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Hudson MF, Oostdyk AM, Simmons VM, Martin JC. Considering context in area-level socioeconomic status, cancer treatment initiation, and survival. JNCI Cancer Spectr 2023; 7:pkad078. [PMID: 37850333 PMCID: PMC10582689 DOI: 10.1093/jncics/pkad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Matthew F Hudson
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
| | - Alicia M Oostdyk
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
| | - Virginia M Simmons
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
| | - Julie C Martin
- Department of Medicine, Prisma Health Cancer Institute, Greenville, SC, USA
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2
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Funkhouser A, Shuster H, Martin JC, Edenfield WJ, Blenda AV. Pattern Analysis of Serum Galectins-1, -3, and -9 in Breast Cancer. Cancers (Basel) 2023; 15:3809. [PMID: 37568625 PMCID: PMC10417135 DOI: 10.3390/cancers15153809] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Galectins have been shown to have roles in cancer progression via their contributions to angiogenesis, metastasis, cell division, and the evasion of immune destruction. This study analyzes galectin-1, -3, and -9 serum concentrations in breast cancer patients through enzyme-linked immunosorbent assay (ELISA) against the characteristics of the patient and the tumor such as stage, molecular subtype, and receptor expression. Galectin-9 was found to be statistically significantly increased in HER2-enriched tumors and reduced in patients with hormone-receptor-positive tumors. Galectin-1 was found to be statistically significantly increased in the serum of patients who had undergone hormonal, immunotherapy, or chemotherapy. These findings provide insight into the changes in galectin levels during the progress of cancer, the response to treatment, and the molecular phenotype. These findings are valuable in the further understanding of the relationships between galectin and tumor biology and can inform future research on therapeutic targets for galectin inhibitors and the utility of galectin biomarkers.
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Affiliation(s)
- Avery Funkhouser
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Hayden Shuster
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Julie C. Martin
- Prisma Health Cancer Institute, Prisma Health, Greenville, SC 29605, USA
| | - W. Jeffery Edenfield
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
- Prisma Health Cancer Institute, Prisma Health, Greenville, SC 29605, USA
| | - Anna V. Blenda
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
- Prisma Health Cancer Institute, Prisma Health, Greenville, SC 29605, USA
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Firooz A, Funkhouser AT, Martin JC, Edenfield WJ, Valafar H, Blenda AV. Abstract 5425: Analysis of cancer patients’ molecular and clinical data using artificial intelligence and machine learning approaches. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-5425] [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: 04/07/2023]
Abstract
Abstract
Background: Development and clinical course of cancer is multifactorial with influences from the general health status of the patient, germline and neoplastic mutations, co-morbidities, and environment including lifestyle. For effective and individualized treatment of each patient, such multifactorial data must be easy-to-access and easy-to-analyze.
Purpose Statement: Cancers are characterized on a molecular level by the presence of complex gene mutations and other specific molecular markers. Moreover, special importance is placed on so-called cancer-critical genes, mutations of which are involved in the development and progression of various cancers. However, not all detected sequence alterations in these genes are known as cancer-causing mutations; thus, a more detailed and sensitive analysis is prudent. In addition, there is a limited number of established and reliable cancer biomarkers of sera. To that end, a complete analysis of molecular basis of cancer needs to include additional biomarkers such as galectins and glycans, since patients’ galectin and glycomic profiles have promising cancer differentiating and diagnostic potential.
Methods: We utilized a Relational Database Management System populated by clinical data from the Prisma Health Cancer Institute Biorepository of ~6,000 cancer patients with at least 66 different cancer diagnoses. Molecular data is available for gene mutations, serum galectin proteins, and glycomic profiles of cancer patients. Mutation status of 50 cancer-critical genes in 1,500 patients, 320 individual patient profiles of 5 serum galectin proteins, and serum and tissue glycomic profiles of 60 patients have been included and will be expanded. In addition, healthy control values for galectin and glycomic profiles were obtained and added for reference. We performed statistical and AI models of Data Analytics using R, Python, and TensorFlow platforms. A comprehensive set of patient data was used to develop a predictive model of patient outcome using the clinical observations as the desired outcome.
Results: The use of typical statistical analyses (linear and logistic regression) revealed insignificant correlation between the predictors and the cancer type of patient outcome. However, the use of the Decision Tree revealed some interesting relationships that can be used for explainability and reliability of the Machine Learning approaches. Finally, Artificial Neural Network approaches provided the best performance in classification of cancer types from the given information.
