1
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Knuth D, Gai L, Silva V, Harkes P, Hofman J, Šudoma M, Bílková Z, Alaoui A, Mandrioli D, Pasković I, Polić Pasković M, Baldi I, Bureau M, Alcon F, Contreras J, Glavan M, Abrantes N, Campos I, Norgaard T, Huerta Lwanga E, Scheepers PTJ, Ritsema CJ, Geissen V. Pesticide Residues in Organic and Conventional Agricultural Soils across Europe: Measured and Predicted Concentrations. Environ Sci Technol 2024; 58:6744-6752. [PMID: 38568876 PMCID: PMC11025110 DOI: 10.1021/acs.est.3c09059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
During the growing season of 2021, 201 soil samples from conventionally and organically managed fields from 10 European countries and 8 cropping systems were taken, and 192 residues of synthetic pesticides were analyzed. Pesticide residues were found in 97% of the samples, and 88% of the samples contained mixtures of at least 2 substances. A maximum of 21 substances were found in conventionally managed fields, and a maximum of 12 were found in organically managed fields. The number and concentration of pesticide residues varied significantly between conventional and organic fields in 70 and 50% of the case study sites, respectively. Application records were available for a selected number of fields (n = 82), and these records were compared to the detected substances. Residues from 52% of the applied pesticides were detected in the soils. Only 21% of the pesticide residues detected in the soil samples were applied during the 2021 growing season. From the application data, predicted environmental concentrations of residues in soil were calculated and compared to the measured concentrations. These estimates turned out not to be accurate. The results of this study show that most European agricultural soils contain mixtures of pesticide residues and that current calculation methods may not reliably estimate their presence.
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Affiliation(s)
- Dennis Knuth
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - Lingtong Gai
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - Vera Silva
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - Paula Harkes
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - Jakub Hofman
- RECETOX,
Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech
Republic
| | - Marek Šudoma
- RECETOX,
Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech
Republic
| | - Zuzana Bílková
- RECETOX,
Faculty of Science, Masaryk University, Kamenice 753/5, 625 00 Brno, Czech
Republic
| | - Abdallah Alaoui
- Institute
of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | - Daniele Mandrioli
- Cesare
Maltoni Cancer Research Center, Ramazzini
Institute, Via Saliceto
3, 40010 Bologna, Bentivoglio, Italy
| | - Igor Pasković
- Department
of Agriculture and Nutrition, Institute
of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Marija Polić Pasković
- Department
of Agriculture and Nutrition, Institute
of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Isabelle Baldi
- Univ.
Bordeaux,
INSERM, BPH, U1219, 146
Rue Léo Saignat, 33076 Bordeaux, France
| | - Mathilde Bureau
- Univ.
Bordeaux,
INSERM, BPH, U1219, 146
Rue Léo Saignat, 33076 Bordeaux, France
| | - Francisco Alcon
- Escuela
Técnica Superior de Ingeniería Agronómica, Universidad Politécnica de Cartagena, Paseo Alfonso XIII, 48, 30203 Cartagena, Spain
| | - Josefa Contreras
- Escuela
Técnica Superior de Ingeniería Agronómica, Universidad Politécnica de Cartagena, Paseo Alfonso XIII, 48, 30203 Cartagena, Spain
| | - Matjaž Glavan
- Agronomy
Department, Biotechnical Faculty, University
of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
| | - Nelson Abrantes
- CESAM
and Department of Biology, University of
Aveiro, 3810-193 Aveiro, Portugal
| | - Isabel Campos
- CESAM
and Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Trine Norgaard
- Department of Agroecology, Aarhus University, Blichers Allé 20, 8830 Tjele, Denmark
| | - Esperanza Huerta Lwanga
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - Paul T. J. Scheepers
- Radboud Institute for Biological and Environmental
Sciences, Radboud
University, Heyendaalseweg 135, 6525 AJ Nijmegen, The Netherlands
| | - Coen J. Ritsema
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
| | - Violette Geissen
- Soil
Physics and Land Management Group, Wageningen
University and Research, Droevendaalsesteeg 3, 6708 PB Wageningen, The Netherlands
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2
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Silva V, Gai L, Harkes P, Tan G, Ritsema CJ, Alcon F, Contreras J, Abrantes N, Campos I, Baldi I, Bureau M, Christ F, Mandrioli D, Sgargi D, Pasković I, Polić Pasković M, Glavan M, Hofman J, Huerta Lwanga E, Norgaard T, Bílková Z, Osman R, Khurshid C, Navarro I, de la Torre A, Sanz P, Ángeles Martínez M, Dias J, Mol H, Gort G, Martins Figueiredo D, Scheepers PTJ, Schlünssen V, Vested A, Alaoui A, Geissen V. Pesticide residues with hazard classifications relevant to non-target species including humans are omnipresent in the environment and farmer residences. Environ Int 2023; 181:108280. [PMID: 37924602 DOI: 10.1016/j.envint.2023.108280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023]
Abstract
Intensive and widespread use of pesticides raises serious environmental and human health concerns. The presence and levels of 209 pesticide residues (active substances and transformation products) in 625 environmental samples (201 soil, 193 crop, 20 outdoor air, 115 indoor dust, 58 surface water, and 38 sediment samples) have been studied. The samples were collected during the 2021 growing season, across 10 study sites, covering the main European crops, and conventional and organic farming systems. We profiled the pesticide residues found in the different matrices using existing hazard classifications towards non-target organisms and humans. Combining monitoring data and hazard information, we developed an indicator for the prioritization of pesticides, which can support policy decisions and sustainable pesticide use transitions. Eighty-six percent of the samples had at least one residue above the respective limit of detection. One hundred residues were found in soil, 112 in water, 99 in sediments, 78 in crops, 76 in outdoor air, and 197 in indoor dust. The number, levels, and profile of residues varied between farming systems. Our results show that non-approved compounds still represent a significant part of environmental cocktails and should be accounted for in monitoring programs and risk assessments. The hazard profiles analysis confirms the dominance of compounds of low-moderate hazard and underscores the high hazard of some approved compounds and recurring "no data available" situations. Overall, our results support the idea that risk should be assessed in a mixture context, taking environmentally relevant mixtures into consideration. We have uncovered uncertainties and data gaps that should be addressed, as well as the policy implications at the EU approval status level. Our newly introduced indicator can help identify research priority areas, and act as a reference for targeted scenarios set forth in the Farm to Fork pesticide reduction goals.
