
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Terra SG, Vincent J. Type 2 Diabetes: Progress Made but Still a Long Road to Travel to Reduce Disease Burden. Clin Pharmacol Ther 2015; 98:108-11. [PMID: 26013760 DOI: 10.1002/cpt.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 01/18/2023]
Affiliation(s)
- S G Terra
- Pfizer Inc., GIPB, Groton, Connecticut, USA
| | - J Vincent
- Pfizer Inc., New York, New York, USA
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Affiliation(s)
- Peyton Wilson
- University of North Carolina at Chapel Hill, NC, USA
| | | | - Eveline Wu
- University of North Carolina at Chapel Hill, NC, USA
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Patel A, Daniels J, Vincent J, Eng T. Comparison of Conditional Survival in Patients With Gastrointestinal Malignancies Treated With Radiation: A Population-Based Analysis. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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34
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Vincent J. Response to “The Failing Right Heart: The Neglected Ventricle?”. Clin Pharmacol Ther 2014; 96:302-3. [DOI: 10.1038/clpt.2014.132] [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] [Received: 06/10/2014] [Accepted: 06/10/2014] [Indexed: 11/09/2022]
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Narayanasamy G, Pyakuryal A, Pandit S, Sio T, Vincent J, Kudrimoti M, Li Y. Radiobiological Evaluation of IMRT Treatment of Head and Neck Patients: Multi-institutional Study. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Livingstone M, Vincent J, Savage T, Srihasam K. Development of Category-Selective Domains in Infant Macaque Inferotemporal Cortex. J Vis 2014. [DOI: 10.1167/14.10.228] [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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37
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Vincent J, Buck S. Rod influence on chromatic discrimination away from chromatic and achromatic backgrounds. J Vis 2014. [DOI: 10.1167/14.10.992] [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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38
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Ballantyne C, Neutel J, Cropp A, Duggan W, Wang E, Plowchalk D, Sweeney K, Kaila N, Vincent J, Bays H. Bococizumab (rn316/pf-04950615), a monoclonal antibody against pcsk9 in statin-treated hypercholesterolemic subjects: Results from a randomized, placebo-controlled, dose-ranging study (nct: 01592240). Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.196] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Elevated low-density lipoprotein cholesterol (LDL-C) is an established risk factor for cardiovascular disease (CVD), and reduction of elevated LDL-C reduces mortality in patients at risk. This benefit has evolved from the use of statins and knowledge of the LDL receptor (LDLR). The most potent drugs used for dyslipidemias act by mechanisms that involve this receptor. Advances in molecular genetics and understanding of the regulation of this receptor have revealed several pharmacological targets that are being explored to develop more targeted therapies for dyslipidemias.
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Affiliation(s)
- J Vincent
- Pfizer Global Pharmaceuticals, New York, New York, USA
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Jurkovic I, Stathakis S, Li Y, Patel A, Vincent J, Papanikolaou N, Mavroidis P. SU-E-T-174: Evaluation of the Optimal Intensity Modulated Radiation Therapy Plans Done On the Maximum and Average Intensity Projection CTs. Med Phys 2014. [DOI: 10.1118/1.4888504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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41
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Jurkovic I, Stathakis S, Li Y, Patel A, Vincent J, Papanikolaou N, Mavroidis P. SU-E-J-79: Internal Tumor Volume Motion and Volume Size Assessment Using 4D CT Lung Data. Med Phys 2014. [DOI: 10.1118/1.4888131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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42
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Vincent J, Kirkwood AE. Variability of water quality, metals and phytoplankton community structure in urban stormwater ponds along a vegetation gradient. Urban Ecosyst 2014. [DOI: 10.1007/s11252-014-0356-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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43
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Eschalier R, McMurray J, Swedberg K, Veldhuisen van D, Krum H, Pocock S, Shi H, Vincent J, Rossignol P, Zannad F, Pitt B. SAFETY AND EFFICACY OF EPLERENONE IN PATIENTS AT HIGH RISK FOR HYPERKALEMIA AND/OR WORSENING RENAL FUNCTION. ANALYSES OF THE EMPHASIS-HF STUDY SUBGROUPS (EPLERENONE IN MILD PATIENTS HOSPITALIZATION AND SURVIVAL STUDY IN HEART FAILURE). Racionalʹnaâ farmakoterapiâ v kardiologii 2014. [DOI: 10.20996/1819-6446-2014-10-1-106-115] [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: 11/22/2022] Open
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Vincent J, Kwong C, Buck S. Differential rod influence on chromatic discrimination along theoretically relevant axes. J Vis 2013. [DOI: 10.1167/13.15.46] [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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Mathew J, Yusuf A, Vincent J, Eikelboom J, Shestakovska O, Fremes S, Noora J, Guo L, Peterson M, Spyropoulos A, Patel A, Schulman S, Pai M, Whitlock R. Efficacy and Safety of Different Bridging Regimens of Parenteral Anticoagulation After Mechanical Valve Replacement. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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47
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Girerd N, Collier T, Pocock S, Krum H, Mcmurray J, Swedberg K, Van Veldhuisen D, Vincent J, Pitt B, Zannad F. Clinical benefits of Eplerenone in patients with systolic NYHA II heart failure when initiated shortly after hospital discharge. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3304] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mathew J, Yusuf A, Vincent J, Eikelboom J, Shestakovska O, Spyropolous A, Patel A, Schulman S, Pai M, Whitlock R. Efficacy and safety of different bridging regimens of parenteral anticoagulation after mechanical valve replacement. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4439] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brouwer AM, Reuderink B, Vincent J, van Gerven MAJ, van Erp JBF. Distinguishing between target and nontarget fixations in a visual search task using fixation-related potentials. J Vis 2013; 13:17. [DOI: 10.1167/13.3.17] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [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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50
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Osawa E, Rhodes A, Vincent J, Almeida J, Fukushima J, Pileggi B, Park C, Camara L, Jr JA, Chan R, Piccioni M, Lima M, Galas F, Hajjar L. Goal-directed resuscitation therapy in high-risk patients undergoing cardiac surgery (GRICS study): a randomized controlled trial - preliminary results. Crit Care 2013. [PMCID: PMC3642541 DOI: 10.1186/cc12131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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