Conclusion: Our studies provide predictive models that could potentially be used to improve the diagnostic and prognostic power of data collected from patients at presentation. However, the dichotomy of black box AI approaches that perform better than explainable approaches, complicate deployment of these techniques in the domain of medicine and healthcare.
Citation Format: Ali Firooz, Avery T. Funkhouser, Julie C. Martin, W. Jeffery Edenfield, Homayoun Valafar, Anna V. Blenda. Analysis of cancer patients’ molecular and clinical data using artificial intelligence and machine learning approaches. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5425.
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Affiliation(s)
- Ali Firooz
- 1University of South Carolina, Columbia, SC
| | | | | | | | | | - Anna V. Blenda
- 2University of South Carolina School of Medicine Greenville, Greenville, SC
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Firooz A, Funkhouser AT, Martin JC, Edenfield WJ, Valafar H, Blenda AV. Comprehensive and User-Analytics-Friendly Cancer Patient Database for Physicians and Researchers. ArXiv 2023:arXiv:2302.01337v1. [PMID: 36776819 PMCID: PMC9915752] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Nuanced cancer patient care is needed, as the development and clinical course of cancer is multifactorial with influences from the general health status of the patient, germline and neoplastic mutations, co-morbidities, and environment. To effectively tailor an individualized treatment to each patient, such multifactorial data must be presented to providers in an easy-to-access and easy-to-analyze fashion. To address the need, a relational database has been developed integrating status of cancer-critical gene mutations, serum galectin profiles, serum and tumor glycomic profiles, with clinical, demographic, and lifestyle data points of individual cancer patients. The database, as a backend, provides physicians and researchers with a single, easily accessible repository of cancer profiling data to aid-in and enhance individualized treatment. Our interactive database allows care providers to amalgamate cohorts from these groups to find correlations between different data types with the possibility of finding "molecular signatures" based upon a combination of genetic mutations, galectin serum levels, glycan compositions, and patient clinical data and lifestyle choices. Our project provides a framework for an integrated, interactive, and growing database to analyze molecular and clinical patterns across cancer stages and subtypes and provides opportunities for increased diagnostic and prognostic power.
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Affiliation(s)
- Ali Firooz
- College of Engineering and Computing, University of South Carolina, Columbia, SC, USA
| | - Avery T Funkhouser
- School of Medicine Greenville, University of South Carolina, Greenville, SC, USA
| | | | | | - Homayoun Valafar
- College of Engineering and Computing, University of South Carolina, Columbia, SC, USA
| | - Anna V Blenda
- School of Medicine Greenville, University of South Carolina, Prisma Health Cancer Institute, Greenville, SC, USA
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5
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Hudson MF, Martin JC. Oncology Nurses Can Build Patient-Centered Outcomes Research Partnerships. Clin J Oncol Nurs 2023; 27:17-21. [PMID: 37677824 DOI: 10.1188/23.cjon.17-21] [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] [Indexed: 02/11/2023]
Abstract
Nurses can inform and lead patient-centered outcomes research (PCOR) projects that address care-related questions prioritized by patients. However, PCOR projects may fail to materialize because time constraints create barrier.
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Chaballout BH, Funkhouser AT, Blair BB, Goodwin JL, Strigenz AM, Arthur CM, Martin JC, Edenfield WJ, Blenda AV. Abstract 5028: Integration of molecular data into cancer patient database. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-5028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Precision medicine holds promise of being a more effective method for treating complex diseases such as cancer. Nuanced care is needed, as the development and clinical course of cancer is multifactorial with influences from the general health status of the patient, germline and neoplastic mutations, co-morbidities, and environment including "lifestyle". To tailor an individualized treatment to the patient, such multifactorial data must be presented in an easy-to-use, easy-to-analyze fashion for providers to use effectively.
Purpose: To address the need, we have built a searchable database integrating cancer-critical gene mutation status, serum galectin protein markers, serum and tumor glycomic profiles, with clinical, demographic, and lifestyle data points of individual patients.