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Affiliation(s)
- Vera Silva
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Lingtong Gai
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands.
| | - Paula Harkes
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Gaowei Tan
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Coen J Ritsema
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Francisco Alcon
- Agricultural Engineering School, Universidad Politécnica de Cartagena, Spain
| | - Josefa Contreras
- Agricultural Engineering School, Universidad Politécnica de Cartagena, Spain
| | - Nelson Abrantes
- CESAM and Department of Biology, University of Aveiro, Portugal
| | - Isabel Campos
- CESAM and Department of Biology, University of Aveiro, Portugal
| | - Isabelle Baldi
- Univ. Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Mathilde Bureau
- Univ. Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Florian Christ
- Institute of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | | | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Italy
| | - Igor Pasković
- Department of Agriculture and Nutrition, Institute of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Marija Polić Pasković
- Department of Agriculture and Nutrition, Institute of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Matjaž Glavan
- Agronomy Department, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
| | - Jakub Hofman
- RECETOX, Faculty of Science, Masaryk University, Brno, The Czech Republic
| | | | - Trine Norgaard
- Department of Agroecology, Aarhus University, Blichers Allé 20, 8830 Tjele, Denmark
| | - Zuzana Bílková
- RECETOX, Faculty of Science, Masaryk University, Brno, The Czech Republic
| | - Rima Osman
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Chrow Khurshid
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Irene Navarro
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Adrián de la Torre
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Paloma Sanz
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - María Ángeles Martínez
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Jonatan Dias
- Wageningen Food Safety Research (WFSR), part of Wageningen University & Research, Wageningen, The Netherlands
| | - Hans Mol
- Wageningen Food Safety Research (WFSR), part of Wageningen University & Research, Wageningen, The Netherlands
| | - Gerrit Gort
- Biometris, Wageningen University, The Netherlands
| | | | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Anne Vested
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Abdallah Alaoui
- Institute of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | - Violette Geissen
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
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Waters MR, Inkman M, Habimana-Griffin L, Contreras J, Markovina S, Schwarz JK, Zhang J. Genomic Characterization of Cervical Tumors Driven by Rare High-Risk HPV Subtypes Utilizing a Deep Learning Framework. Int J Radiat Oncol Biol Phys 2023; 117:S131. [PMID: 37784338 DOI: 10.1016/j.ijrobp.2023.06.480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As many as 30-50% of patients with locally advanced cervical cancer (LACC) experience recurrence after chemoradiation therapy (CRT). More sophisticated prognostic schemes and targeted therapeutic options are urgently needed. Human papillomavirus (HPV) is responsible for the majority of invasive cervical carcinomas, most commonly HPV 16 and 18 subtypes. In large part due to their rarity, little is known about the biologic behavior of LACC driven by non-16/18 HPV genotypes. We hypothesized that rare HPV subtypes drive distinct gene expression patterns. To aid in the common dilemma of limited sample procurement, we developed a tool which leverages population data and generative adversarial neural network (GAN) modelling to exploit patterns of gene expression of small phenotypic groups for downstream analysis. Here, we employed a deep learning approach to identify gene expression patterns unique to tumors caused by rare HPV subtypes. MATERIALS/METHODS Whole transcriptome analysis of tumor biopsies from an institutional LACC tumor bank were employed including 130 HPV16/18 positive, and at least 3 each of rare HPV subtypes 31, 33, 39, 45, 52, 58, and 59. A Wasserstein GAN model (WGAN) was trained for each rare HPV subtype, and used to generate augmented rare HPV population data for downstream differential expression testing between rare HPV subtypes and HPV16/18. K-means clustering analysis was performed using R stats package. Differential gene expression testing between rare HPV subtype populations was performed using the EdgeR R-package. Pathway Enrichment analysis was conducted using EnrichR software. RESULTS By minimizing intergroup clustering distance, 3 clusters of HPV driven disease were demonstrated. The first cluster demonstrated biology similar to HPV16 and HPV18. Namely, pathway enrichment analysis performed on lists of differentially expressed genes between GAN augmented rare HPV subtypes (HPV45, HPV52, and HPV58) and classical HPV subtypes 16 and 18, yielded no significant statistical differences. The second cluster demonstrated enriched gene expression in proinflammatory IL-1 and IL-6 family cytokines and focal adhesion signaling (HPV31, HPV33, HPV39) (IL-1 regulation of extracellular matrix, p = 5.0e-6; Oncostatin M signaling, p = 2.0e-7; Integrin Signaling, 2.5e-7). The last cluster demonstrated an increased Th2/myeloid signature (HPV59) (T helper cell surface molecules 1.2e-7, myeloid cell signature 8.5e-9). CONCLUSION Utilizing a deep learning architecture to model gene expression of rare HPV subtypes we demonstrate 3 groups of HPV driven cervical cancer biology. These groups include a classical subtype, a high IL-1/IL-6 high subtype, and a myeloid associated subtype. Knowledge of such tumor heterogeneity can aid in the future development of targeted treatment plans and patient prognosis.
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Affiliation(s)
- M R Waters
- Siteman Cancer Center, Barnes-Jewish Hospital, St. Louis, MO; Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - M Inkman
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | | | - J Contreras
- Washington University in St. Louis, St. Louis, MO
| | - S Markovina
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - J K Schwarz
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - J Zhang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
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4
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Waters MR, Inkman M, Habimana-Griffin L, Cohen A, Zhang J, Contreras J, Schwarz JK, Markovina S. Mutational Landscape of ER Receptor Negative Endometrial Cancer Patients Categorized as No Specific Molecular Profile (NSMP). Int J Radiat Oncol Biol Phys 2023; 117:S9-S10. [PMID: 37784600 DOI: 10.1016/j.ijrobp.2023.06.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The endometrial cancer (EC) molecular classification introduced by The Cancer Genome Atlas (TCGA) has initiated molecular-based classification with clear prognostic value. Four major tumor subtypes exist: 1) TP53 mutation (p53abn); 2) POLE mutation (POLEmut); 3) mismatch repair protein deficient (MMRd); and 4) no specific molecular profile (NSMP). Of these subtypes, p53abn patients exhibited the worst prognosis. Recently, a prognostic refinement of NSMP EC using estrogen receptor (ER) status, from PORTEC-III trial data, showed that (ER-) NSMP patients had a strikingly poor prognosis, similar to p53abn patients. Currently, drivers of NSMP (ER-) disease are unknown and require genomic characterization. In this study, we perform an integrated molecular analysis to characterize this aggressive and poorly understood cohort. MATERIALS/METHODS RNAseq and mutational data was downloaded from the TCGA, PanCancer Atlas, Uterine Endometrial Carcinoma dataset via the genomic data commons (GDC). All patients in this cohort demonstrated endometrioid histology. P53abn, and POLE mutated patients were filtered using mutational data. MMRd and NSMP ESR1 gene low expressors (ER Low) were filtered using Z-score cutoffs of RNAseq expression data. Survival analysis was performed using the Survival R-package. Gene expression testing was performed using the EdgeR R-package. Pathway Enrichment analysis was conducted using EnrichR software. RESULTS Forty-two patients out of 529 samples met our GDC NSMP (ER low) filtering criteria (7%), similar to the 5% of PORTEC-III patients classified as NSMP (ER -). Strikingly 83% percent of GDC NSMP (ER low) patients harbored a mutation in the PI3K-AKT-mTOR signaling pathway, with 48% of GDC NSMP (ER low) patients carrying a mutation in the p110 alpha (PIK3CA) gene. Interestingly, of the patients with PIK3CA mutant tumors, 2/20 patients died in 5 years (10%), compared to 9/22 patients whose tumors were PIK3CA WT (41%) (p = 0.02). Among GDC NSMP (ER low) patients with PIK3CA WT tumors gene expression signatures were enriched for MYC target genes (p = 1.1e-51), DNA replication (p = 4.3e-30), cell cycle (p = 9.32e-20), and cell cycle checkpoints (p = 6.4e-20) pathways. Additionally, strongly in PIK3CA WT tumors are mitochondrial membrane proteins (p = 1.63e-37) and ribosomal proteins (2.9e-24). CONCLUSION In this analysis, we show that GDC NSMP (ER low) tumors nearly all harbor a mutation in the PI3K-AKT-mTOR signaling pathway. Further we demonstrate that the most common gene mutation in the cohort, PIK3CA, is counterintuitively a marker of improved survival. Additionally, we show that within that this subpopulation, PIK3CA WT patients exhibit robustly upregulated gene expression programs dedicated to energy production, cell cycling, and division.