Methods: The initial data was acquired from breast, colon, and lung cancer patients’ serum and biopsy samples from the Prisma Health Cancer Institute Biorepository. The acquired data contains the status of 2,800 COSMIC cancer-critical gene mutations, individual patient profiles of five serum galectins, and serum and biopsy glycan structures from each patient’s glycomic profile. DNA from tumor cells was used to screen the regions frequently mutated in human cancer genes. Multiplex PCR using Ion AmpliSeq࣪ Cancer Hotspot panel v2 was performed by Precision Genetics. Enzyme-linked immunosorbent assay was employed to perform galectin profiling of cancer patient serum samples. Glycomic profiling of serum and biopsy samples was performed by the Emory Comprehensive Glycomic Core. In addition, healthy control values for galectin and glycomic profiles were obtained and added to the patient database for reference. The data is being stored using Microsoft SQL servers and is fed into an interactive web application using RStudio.
Results: Our interactive database allows care providers to amalgamate cohorts from these groups to find correlations between different data types with the possibility of finding a "stage signature" based upon a combination of genetic mutations, galectin serum levels, glycan signatures, and patient clinical data and lifestyle choices.
Conclusion: Our project provides a framework for an integrated interactive database to analyze molecular and clinical patterns across cancer stages and provides opportunities for increased diagnostic and prognostic power.
Citation Format: Basil H. Chaballout, Avery T. Funkhouser, Bailey B. Blair, Jane L. Goodwin, Alexander M. Strigenz, Connie M. Arthur, Julie C. Martin, W. Jeffery Edenfield, Anna V. Blenda. Integration of molecular data into cancer patient database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5028.
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Affiliation(s)
| | | | - Bailey B. Blair
- 1University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Jane L. Goodwin
- 1University of South Carolina School of Medicine Greenville, Greenville, SC
| | | | - Connie M. Arthur
- 2Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | | | - Anna V. Blenda
- 1University of South Carolina School of Medicine Greenville, Greenville, SC
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Funkhouser AT, Strigenz AM, Blair BB, Miller AP, Shealy JC, Ewing JA, Martin JC, Funk CR, Edenfield WJ, Blenda AV. KIT Mutations Correlate with Higher Galectin Levels and Brain Metastasis in Breast and Non-Small Cell Lung Cancer. Cancers (Basel) 2022; 14:cancers14112781. [PMID: 35681762 PMCID: PMC9179545 DOI: 10.3390/cancers14112781] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
To investigate a potential role for galectins as biomarkers that enable diagnosis or prognostication of breast or non-small cell lung cancer, the serum levels of galectins -1, -3, -7, -8, and -9 of cancer patients determined by ELISA assays were compared to the mutation status of 50 known cancer-critical genes, which were determined using multiplex PCR in tumors of the same patients. Mutations in the KIT proto-oncogene, which codes for the c-Kit protein, a receptor tyrosine kinase, correlated with higher levels of galectins -1, -3, -8, and -9 in breast cancer patients and galectin-1 in non-small cell lung cancer patients. Mutations in the KIT gene were more likely found in brain metastases from both of these primary cancers. The most common KIT mutation in our panel was p.M541L, a missense mutation in the transmembrane domain of the c-Kit protein. These results demonstrate an association between KIT oncogenic signaling and elevated serum galectins in patients with metastatic disease. Changes in protein trafficking and the glycocalyx composition of cancer cells may explain the observed alterations in galectin expression. This study can be useful for the targeted selection of receptor tyrosine kinase and galectin inhibitor anti-cancer treatments.