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Affiliation(s)
- M R Waters
- Siteman Cancer Center, Barnes-Jewish Hospital, St. Louis, MO; Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - M Inkman
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | | | - A Cohen
- Washington University in St Louis, St Louis, MO
| | - J Zhang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - J Contreras
- Washington University in St. Louis, St. Louis, MO
| | - J K Schwarz
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - S Markovina
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
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Hogan JS, Kalaghchi B, Agabalogun T, Hilliard J, Kavanaugh J, Schmidt M, Atkinson AR, Ochoa LL, Contreras J, Samson P, Yang JC, Bergom C, Zoberi I, Thomas MA. Effect of Dose to the Heart and Cardiac Substructures on Cardiac Toxicity after Breast Cancer Radiation. Int J Radiat Oncol Biol Phys 2023; 117:e180. [PMID: 37784801 DOI: 10.1016/j.ijrobp.2023.06.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Pre-existing cardiovascular disease, chemotherapy, and higher mean heart dose are known risk factors for cardiac toxicity after breast radiation therapy. However, the relationship between cardiac substructure radiation exposure and toxicity is not well understood. We hypothesized that mean heart dose is a surrogate for global cardiac radiation exposure but that more specific dosimetric thresholds for the heart and its substructures could be identified, which could be used to guide radiation planning for breast cancer patients in the future. MATERIALS/METHODS In this cohort study, all breast cancer patients who received curative intent breast or chest wall radiotherapy at a single high-volume institution in 2014 and 2017 were included (n = 841). Baseline characteristics included hormone therapy, chemotherapy, menopausal status, diabetes, dyslipidemia, pre-existing cardiac toxicity, and age at diagnosis. Outcomes included any cardiac toxicity, arrhythmia, cardiomyopathy, ischemia, valvular, pericardial disease, and death. The heart and substructures, including left ventricle, right ventricle, left atrium, right atrium, aortic valve, pulmonic valve, mitral valve, tricuspid valve, and left anterior descending artery, were delineated on the simulation CT for each patient. Dosimetric variables, including mean dose, max dose, and V1, 2, 3, 4, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, and 70 Gy for the heart and substructures (in cc) were extracted. For each dosimetric variable, multivariable logistic regression was performed using baseline covariates in addition to the single dosimetric variable. Patients with missing data values were excluded. Results were combined and False Discovery Rate p-value correction was performed. RESULTS Multiple cardiac substructure dosimetric variables were associated with increased risk of mortality on multivariable analysis (p < 0.05). For left atrium and right atrium, V2, 3, 4, and 5 Gy were all significant. For right ventricle, mean dose, V1, 2, 3, 4, 5, 10, 15, 20, 25, 30, and 35 Gy were significant. For mitral valve, mean dose, max dose, V3, 4, and 5 Gy were significant. For tricuspid valve, mean dose was significant. For aortic valve, max dose, mean dose, V4, and V5 Gy were significant. For the whole heart, V1, 2, 3, 4, 5, 10, 15, 20, 25, 30, and 35 Gy were significant. CONCLUSION We have identified multiple dosimetric variables for the heart and its substructures which were associated with increased risk of mortality after breast cancer radiation. In fact, for certain structures, there were multiple exposure thresholds which showed increased risk of toxicity, highlighting the complex relationship between substructure dose and outcomes. Further study into these relationships will identify the most critical cardiac substructure constraints that could be used in radiation treatment planning.
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Affiliation(s)
- J S Hogan
- Washington University in St. Louis, St. Louis, MO
| | - B Kalaghchi
- Washington University in St. Louis, St. Louis, MO
| | - T Agabalogun
- Washington University in St. Louis, St. Louis, MO
| | - J Hilliard
- Washington University in St. Louis, St. Louis, MO
| | - J Kavanaugh
- Washington University in St. Louis, St. Louis, MO
| | - M Schmidt
- Washington University in St. Louis, St. Louis, MO
| | - A R Atkinson
- Washington University in St. Louis, St. Louis, MO
| | - L L Ochoa
- Washington University in St. Louis, St. Louis, MO
| | - J Contreras
- Washington University in St. Louis, St. Louis, MO
| | - P Samson
- Washington University in St. Louis, St. Louis, MO
| | - J C Yang
- Washington University in St. Louis, St. Louis, MO
| | - C Bergom
- Washington University in St. Louis, St. Louis, MO
| | - I Zoberi
- Washington University in St. Louis, St. Louis, MO
| | - M A Thomas
- Washington University in St. Louis, St. Louis, MO
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Sandoval AF, Bonenfant S, Sparaco T, Roldan J, Cagliostro M, Contreras J, Mancini D, Anyanwu A, Moss N. VADs on the Move: Safety of Travelling with an LVAD Internationally. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1643] [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: 04/05/2023] Open
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Mahmood K, Contreras J, Omar A, Fox A, Balboul Y, Lorente Ros M, Riasat M, Roldan J, Correa A, Pirlamarla P, Parikh A, Moss N, Anyanwu A, Gidea C. Achieving Equity in Minority Populations by Using the “Hub-And-Spoke” Model for Durable Left Ventricular Assist Devices. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.808] [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: 04/05/2023] Open
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8
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Cagliostro M, Folch A, Ali S, Lala-Trindade A, Moss N, Parikh A, Contreras J, Mitter S, Trivieri M, Gidea C, Mancini D, Barghash M. Added Value of Molecular Microscope Diagnostic System (mmdx) to Established Indicators of Heart Transplant Rejection: A Single Center Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1222] [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: 04/05/2023] Open
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9
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Lewing B, Zakeri M, Contreras J, Sansgiry S. Elderly Diabetes Patients Receiving Guideline Adherent Medications Had Less Complications and Costs. Res Social Adm Pharm 2023. [DOI: 10.1016/j.sapharm.2022.08.008] [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: 01/23/2023]
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10
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Reyes EG, Tonse R, Chuong M, Contreras J, Hall M, Gutierrez A, Kaiser A, Kotecha R, Wroe A, Kalman N. Impact of Treatment Modality on Post-Radiation Imaging in Post-Operative Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1361] [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: 10/31/2022]