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Affiliation(s)
- Avery T Funkhouser
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Alexander M Strigenz
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Bailey B Blair
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Andrew P Miller
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Jonah C Shealy
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
| | - Joseph A Ewing
- Data Support Core, Prisma Health, Greenville, SC 29605, USA
| | - Julie C Martin
- Prisma Health Cancer Institute, Prisma Health, Greenville, SC 29605, USA
| | - Christopher R Funk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | | | - Anna V Blenda
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA
- Prisma Health Cancer Institute, Prisma Health, Greenville, SC 29605, USA
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Martin JC, Awoke MA, Misso ML, Moran LJ, Harrison CL. Preventing weight gain in adults: A systematic review and meta-analysis of randomized controlled trials. Obes Rev 2021; 22:e13280. [PMID: 34028958 DOI: 10.1111/obr.13280] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/17/2020] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/22/2022]
Abstract
Weight gain prevention is a global public health priority to address escalating adiposity in adults. This review evaluates the efficacy of weight gain prevention trials targeting adults aged 18-50 years and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Trials of any duration from inception to May 2020 that evaluated a weight gain prevention intervention (using either prescriptive diet, prescriptive physical activity, prescriptive diet, and/or physical activity or non-prescriptive lifestyle) and included weight or body mass index (weight [kg]/height [m2 ]) were eligible. Twenty-nine trials across 34 publications (participants n = 37,407) were included. Intervention resulted in less weight gain compared with controls (-1.15 kg [95% CI -1.50, -0.80 kg] p < 0.001). Subgroup analysis demonstrated greater effectiveness with prescriptive (-1.60 kg [95% CI -2.00, -1.19] p < 0.001) compared with non-prescriptive (-0.81 kg [95% CI 1.10, -0.53] p < 0.001) intervention types. Interventions had greatest impact in healthy weight (18.5-24.9 kg/m2 ) (-0.82 kg [95% CI -1.5, -0.50] p < 0.001) or overweight (25.0-29.9 kg/m2 ) (-1.48 kg [95% CI -1.85, -1.12] p < 0.001) compared with obese populations (≥30.0 kg/m2 ) (-0.56 kg [95% CI -1.40, 0.27] p = 0.19). These findings demonstrate that lifestyle intervention prevents cumulative weight gain in non-obese adults, with future research required to inform cost-effectiveness and implementation feasibility.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mamaru Ayenew Awoke
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Marie L Misso
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Blair BB, Funkhouser AT, Goodwin JL, Strigenz AM, Chaballout BH, Martin JC, Arthur CM, Funk CR, Edenfield WJ, Blenda AV. Increased Circulating Levels of Galectin Proteins in Patients with Breast, Colon, and Lung Cancer. Cancers (Basel) 2021; 13:cancers13194819. [PMID: 34638303 PMCID: PMC8508020 DOI: 10.3390/cancers13194819] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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] [Received: 08/05/2021] [Revised: 09/12/2021] [Accepted: 09/22/2021] [Indexed: 12/20/2022] Open
Abstract
Galectins are proteins with high-affinity β-galactoside-binding sites that function in a variety of signaling pathways through interactions with glycoproteins. The known contributions of galectins-1, -3, -7, -8, and -9 to angiogenesis, metastasis, cell division, and evasion of immune destruction led us to investigate the circulating levels of these galectins in cancer patients. This study compares galectin concentrations by enzyme-linked immunosorbent assay (ELISA) from each stage of breast, lung, and colon cancer. Galectins-1 and -7, which share a prototype structure, were found to have statistically significant increases in breast and lung cancer. Of the tandem-repeat galectins, galectin-8 showed no statistically significant change in these cancer types, but galectin-9 was increased in colon and lung cancer. Galectin-3 is the only chimera-type galectin and was increased in all stages of breast, colon, and lung cancer. In conclusion, there were significant differences in the galectin levels in patients with these cancers compared with healthy controls, and galectin levels did not significantly change from stage to stage. These findings suggest that further research on the roles of galectins early in disease pathogenesis may lead to novel indications for galectin inhibitors.
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Affiliation(s)
- Bailey B. Blair
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (B.B.B.); (A.T.F.); (J.L.G.); (A.M.S.); (B.H.C.)
| | - Avery T. Funkhouser
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (B.B.B.); (A.T.F.); (J.L.G.); (A.M.S.); (B.H.C.)
| | - Jane L. Goodwin
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (B.B.B.); (A.T.F.); (J.L.G.); (A.M.S.); (B.H.C.)
| | - Alexander M. Strigenz
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (B.B.B.); (A.T.F.); (J.L.G.); (A.M.S.); (B.H.C.)
| | - Basil H. Chaballout
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (B.B.B.); (A.T.F.); (J.L.G.); (A.M.S.); (B.H.C.)
| | - Julie C. Martin
- Prisma Health Cancer Institute, Greenville, SC 29605, USA; (J.C.M.); (W.J.E.)
| | - Connie M. Arthur
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Christopher Ronald Funk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | | | - Anna V. Blenda
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA; (B.B.B.); (A.T.F.); (J.L.G.); (A.M.S.); (B.H.C.)
- Prisma Health Cancer Institute, Greenville, SC 29605, USA; (J.C.M.); (W.J.E.)
- Correspondence:
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Makama M, Lim S, Skouteris H, Harrison CL, Joham AE, Mishra GD, Teede H, Brown W, Martin JC, Moran LJ. 1209Physical activity and sitting time across postpartum life stages: A cross-sectional analysis. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Physical activity (PA) is beneficial for psychological wellbeing and weight management but is generally low in postpartum women. This study aimed to investigate how PA and sitting time (ST) varied with time since last childbirth.
Methods
Data from survey 5 (N = 5219) of the 1973-8 birth cohort (31 – 36 years) of the Australian Longitudinal Study on Women’s Health were used to assess association of time since last childbirth (0–6, 7–12 and >12 months) with PA and ST using multiple linear regression.
Results
In adjusted model, PA was lower at 0–6 (-238.5METmin/day; 95%CI -319.6, -157.4) and 7–12 (-81.2METmin/day; 95%CI -157.0, -5.5) than >12 months postpartum. ST was longer at 0–6 (0.65hours/day; 95%CI 0.39, 0.91), but not different at 7–12 than at > 12 months postpartum. Overall, higher BMI and being pregnant were inversely associated, while being single, higher stress levels and better self-rated health were positively associated with PA. Conversely, better self-rated health, having more children and breastfeeding were inversely associated, while higher BMI, income and stress levels were positively associated with ST.
Conclusion
In the first 6 months, women are less physically active and sit longer than beyond the first postpartum year. This may be due to the high demands of infant feeding/care in early postpartum suggesting a need for additional support to safely resume PA e.g. walking and reduce sitting time.
Key message
The first 6 months postpartum is characterized by lower PA and longer ST which may contribute to obesity and chronic diseases.
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Affiliation(s)
- Maureen Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Gita D. Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Wendy Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia
| | - Julie C. Martin
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Australia
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Martin JC. Rising to the Occasion During the COVID-19 Pandemic. Clin J Oncol Nurs 2021; 25:115-116. [PMID: 33739335 DOI: 10.1188/21.cjon.115-116] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nurses across specialties continue to play a key role in the response to the COVID-19 pandemic. Oncology nurses are no exception. In response to COVID-19 and other healthcare issues, nurses have established core competencies. These core competencies allow us to mentor others if we simply step up and take the lead.
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Abstract
Global environmental and societal changes have resulted in an increased consumption of energy-dense foods contributing to escalating obesity prevalence, with most rapid weight gain occurring in young adults. Diet is one major modifiable factor contributing to escalating obesity prevalence. Understanding overall diet quality of populations at high risk for weight gain and obesity development, including young adults, provides evidence of dietary intakes, dietary patterns, and associated behaviors, to inform the development of targeted interventions aimed at the prevention of weight gain. This narrative review synthesizes the current evidence of the association between diet quality and weight gain in young adults. Overall, there is a consistent direction of association between improved diet quality and reduced weight gain in adults. This demonstrates the potential of small improvements in diet quality over time as a probable contributor to minimizing weight gain in young adults. Future research evaluating environmental nutrition policies with associated change in diet quality and prospective weight change in population-based studies is warranted to determine their longer-term impact in improving overall diet quality as one strategy to halt escalating obesity prevalence rates.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
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Abstract
Convalescent plasma has emerged as a treatment that merits consideration for COVID-19-positive patients requiring hospitalization. With millions of cases of COVID-19 being reported worldwide, nurses across specialties are caring for infected patients and are often the primary patient educators about convalescent plasma treatment. Keeping abreast of current clinical guidelines and evidence-based practice allows nurses to identify patients who should be considered for treatment, understand the administration guidelines, and be aware of the toxicity profile to provide safe and high-quality care to patients. The purpose of this article is to provide information on convalescent plasma as a treatment for COVID-19.
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Abstract
BACKGROUND In the management of lung cancer, molecular profiling of the tumor is pivotal to defining a personalized treatment plan and is recommended for each patient. OBJECTIVES The purpose of this article is to provide an update on genomic testing in lung cancer and the associated targeted treatment options. In addition, emerging biomarkers and mechanisms of resistance are discussed. METHODS A comprehensive review of the CINAHL®, MEDLINE®, and PubMed® databases was performed. FINDINGS Molecular tumor profiling has advanced treatment options for patients diagnosed with lung cancer. Knowledge about pathologic variants and inhibitory pathways have led to the development of targeted treatments for lung cancer. Based on a solid understanding of molecular biomarkers, testing protocols, testing results, and how biomarkers affect treatment decisions, nurses can best educate and support patients and family members as clinical care incorporates molecular profiling.