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Alcazar M, Escribano J, Ferré N, Closa-Monasterolo R, Selma-Royo M, Feliu A, Castillejo G, Luque V, Closa-Monasterolo R, Escribano J, Luque V, Feliu-Rovira A, Ferré N, Muñoz-Hernando J, Gutiérrez-Marín D, Zaragoza-Jordana M, Gispert-Llauradó M, Rubio-Torrents M, Núñez-Roig M, Alcázar M, Sentís S, Esteve M, Monné-Gelonch R, Basora J, Flores G, Hsu P, Rey-Reñones C, Alegret C, Guillen N, Alegret-Basora C, Ferre R, Arasa F, Alejos A, Diéguez M, Serrano M, Mallafré M, González-Hidalgo R, Braviz L, Resa A, Palacios M, Sabaté A, Simón L, Losilla A, De La Torre S, Rosell L, Adell N, Pérez C, Tudela-Valls C, Caro-Garduño R, Salvadó O, Pedraza A, Conchillo J, Morillo S, Garcia S, Mur E, Paixà S, Tolós S, Martín R, Aguado F, Cabedo J, Quezada L, Domingo M, Ortega M, Garcia R, Romero O, Pérez M, Fernández M, Villalobos M, Ricomà G, Capell E, Bosch M, Donado A, Sanchis F, Boix A, Goñi X, Castilla E, Pinedo M, Supersaxco L, Ferré M, Contreras J, Sanz-Manrique N, Lara A, Rodríguez M, Pineda T, Segura S, Vidal S, Salvat M, Mimbrero G, Albareda A, Guardia J, Gil S, Lopez M, Ruiz-Escusol S, Gallardo S, Machado P, Bocanegra R, Espejo T, Vendrell M, Solé C, Urbano R, Vázquez M, Fernández-Antuña L, Barrio M, Baudoin A, González N, Olivé R, Lara R, Dinu C, Vidal C, González S, Ruiz-Morcillo E, Ainsa M, Vilalta P, Aranda B, Boada A, Balcells E. Gut microbiota is associated with metabolic health in children with obesity. Clin Nutr 2022; 41:1680-1688. [DOI: 10.1016/j.clnu.2022.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/16/2022] [Accepted: 06/04/2022] [Indexed: 11/03/2022]
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12
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Autrey C, Mittauer K, Alvarez D, Chuong M, Contreras J, Gutierrez A, Kaiser A, McCulloch J, Romaguera T, Kalman N. MR-Guided Radiotherapy (MRgRT) for Laryngeal Cancer With Real-Time Visualization of Intrafraction Larynx Motion. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Kutuk T, McAllister N, Rzepczynski A, Young G, Crawley M, Kaiser A, Contreras J, Kalman N. Submandibular Gland Transfer for the Prevention of Radiation Induced Xerostomia in Head and Neck Cancer — Dosimetric Impact With Intensity Modulated Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Chuong M, Herrera R, Mustafayev T, Gungor G, Ugurluer G, Atalar B, Kotecha R, Hall M, Rubens M, Mittauer K, Contreras J, Gutierrez A, Kalman N, Alvarez D, Romaguera T, McCulloch J, Garcia J, Kaiser A, Mehta M, Ozyar E. Multi-Institutional Outcomes of Stereotactic Magnetic Resonance Image-Guided Adaptive Radiation Therapy (SMART) With Median Biologically Effective Dose of 100 Gy10 for Oligometastases. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1322] [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: 12/01/2022]
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15
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Walters R, Kutuk T, Williams A, Rosen E, Contreras J, Coutinho L, Gelover Reyes E, Hobson M, Kaiser A, Kalman N. Proton Therapy Specific Salivary Gland Volume Changes After Head and Neck Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Rodriguez L, Kotecha R, Tom M, Chuong M, Contreras J, Romaguera T, Alvarez D, McCulloch J, Hernandez R, Mercado J, Mehta M, Gutierrez A, Mittauer K. Impact of Breath-Hold MR-Guided Radiotherapy (MRgRTBH) vs. Free-Breathing CT Image-Guided Radiotherapy (CT-IGRTFB) on Gastrointestinal Sparing and Dose Conformality in Adrenal SBRT. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Chuong M, Herrera R, Chundru S, Gutierrez A, Romaguera T, Alvarez D, Kotecha R, Hall M, McCulloch J, Contreras J, Kaiser A, Mittauer K. Cumulative Target Volume Dose and Locoregional Failure in Pancreatic Cancer Patients With Treated With Ablative Stereotactic MR-Guided Adaptive Radiation Therapy (SMART). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Gelover Reyes E, Chuong M, Contreras J, Goughenour A, Gutierrez A, Hall M, Kaiser A, Khan F, Kotecha R, Wroe A, Yam M, Kalman N. Evaluation of Biological Dose Enhancement in Mucosal Surfaces of Oropharyngeal Cancer Patients Treated With Ipsilateral Discrete Spot-Scanning Proton Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1173] [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]
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19
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Yu J, Wroe A, Acosta M, Fagundes M, Sabouri P, Panoff J, Rodrigues M, Contreras J, Mehta M, Gutierrez A. Impact of Dose Calculation Algorithm on Skin Dose for Breast Cancer Treated With Intensity Modulated Proton Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Hirshfield S, Contreras J, Luebe RQ, Swartz JA, Scheinmann R, Reback CJ, Fletcher JB, Kisler KA, Kuhns LM, Molano LF. Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative. AIDS Behav 2021; 25:20-30. [PMID: 31520240 DOI: 10.1007/s10461-019-02667-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Transgender women (TW) have higher HIV prevalence rates than cisgender (i.e., non-transgender) women. However, utilization of healthcare for transgender people in the U.S. is low. As part of a multisite initiative to facilitate entry and retention in HIV care for TW of color, we compared health outcomes between participants who became Peer Leaders and those who did not. From 2013 to 2016, 163 New York City, mostly Latina, TW enrolled in the Transgender Women Engagement and Entry to Care Project (TWEET). The TWEET intervention included peer-led, group-based educational sessions called Transgender Leader-Teach Back; 39% completed Peer Leadership requirements. Comparing pre-post change by Peer Leader status, Peer Leaders had a significant decrease in viral load and significant increase in CD4 at the last HIV care visit compared to the first. In multivariable logistic regression, predictors associated with Peer Leadership included having at least some college education, being in a relationship, stable housing, receiving legal assistance for political asylum, and having two or more HIV care visits during the intervention. Findings suggest that, for trans women who have completed at least secondary school education, participating in a peer-led intervention can lead to improved HIV care engagement. Understanding which program components lead to becoming a Peer Leader, and how to better engage non-Peer Leaders, are important next steps.
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Reguilón Gallego L, Chen Liang T, Martín Santos T, Salar A, Fernández González M, Celades C, Tomás Navarro J, Martínez A, Andreu R, Balaguer Rosello A, Martín A, Baile M, López Jiménez J, Marquet J, Teruel A, Terol M, Benet C, Frutos L, Navarro J, Uña J, Suarez M, Cortes M, Contreras J, Ruiz C, Tamayo P, Mucientes J, Sopena Novales P, Sánchez Blanco J, Pérez Ceballos E, Jeréz Cayuela A, Ortuño F. THE ROLE OF FDG‐PET/CT AND BONE MARROW BIOPSY IN DETECTING BONE MARROW INVOLVEMENT IN THE INITIAL STAGING OF FOLLICULAR LYMPHOMA: AN ANALYSIS OF ACCURACY AND PROGNOSTIC IMPACT. Hematol Oncol 2021. [DOI: 10.1002/hon.34_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- L. Reguilón Gallego
- Hospital Morales Meseguer IMIB‐Arrixaca, Servicio de Hematología y Oncología Médica Murcia Spain
| | - T. Chen Liang
- Hospital Morales Meseguer IMIB‐Arrixaca, Servicio de Hematología y Oncología Médica Murcia Spain
| | - T. Martín Santos
- Hospital Universitario de Canarias Servicio de Hematología, La Laguna Tenerife Spain
| | - A. Salar
- Hospital del Mar Servicio de Hematología Barcelona Spain
| | - M. Fernández González
- Hospital Universitario de Canarias Servicio de Hematología, La Laguna Tenerife Spain
| | - C. Celades
- Josep Carreras Leukaemia Research Institute (IJC) Servicio de Hematología Badalona Spain
| | - J. Tomás Navarro
- ICO‐H. Germans Trias i Pujol Servicio de Hematología Badalona Spain
| | - A.‐B. Martínez
- Hospital Santa Lucía Servicio de Hematología Cartagena Spain
| | - R. Andreu
- Hospital La Fe Servicio de Hematología Valencia Spain
| | | | - A. Martín
- Hospital Clínico Universitario de Salamanca Servicio de Hematología Salamanca Spain
| | - M. Baile
- Hospital Clínico Universitario de Salamanca Servicio de Hematología Salamanca Spain
| | | | - J. Marquet
- Hospital Ramón y Cajal Servicio de Hematología Madrid Spain
| | - A.‐I. Teruel
- Hospital Clinico de Valencia Servicio de Hematología Valencia Spain
| | - M.‐J. Terol
- Hospital Clinico de Valencia Servicio de Hematología Valencia Spain
| | - C. Benet
- Hospital Arnau de Villanova Servicio de Hematología Valencia Spain
| | - L. Frutos
- Hospital Virgen de la Arrixaca Servicio de Medicina Nuclear Murcia Spain
| | - J.‐L. Navarro
- Hospital Virgen de la Arrixaca Servicio de Medicina Nuclear Murcia Spain
| | - J. Uña
- Hospital Universitario Nuestra Señora de la Candelaria Servicio de Medicina Nuclear Tenerife Spain
| | - M. Suarez
- Hospital del Mar Servicio de Medicina Nuclear Barcelona Spain
| | - M. Cortes
- Hospital Universitari de Bellvitge‐IDIBELL Servicio de Medicina Nuclear Barcelona Spain
| | - J. Contreras
- Hospital Santa Lucia Servicio de Medicina Nuclear Cartagena Spain
| | - C. Ruiz
- Hospital La Fe Servicio de Medicina Nuclear Valencia Spain
| | - P. Tamayo
- Hospital Clínico Universitario de Salamanca/IBSAL Servicio de Medicina Nuclear Salamanca Spain
| | - J. Mucientes
- Hospital Puerta de Hierro Servicio de Medicina Nuclear Madrid Spain
| | | | - J.‐J. Sánchez Blanco
- Hospital Morales Meseguer IMIB‐Arrixaca, Servicio de Hematología y Oncología Médica Murcia Spain
| | - E. Pérez Ceballos
- Hospital Morales Meseguer IMIB‐Arrixaca, Servicio de Hematología y Oncología Médica Murcia Spain
| | - A. Jeréz Cayuela
- Hospital Morales Meseguer IMIB‐Arrixaca, Servicio de Hematología y Oncología Médica Murcia Spain
| | - F. Ortuño
- Hospital Morales Meseguer IMIB‐Arrixaca, Servicio de Hematología y Oncología Médica Murcia Spain
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22
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Gibson G, Rangasamy S, Contreras J, Roldan J, Mitter S, Barghash M, Mancini D, Anyanwu A, Lala A, Moss N. Dynamic LVAD Inflow Cannula Obstruction Due to Mobile Thrombi. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2114] [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: 11/17/2022] Open
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23
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Gibson G, Rangasamy S, Contreras J, Singhvi A, Fox A, Moss N, Triveri M, Lala A, Mancini D, Itagaki S, Anyanwu A, Parikh A. Loeffler's Endocarditis Treated with Total Artificial Heart as Bridge to Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2112] [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: 10/21/2022] Open
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24
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Isath A, Perembeti S, Correa A, Rao S, Chahal A, Padmanabhan D, Contreras J, Garg V. Does cardiac transplant protect against broken hearts? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Takotsubo cardiomyopathy (TC) is a reversible stress-induced myocardial dysfunction with increased sympathetic activity caused by excessive release of catecholamines playing a central role in its pathophysiology. The occurrence of TC in transplanted hearts is rare given the complete denervation done during transplantation. However, it has been demonstrated that 40% of transplant recipients undergo sympathetic re-innervation. There have only been case reports describing TC in post-transplant recipients.
Purpose
To evaluate the incidence, baseline characteristics and outcomes of TC occurring in heart transplant recipients using Healthcare Cost and Utilization Project (HCUP) National (nationwide) Inpatient Sample (NIS) in United States from 2009 to 2014.
Methods
Using NIS data, we identified patients who underwent cardiac transplantation using ICD9 procedure codes 37.5 and 33.6. Among these patients, we identified those admitted to the hospital with diagnosis of TC based on ICD-9-CM code 429.83. We presented categorical data as percentages and continuous data as mean or median as appropriate.
Results
We identified 257 hospitalizations for TC in heart transplant recipient patients. There was an approximately 9-fold increase in admissions from 11 in 2009 to 95 in 2014. Among patients with TC, the mean age was 65.3±1.8 years and majority were female (76.6%). A majority of patients were Caucasians (63%) followed by smaller proportion of African-Americans (13.2%).
In-patient mortality in patients admitted with TC following heart transplant was 11.3% (n=29). During the hospitalization, 4.8% of patients had cardiogenic shock and 2.8% required mechanical circulatory support. The average length of stay for patients with TC was 16.6±3.3 days. The mean cost of hospitalization for these patients when adjusted for inflation were 237248±55709 dollars.
Conclusion
TC can still occur in substantially in heart transplant recipients and should be considered one of the differential diagnosis in transplant patients presenting to the hospital.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Isath
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Perembeti
- St Luke's Roosevelt Hospital, New York, United States of America
| | - A Correa
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Rao
- University of Pennsylvania, Philadelphia, United States of America
| | - A Chahal
- University of Pennsylvania, Philadelphia, United States of America
| | | | - J Contreras
- St Luke's Roosevelt Hospital, New York, United States of America
| | - V Garg
- St Luke's Roosevelt Hospital, New York, United States of America
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25
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Mittauer K, Herrera R, Chuong M, Contreras J, Alvarez D, Romaguera T, Kotecha R, Hall M, Mehta M, Gutierrez A. A Novel Pre-plan Technique for On-table Adaptation of Pancreatic Stereotactic MR-guided Online Adaptive Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.982] [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]
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26
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Chuong M, Bryant J, Kotecha R, Hall M, Contreras J, Mittauer K, Alvarez D, Herrera R, Romaguera T, Luciani G, Godley A, Mishra V, Gutierrez A. Median 50 Gy in 5 Consecutive Fractions Delivered with Stereotactic Magnetic Resonance Image-guided Radiation Therapy for Inoperable Pancreas Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.901] [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: 10/23/2022]
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27
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Isath A, Perembeti S, Rao S, Sherif A, Correa A, Chahal A, Padmanabhan D, Garg V, Contreras J, Mehta D. A nationwide 16 year analysis of trends and impact of arrythmias in transplant recipients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Orthotopic heart transplantation is the most effective long-term therapy for end-stage heart disease. Denervation of transplanted heart with the loss of autonomic modulation, vasculopathy, utilization of immunosuppressant drugs, and risk of allograft rejection may result in change in the prevalence of arrhythmias in transplanted hearts.
Purpose
To describe the trends, distribution and the clinical impact of arrhythmias in transplanted hearts in a large nationwide population.
Methods
We queried the National Inpatient Sample with administrative codes. Cardiac transplant patients were identified using procedure ICD-9-CM codes 37.5 and 33.6. Common arrhythmias were extracted using appropriate validated ICD-9-CM codes. Statistical Analysis System (SAS) version 9.4 was used for analysis of data.
Results
There was a total of 30,020 hospitalizations of heart transplant recipients between 1999 and 2014 in the United States and 16342 (54.4%) of these had arrhythmias. The prevalence of total arrhythmias increased from 53.6% (n=1,158) in 1999 to 67.3% (n=1,575) in 2014. The most common arrhythmia was atrial fibrillation (26.83%) followed by ventricular tachycardia (22.86%) and the prevalence of individual arrhythmias is as shown in Figure 1.