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Gluck WL, Callahan SP, Brevetta RA, Stenbit AE, Smith WM, Martin JC, Blenda AV, Arce S, Edenfield WJ. Efficacy of therapeutic plasma exchange in the treatment of penn class 3 and 4 cytokine release syndrome complicating COVID-19. Respir Med 2020; 175:106188. [PMID: 33190086 PMCID: PMC7648522 DOI: 10.1016/j.rmed.2020.106188] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 01/06/2023]
Abstract
Objectives Cytokine release syndrome (CRS) is a potentially severe complication of COVID-19 most commonly resulting in respiratory failure. This ten-patient study was designed to determine the efficacy of therapeutic plasma exchange (TPE) in improving oxygenation and in reducing the cytokine load in a critically ill subset of patients. Methods Five single volume plasma exchanges over eight days within a 14-day study period. In mechanically ventilated patients, oxygenation was measured via the PaO2/FiO2 (P/F) ratio and the oxygenation index (OI) daily for 14 days. Supplemental oxygen requirements were tracked daily for non-ventilated patients. Results Non-ventilated patients were liberated from supplemental oxygen after TPE. The response was rapid with an 87% average reduction in oxygenation requirements following and average time to return to room air of 5.25 days. All mechanically ventilated patients demonstrated improvement in oxygenation with a 78% average improvement in the P/F ratio and a 43% improvement in OI. C-reactive protein (CRP) and serum levels of IL-6, IL-8, IL-10, TNFα, IFNγ and GM-CSF, were measured daily with immediate post TPE levels drawn on days 1, 2, 4, 6 and 8. All patients demonstrated significant reductions in CRP, IL-6, IL-10 and TNFα. Conclusions In the majority of patients with Penn class 3 and 4 CRS complicating COVID-19, TPE demonstrated a prompt improvement in oxygenation and reduction in cytokine load without compromising patient safety. As this pilot study was envisioned to be hypothesis generating, expanded trials using TPE alone and in conjunction with novel pharmacologic agents are warranted. Registration ClinicalTrials.gov NCT04374149. Plasmapheresis can effectively reduce injurious cytokines that complicate COVID-19. Plasmapheresis can produce clinically meaningful improvement in oxygenation. Plasmapheresis can be safely used as a treatment for COVID-19 cytokine storm.
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Affiliation(s)
| | | | | | | | | | | | - Anna V Blenda
- University of South Carolina School of Medicine Greenville, SC, USA
| | - Sergio Arce
- University of South Carolina School of Medicine Greenville, SC, USA
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16
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Martin JC, Joham AE, Mishra GD, Hodge AM, Moran LJ, Harrison CL. Postpartum Diet Quality: A Cross-Sectional Analysis from the Australian Longitudinal Study on Women's Health. J Clin Med 2020; 9:jcm9020446. [PMID: 32041231 PMCID: PMC7073585 DOI: 10.3390/jcm9020446] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 12/19/2019] [Revised: 01/30/2020] [Accepted: 02/04/2020] [Indexed: 02/06/2023] Open
Abstract
Reproductive-aged women are at high risk of developing obesity, and diet quality is a potential modifiable risk factor. There is limited research exploring diet quality and its association with time since childbirth. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH) survey 5 (2009) of women born between 1973–1978, who reported having previously given birth, we investigated the association between time since childbirth and diet quality, and differences in energy, macronutrients, micronutrient intake, and diet quality assessed by the dietary guideline index (DGI) in women stratified by time from last childbirth, early (0–6 months; n = 558) and late (7–12 months; n = 547), and all other women with children (>12 months post childbirth n = 3434). From this cohort, 8200 participants were eligible, of which 4539 participants completed a food frequency questionnaire (FFQ) and were included in this analysis. Overall, diet quality was higher in early and late postpartum women (mean DGI score 89.8 (SD 10.5) and mean DGI score 90.0 (SD 10.2), respectively) compared to all other women with children (>12 months post childbirth), mean DGI score 85.2 (SD 11.7), p < 0.001. Factors positively associated with diet quality included higher education, physical activity, health provider support, and vitamin and/or mineral supplement use. Conversely, increasing time from childbirth (>12 months), smoking compared with non-smoking and medium income level compared with no income was negatively associated with diet quality. A lower diet quality in women greater than 12 months post childbirth may be reflective of increased pressures, balancing childrearing and return to work responsibilities. This highlights the need to support women beyond the postpartum period to improve modifiable factors associated with weight gain, including diet quality, to optimize health and reduce chronic disease risk.