Cardiogenic shock was higher in transplanted hearts with arrhythmias when compared with patients without arrhythmias (25.96% vs 18.18%; p<0.001). Transplant recipients with arrhythmias were also associated with an increased use of mechanical circulatory device (18.22% vs 12.67%, p<0.001). The use of implantable cardiac defibrillators and permanent pacemaker was also higher in the arrhythmia group (2.19% vs 0.63% and 40.43% vs 30.24% respectively, p<0.0001). However, there was no significant difference in inpatient mortality between transplant recipients with arrhythmias and without arrhythmias (7.72% vs 6.90%, p=0.225). Further, there was no significant difference in frequency of strokes between the groups (4.98% vs 5.08%; p=0.857).
The total hospital cost when adjusted for inflation was significantly higher in the arrhythmic patients, with an average cost of about $570,415±9,590 vs $439,707±8362 in patients without arrhythmias (p<0.0001). The mean length of hospitalization was 44.2±0.8 days in patients with arrhythmias compared to 33.9±0.8 days in patients without arrhythmias (p<0.0001).
Conclusion
A significant proportion of patients with heart transplant have cardiac arrhythmias and are associated with worse in-hospital outcomes of cardiogenic shock, increased length of stay, and cost of hospitalization. However, they are not associated with worse inpatient mortality.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Isath
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Perembeti
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Rao
- University of Pennsylvania, Philadelphia, United States of America
| | - A Sherif
- Saint Vincent Hospital, Worcester, United States of America
| | - A Correa
- St Luke's Roosevelt Hospital, New York, United States of America
| | - A Chahal
- University of Pennsylvania, Philadelphia, United States of America
| | | | - V Garg
- St Luke's Roosevelt Hospital, New York, United States of America
| | - J Contreras
- St Luke's Roosevelt Hospital, New York, United States of America
| | - D Mehta
- St Luke's Roosevelt Hospital, New York, United States of America
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28
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Contreras J, Kalman N, Gutierrez A, Gatcliffe T, Lambrou N, Diaz J, Schroeder E, Alvarez D, Romaguera T, Mehta M, Mittauer K. Assessment of Intrafraction Cervico-Uterine Motion in the Definitive Treatment of Locally Advanced Cervical Cancer Using MR-Guided Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2363] [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: 10/23/2022]
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29
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Isath A, Perembeti S, Correa A, Chahal A, Padmanabhan D, Rao S, Garg V, Contreras J. A nationwide analysis of 16 year trends in cardiac transplantation for cardiac sarcoidosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Orthotopic heart transplant (OHT) is indicated for end-stage heart failure due to cardiac sarcoidosis (CS). However, utilization of OHT for CS has been controversial due to concern for involvement of other organs by sarcoidosis affecting long term outcomes.
Purpose
Our objective was to study the trends in OHT in patients with CS in the United States using Healthcare Cost and Utilization Project (HCUP) National (nationwide) Inpatient Sample (NIS) from 1999 to 2014.
Methods
Using NIS data, we identified patients older than 18 years with cardiac sarcoidosis using codes ICD 9-CM codes of 135 and 425.8. Among these patients, we identified those who underwent cardiac transplantation using ICD 9-CM procedure codes 37.5 and 33.6. We presented categorical data as percentages and continuous data as mean or median as appropriate.
Results
A weighted total of 24231 hospitalizations for CS was extracted from 1999 to 2014 of which 248 (1.02%) CS patients underwent OHT. The trends in cardiac transplant for CS is as shown in Figure 1.
The mean age of CS patients undergoing OHT was 51.7±1.1 years and 60.4% (n=150) were males. 114 (45.9%) were Caucasians and 27.8% (n=25) were African-American. 100% of the transplants were performed at medium (n=5) or large sized (n=243) teaching hospitals and 97.9% of cardiac transplants were also done at teaching hospitals. Heart transplants were mostly done in the South (36.3%) followed by Midwest (26.2%), West (25%) and Northeast (12.5%). Private insurance was the major payor source which covered 149 (60.1%) patients followed by Medicare covering 65 (26.2%) patients.
A total of 10 (3.9%) cardiac sarcoidosis patients died during the same hospitalization for cardiac transplantation. Following OHT, 84.2% (n=209) were discharged home and 11.6% (n=29) to short term hospitalization. The mean cost of hospitalization for OHT in CS when adjusted for inflation was 535144±56060 dollars while the average length of stay for heart transplant for CS was 46.2±6.6 days.
Conclusions
Cardiac transplant trends in CS have not changed from 1999 to 2014 despite recent studies showing improved outcomes and are associated with substantial cost of hospitalization and length of stay. Majority of cardiac transplant was done in Caucasians despite cardiac sarcoidosis being more common in African-Americans.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Isath
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Perembeti
- St Luke's Roosevelt Hospital, New York, United States of America
| | - A Correa
- St Luke's Roosevelt Hospital, New York, United States of America
| | - A Chahal
- University of Pennsylvania, Philadelphia, United States of America
| | | | - S Rao
- University of Pennsylvania, Philadelphia, United States of America
| | - V Garg
- St Luke's Roosevelt Hospital, New York, United States of America
| | - J Contreras
- St Luke's Roosevelt Hospital, New York, United States of America
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30
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Bryant J, Mittauer K, Kotecha R, Contreras J, Alvarez D, Kalman N, Hall M, Luciani G, Romaguera T, Mishra V, Mehta M, Gutierrez A, Chuong M. Favorable Initial Outcomes of Abdominopelvic Reirradiation Using Dose-Escalated Magnetic Resonance Image-Guided Radiation Therapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1378] [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: 11/27/2022]
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31
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Chuong M, Herrera R, Contreras J, Kotecha R, Kalman N, Garcia J, Romaguera T, Gutierrez A, Mittauer K, Alvarez D, Luciani G, Godley A, Hall M. Ablative Dose Prescribed to Oligometastases Near Gastrointestinal Luminal Structures is Well Tolerated Using Stereotactic Magnetic Resonance Image-Guided Adaptive Radiation Therapy (SMART). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1393] [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: 10/23/2022]
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Huang Lucas C, Yue B, Wei X, Wu L, Abed R, Bachoo N, Lopes J, Isath A, Narasimhan B, Contreras J. Breast cancer patients have lower in-hospital mortality after acute coronary syndrome, a 5 year nationwide analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Breast cancer and cardiovascular disease (CVD) share common risk factors, and breast cancer therapies are well known to cause cardiotoxicity. Prior studies highlighted the higher burden coronary artery disease and the importance to further assess its consequences on breast cancer patients.
Purpose
We sought to evaluate the revascularization rate and in-hospital short-term outcomes of breast cancer patients following acute coronary syndrome (ACS) compared to the general female population.
Methods
We reviewed the Nationwide Inpatient Sample from 2010 to 2014 to identify female patients with principal diagnosis of ACS (ST-elevation and non ST-elevation myocardial infarction, and unstable angina). Two subgroups were identified, women with a history of breast cancer and women without, and were propensity matched.
Multivariate regression analyses were performed to evaluate the impact of breast cancer on primary outcome (in-hospital mortality) and secondary outcomes: occurrence of shock, acute kidney injury (AKI), mechanical ventilation (MV), and length of stay (LOS). We also compared the rate of cardiac procedures. Statistical significance of odd ratios (OR) is defined with p-value<0.05 and reported 95% confidence intervals (CI).
Results
We identified a total of 245,563 female patients with primary diagnosis of ACS, among them 10,625 (4.3%) had a history of breast cancer. The comorbidity of breast cancer was associated with statistically significant lower rates of mortality (OR 0.83, CI 0.74–0.94), shock (OR 0.87, CI 0.77–0.99), AKI (OR 0.90, CI 0.82–0.98), MV (OR 0.81, CI 0.71–0.92) and relative 5.4% decrease in LOS (CI: −7.8%, −3.0%). The cardiac procedural rates were similar for left heart catheterization (OR 0.96, CI 0.90–1.02), for percutaneous coronary intervention (OR 0.95, CI 0.89–1.02) and for CABG (OR 0.88, CI 0.78–1.00) compared to control group.
Conclusion
Breast cancer patients received a comparable catheterization and revascularization procedure rate and exhibited a statistically significant lower morbidity and mortality rates during hospitalization after an ACS event compared to the general female population.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Huang Lucas
- St Luke's Roosevelt Hospital, New York, United States of America
| | - B Yue
- St Luke's Roosevelt Hospital, New York, United States of America
| | - X Wei
- Virginia Commonwealth University, Cardiology, Richmond, United States of America
| | - L Wu
- St Luke's Roosevelt Hospital, New York, United States of America
| | - R Abed
- St Luke's Roosevelt Hospital, New York, United States of America
| | - N Bachoo
- St Luke's Roosevelt Hospital, New York, United States of America
| | - J Lopes
- St Luke's Roosevelt Hospital, New York, United States of America
| | - A Isath
- St Luke's Roosevelt Hospital, New York, United States of America
| | - B Narasimhan
- St Luke's Roosevelt Hospital, New York, United States of America
| | - J Contreras
- Icahn School of Medicine at Mount Sinai, Cardiology - Heart Failure, New York, United States of America
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Isath A, Perembeti S, Correa A, Haider S, Ho K, Rao S, Chahal A, Narasimhan B, Padmanabhan D, Garg V, Contreras J. A nationwide analysis of 16 year trends in cardiac transplantation for acute myocarditis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Orthotopic heart transplant (OHT) is indicated in 1–8% of patients with myocarditis. However, national trends in the utilization of transplantation and outcomes in myocarditis across the United States are not well established.
Purpose
Our objective was to study the trends and baseline characteristic of myocarditis patients undergoing heart transplant in the United States using Healthcare Cost and Utilization Project (HCUP) National (nationwide) Inpatient Sample (NIS) from 1999 to 2014.
Methods
Using NIS data, we identified patients older than 18 years with myocarditis using codes ICD9 codes of 422.0 and 422.9. Among these patients, we identified those who underwent cardiac transplantation using ICD9 procedure codes 37.5 and 33.6. We presented categorical data as percentages and continuous data as mean or median as appropriate.
Results
We identified a total of 62,264 hospitalizations for myocarditis from 1999–2014. 430 (0.69%) myocarditis patients underwent OHT which consisted of 0.82% of all 29990 cardiac transplants identified in the same period. The trends in OHT for myocarditis is as shown in Figure 1.
The mean age was 32.9±2.4 years and 51.1% (n=219) were females. 235 (54.6%) were Caucasians and 60 (13.9%) were Hispanic. Majority of the transplants were performed at medium (16%) and large sized hospitals (80.4%). Cardiac transplants were mainly done at teaching hospitals (98.9%). Further, with regards to the geographical distribution of transplant procedure, most were done in the West (37.2%) followed by South (25.3%), Northeast (21.4%) and Mid-west (16%) of the United States. Private insurance was the major payor source which covered 245 (58%) patients followed by Medicaid covering 112 (26%) patients.
A total of 26 (6%) myocarditis patients died during the same hospitalization for OHT. In terms of discharge following OHT in myocarditis 85.8% (n=369) were discharged home and 8.1% (n=35) to short term hospitalization. The average length of stay for OHT for myocarditis was 64.3±6.3 days. Also, the mean cost of hospitalization for heart transplant in myocarditis when adjusted for inflation was 789,566±93,108 dollars.
In-patient mortality following OHT was not significantly different in large sized hospital compared to small and medium sized hospitals (7.6% vs 5.7%, p=0.54). However, the cost of hospitalization was significantly lesser in small and medium sized hospitals (588,363±154,349 vs 826,864±106,110 dollars, p<0.0001).
Conclusions
Only a small percentage of OHT is done for myocarditis with high proportion done in female when compared to OHT for other etiologies. Further studies need to be done to compare long term outcomes of heart transplant in myocarditis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Isath
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Perembeti
- St Luke's Roosevelt Hospital, New York, United States of America
| | - A Correa
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Haider
- St Luke's Roosevelt Hospital, New York, United States of America
| | - K Ho
- St Luke's Roosevelt Hospital, New York, United States of America
| | - S Rao
- University of Pennsylvania, Philadelphia, United States of America
| | - A Chahal
- University of Pennsylvania, Philadelphia, United States of America
| | - B Narasimhan
- St Luke's Roosevelt Hospital, New York, United States of America
| | | | - V Garg
- St Luke's Roosevelt Hospital, New York, United States of America
| | - J Contreras
- St Luke's Roosevelt Hospital, New York, United States of America
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Kennedy W, Srivastava A, Chundury A, Cosper P, Contreras J, Gay H, Parikh P, Wang X, Gondim D, Chernock R, Thorstad W. HPV-Positive EBV-Negative Nasopharyngeal Cancer: Prevalence and Impact on Outcomes in a Non-Endemic Population. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Modi V, Mazurek J, Menachem J, Contreras J, Joshi A, Birati E, Fox A. Interplay of Pulmonary Artery Systolic Pressure and Pulmonary Vascular Resistance on Post-Transplant Survival. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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36
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Milbury K, Lopez G, Contreras J, Weather SP, Bruera E. Financial Distress and its Associated Burden in Couples Coping with an Incurable Cancer. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1055-9965.epi-20-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Although financial toxicity has been linked to poor disease outcomes in cancer patients, the associations between subjective financial distress (FD) and symptom burden and quality of life (QOL) are rarely examined from a patient-partner dyadic perspective. Thus, this cross-sectional study seeks to examine dyadic associations in couples coping with an incurable cancer. Method: Patients undergoing systemic and/or radiotherapy for advanced lung cancer (n = 50) or high grade glioma (n = 50) and their spouses/romantic partners completed measures of psychological distress (BSI-18), symptom severity including FD (ESAS, 0–10 scale), QOL (PROMIS-10), relationship wellbeing (SRI), and avoidance (AAQ-2). Results: Patients were mainly female (60%), and patients and partners were all in a heterosexual relationship (mean length: 30.12 ± 15.1 yrs), mainly non-Hispanic White (80%), married to each other (93%) and well educated with a mean age of 57.9 years (range: 28.5–79.0 years). FD was interrelated in couples (ICC = 0.53, P<0.0001), and mean score did not significantly differ by role (patient = 2.32 vs partner = 2.81). Controlling for medical and demographic factors, based on dyadic level analyses, FD was significantly associated with physical QOL (P = 0.01) so that those with higher FD reported lower QOL. Interestingly, FD was significantly associated with psychological distress (P = 0.001), mental QOL (P<0.001), avoidance (P = 0.01), and relationship wellbeing (P = 0.03) for partners but not for patients so that partners reporting higher FD had worse health and wellbeing. Moreover, in terms of relative burden, FD was the 7th (out of 12) most severe symptom for patients, and the 2nd most severe symptom for partners (after sleep disturbances). Based on concordance analyses, patients significantly underestimated their partners' FD (P = 0.007), which was further associated with increased partner psychological distress (P = 0.04). Conclusion: Although FD is interdependent in couples coping with an incurable cancer, FD appears to be a greater relative burden for partners than patients. In the palliative care setting, reducing FD may be an important target for caregiver interventions seeking to improve their health and wellbeing and reduce the overall cancer burden.