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Affiliation(s)
- Julie C. Martin
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton 3168, Australia
| | - Gita D. Mishra
- Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Brisbane 4000, Australia;
| | - Allison M. Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne 3000, Australia;
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3000, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Monash University, Melbourne 3000, Australia; (J.C.M.); (A.E.J.); (L.J.M.)
- Correspondence: ; Tel.: +61-03-8572-2662
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Casanovas N, Narro F, Taibi F, Guillaumet E, Lloreda M, Martin JC, Panelo M, Bosch E, Berna L, Martinez-Rubio A. P132Differences in clinical characteristics, results and management of patients referred for pharmacologic cardiac stress SPECT depending on the protocol used. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.019] [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)
- N Casanovas
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - F Narro
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - F Taibi
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - E Guillaumet
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - M Lloreda
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - J C Martin
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Nuclear Medicine, Sabadell, Spain
| | - M Panelo
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - E Bosch
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
| | - L Berna
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Nuclear Medicine, Sabadell, Spain
| | - A Martinez-Rubio
- Hospital de Sabadell. Institut Universitari Parc Tauli-UAB, Cardiology, Sabadell, Spain
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18
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Edenfield WJ, Merchant K, Martin JC, Drusbosky L, Elliott MH, Reddy SK, Szeto C, Cecchi F, Schammel C, Schammel DP, Grinstead RM, Chung KY. Selected reaction monitoring mass spectrometry (SRM-MS) evaluation of HER2 equivocal breast cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12510 Background: Human epidermal growth factor receptor type 2 (HER2) is a significant driver of breast oncogenesis and has been found to be amplified in one-fifth of all breast cancers. Identification of cell surface over-expression of HER2 can be completed using immunohistochemistry (IHC), while amplification of the gene can be detected using fluorescence in situ hybridization (FISH) or differential polymerase chain reaction (PCR). Definitive diagnostic standards for each detection method are established, however approximately 5-10% of breast cancer patients have a HER2 status of “double equivocal,” offering little guidance to directing therapy. Previously, selected reaction monitoring mass spectrometry (SRM-MS) illustrated the dynamic range of HER2 positive protein expression by IHC or amplified FISH to have a threshold determination of 740amol.We hypothesized that this method could delineate which ‘double equivocal’ patients may indeed express enough HER2 to be candidates for targeted therapy. Methods: Overall, 76 invasive breast cancer samples identified as equivocal by IHC and FISH between 1/1/2010 and 12/31/2017 were evaluated. Typical demographic and clinicopathologic data were collected to include age, race, histology, size, hormone receptor status, treatments and outcomes. HER2 levels in each equivocal sample were quantitated using SRM-MS. Data were analyzed using Fisher’s t-tests, chi-square and ANOVA (p < 0.05). Results: Using the 740 amol/ng as the SRM-MS cut-off for HER2 positivity, the group was divided into two cohorts. No significant differences were found for demographic or pathologic variables. While identified HER2 levels were between 209.1-1286.6amol, 18 patients had SRM-MS results above the threshold but outcomes were not correlated with treatment received. Conclusions: We report the largest series of doubly equivocal HER2 patients evaluated with SRM-MS. For patients with invasive ductal carcinoma, SRM-MS was not able to identify patients for whom HER2 directed therapy would be a benefit. Future plans include an assessment of this cohort with an RNA seq algorithm given the high degree of accuracy we have shown with known HER2 positives and negatives.