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Contreras J, Srivastava A, Chernock R, Dehdashti F, Siegel B, Chen D, Paniello R, Rich J, Pipkorn P, Jackson R, Zevallos J, Gay H, Thorstad W. PET-CT as a Predictor of Regional Nodal Involvement in Head and Neck Squamous Cell Carcinomas by Disease Subsite. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rodríguez A, Arenas M, Lara PC, López-Torrecilla J, Algara M, Conde A, Pérez-Montero H, Muñoz JL, Peleteiro P, Pérez-Calatayud MJ, Contreras J, Ferrer C. Are there enough radiation oncologists to lead the new Spanish radiotherapy? Clin Transl Oncol 2019; 21:1663-1672. [DOI: 10.1007/s12094-019-02095-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/18/2019] [Indexed: 11/29/2022]
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39
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Moss N, Parikh A, Rakita V, Lala A, Mitter S, Roldan J, Cuca A, Barghash M, Contreras J, Pinney S, Anyanwu A, Mancini D. Comparison of Exercise Hemodynamics in Patients Supported with Centrifugal and Axial Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.363] [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: 10/27/2022] Open
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40
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Srivastava A, Contreras J, Heimos H, Perkins S. PO-0873 Associations between vessel volume and neurocognition In children treated with proton therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31293-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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41
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Srivastava A, Contreras J, Daly M, Gay H, Thorstad W, Apicelli A. EP-1202 Associations between smoking cessation after radiotherapy for larynx cancer and patient outcomes. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31622-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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42
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Brenneman R, Fischer-Valuck B, Gay H, Contreras J, Arora V, Christodouleas J, Andriole G, Bullock A, Figenshau R, Kim E, Knoche E, Pachynski R, Picus J, Roth B, Michalski J, Baumann B. A Propensity Analysis Comparing Definitive Chemo-Radiation for Muscle-Invasive Adenocarcinoma of the Bladder Versus Urothelial Carcinoma of the Bladder using the National Cancer Database (NCDB). Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.445] [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: 11/29/2022]
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43
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Srivastava A, Contreras J, Davis M, Markovina S, Schwarz J, Grigsby P. Early Post-Therapy Clearance of Human Papillomavirus and Treatment Response in Cervical Carcinoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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44
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Contreras J, Spencer C, Henke L, Chin R, DeWees T, Paniello R, Rich J, Haughey B, Nussenbaum B, Adkins D, Gay H, Thorstad W. Eliminating Post-operative Radiation to the Pathologically Node Negative Neck: Long-Term Results of a Prospective Phase II Study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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45
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Contreras J, Srivastava A, Chundury A, Reynoso F, Zhao T, Sun B, Roach M, Robinson C, Bradley J. P3.17-02 Increasing Radiation Dose to Central Structures is Associated with Worse Survival Following Thoracic Proton Reirradiation. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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46
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Teerlink C, Cannon-Albright L, Dintelman S, Maness T, Cerny J, Thomas A, Backus S, FarnHam JM, Contreras J, Kauwe J, Meyer L. P1‐592: A U.S. POPULATION GENEALOGY RESOURCE SHOWS EVIDENCE OF FAMILIAL CLUSTERING FOR ALZHEIMER'S DISEASE IN VETERANS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Craig Teerlink
- University of Utah School of MedicineSalt Lake CityUTUSA
| | | | - Sue Dintelman
- Pleiades Software Development, Inc.Salt Lake CityUTUSA
| | | | | | - A. Thomas
- University Of UtahSalt Lake CityUTUSA
| | - S. Backus
- University Of UtahSalt Lake CityUTUSA
| | | | | | | | - L.J. Meyer
- University Of UtahSalt Lake CityUTUSA
- George E. Wahlen Department of Veterans Affairs Medical CenterSalt Lake CityUTUSA
- Department of Veterans AffairsWashington, DCWAUSA
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Abstract
BACKGROUND Bipolar disorder type I (BPI) affects approximately 1% of the world population. Although genetic influences on bipolar disorder are well established, identification of genes that predispose to the illness has been difficult. Most genetic studies are based on categorical diagnosis. One strategy to overcome this obstacle is the use of quantitative endophenotypes, as has been done for other medical disorders. METHODS We studied 619 individuals, 568 participants from 61 extended families and 51 unrelated healthy controls. The sample was 55% female and had a mean age of 43.25 (SD 13.90; range 18-78). Heritability and genetic correlation of the trait scale from the Anxiety State and Trait Inventory (STAI) was computed by using the general linear model (SOLAR package software). RESULTS we observed that anxiety trait meets the following criteria for an endophenotype of bipolar disorder type I (BPI): 1) association with BPI (individuals with BPI showed the highest trait score (F = 15.20 [5,24], p = 0.009), 2) state-independence confirmed after conducting a test-retest in 321 subjects, 3) co-segregation within families 4) heritability of 0.70 (SE: 0.060), p = 2.33 × 10-14 and 5) genetic correlation with BPI was 0.20, (SE = 0.17, p = 3.12 × 10-5). LIMITATIONS Confounding factors such as comorbid disorders and pharmacological treatment could affect the clinical relationship between BPI and anxiety trait. Further research is needed to evaluate if anxiety traits are specially related to BPI in comparison with other traits such as anger, attention or response inhibition deficit, pathological impulsivity or low self-directedness. CONCLUSIONS Anxiety trait is a heritable phenotype that follows a normal distribution when measured not only in subjects with BPI but also in unrelated healthy controls. It could be used as an endophenotype in BPI for the identification of genomic regions with susceptibility genes for this disorder.
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Affiliation(s)
- J Contreras
- Centro de Investigación en Biología Celular y Molecular, Universidad de Costa Rica, Costa Rica.
| | - E Hare
- Genetics and Genomics Research and Breeding Program Planning, Dog Genetics LLC., Sunnyside, NY, United States
| | - G Chavarría
- Escuela de Biología, Universidad de Costa Rica, Costa Rica
| | - H Raventós
- Centro de Investigación en Biología Celular y Molecular, Universidad de Costa Rica, Costa Rica; Escuela de Biología, Universidad de Costa Rica, Costa Rica
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48
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Contreras J, Chundury A, Reynoso F, Zhao T, Sun B, Roach M, Robinson C, Bradley J. Proton Therapy Reirradiation for Thoracic Recurrences: Toxicity and Outcomes. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1676] [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]
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49
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Brown D, Norris M, Gandell D, Jaunkalns R, Contreras J, Liu B. ANTIPSYCHOTIC STEWARDSHIP FOR OLDER PATIENTS IN ACUTE CARE: PROMOTING APPROPRIATE PRESCRIBING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D. Brown
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - M. Norris
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - D. Gandell
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - R. Jaunkalns
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - J. Contreras
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- Regional Geriatric Program of Toronto, Toronto, Ontario, Canada
| | - B.A. Liu
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
- Regional Geriatric Program of Toronto, Toronto, Ontario, Canada
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50
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O’Leary B, Denomme J, Kitchen-Clark T, Contreras J, Li-Wong F, Evans S, Sahota T, Abji T. IDENTIFYING PATIENT DELIRIUM: RELYING ON SCREENING IS NOT ENOUGH. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B. O’Leary
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
| | - J.E. Denomme
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - T. Kitchen-Clark
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - J. Contreras
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- Regional Geriatric Program of Toronto, Toronto, Ontario, Canada
| | - F. Li-Wong
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
- University of Toronto, Toronto, Ontario, Canada,
| | - S. Evans
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
| | - T. Sahota
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
| | - T. Abji
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,
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