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Affiliation(s)
- William Jeffery Edenfield
- Institute for Translational Oncology Research, Prisma Health-Upstate Cancer Institute, Greenville, SC
| | - Krupa Merchant
- Institute for Translational Oncology Research, Prisma Health-Upstate Cancer Institute, Greenville, SC
| | - Julie C. Martin
- Institute for Translational Oncology Research, Prisma Health-Upstate Cancer Institute, Greenville, SC
| | | | | | | | | | | | | | | | - Rhett M Grinstead
- Institute for Translational Oncology Research, Prisma Health-Upstate Cancer Institute, Greenville, SC
| | - Ki Y. Chung
- Institute for Translational Oncology Research, Prisma Health-Upstate Cancer Institute, Greenville, SC
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19
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Martin JC, Moran LJ, Teede HJ, Ranasinha S, Lombard CB, Harrison CL. Diet Quality in a Weight Gain Prevention Trial of Reproductive Aged Women: A Secondary Analysis of a Cluster Randomized Controlled Trial. Nutrients 2018; 11:E49. [PMID: 30591672 PMCID: PMC6357112 DOI: 10.3390/nu11010049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/10/2018] [Accepted: 12/18/2018] [Indexed: 11/16/2022] Open
Abstract
Reproductive-aged women are at high risk for obesity development. Limited research exploring weight gain prevention initiatives and associated modifiable risk factors, including diet quality exists. In a secondary analysis of a 12 month, cluster randomized controlled trial for weight gain prevention in reproductive-aged women, we evaluated change in diet quality, macronutrient and micronutrient intake, predictors of change and associations with weight change at follow-up. Forty-one rural towns in Victoria, Australia were randomized to a healthy lifestyle intervention (n = 21) or control (n = 20). Women aged 18⁻50, of any body mass index and without conditions known to affect weight, were recruited. Diet quality was assessed by the Dietary Guideline Index (DGI) and energy, macronutrient, and micronutrient intake as well as anthropometrics (weight; kg) were measured at baseline and 12 months. Results were adjusted for group (intervention/control), town cluster, and baseline values of interest. Of 409 women with matched data at baseline and follow-up, 220 women were included for final analysis after accounting for plausible energy intake. At 12 months, diet quality had improved by 6.2% following the intervention, compared to no change observed in the controls (p < 0.001). Significant association was found between a change in weight and a change in diet quality score over time β -0.66 (95%CI -1.2, -0.12) p = 0.02. The percentage of energy from protein (%) 0.009 (95%CI 0.002, 0.15) p = 0.01 and glycemic index -1.2 (95%CI -2.1, -0.24) p = 0.02 were also improved following the intervention, compared to the control group. Overall, a low-intensity lifestyle intervention effectively improves diet quality, with associated weight gain preventions, in women of reproductive age.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
- Endocrinology and Diabetes Units, Monash Health, Melbourne, VIC 3004, Australia.
| | - Sanjeeva Ranasinha
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Catherine B Lombard
- Department of Nutrition and Dietetics, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC 3004, Australia.
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20
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Miller GJ, Stirling Y, Esnouf MP, Heinrich J, van de Loo J, Kienast J, Wu KK, Morrissey JH, Meade TW, Martin JC, Imeson JD, Cooper JA, Finch A. Factor VII-Deficient Substrate Plasmas Depleted of Protein C Raise the Sensitivity of the Factor VII Bio-Assay to Activated Factor VII: an International Study. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1642382] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryPlasma from healthy individuals, pregnant women and patients on warfarin were distributed to 3 laboratories supporting major cardiovascular surveys (Northwick Park, Muenster and Houston) for assay of factor VII coagulant activity (VIIC) with their own bio-assays. The mean VIIC in 147 samples agreed to within 1% of standard in Northwick Park and Houston, but was 14% of standard lower in Muenster owing to its more potent standard. In samples with an increased VIIC the Northwick Park assay gave a higher result than the other assays owing to its increased responsiveness to activated factor VII (VIIa). Thus when VIIa concentrations were determined directly with a clotting assay which utilises a soluble recombinant tissue factor, the increase in VIIC with increase in VIIa was considerably greater with the Northwick Park assay than the Muenster assay. This feature of the Northwick Park assay was traced to the virtual absence of protein C in its substrate plasma. Factor Va appears rate-limiting for the coagulant expression of VIIa in test plasma. If the thrombotic response to release of tissue factor is determined by the circulating concentration of VIIa, then the Northwick Park factor VII bio-assay may be preferable to other bio-assays currently employed to estimate risk of acute coronary events.
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Affiliation(s)
- G J Miller
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - Y Stirling
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - M P Esnouf
- The Nuffield Department of Clinical Biochemistry, Radcliffe Infirmary, Oxford, England
| | - J Heinrich
- The Institute of Clinical Chemistry and Laboratory Medicine, University of Muenster, Muenster, Germany
| | - J van de Loo
- Department of Internal Medicine, University of Muenster, Muenster, Germany
| | - J Kienast
- Department of Internal Medicine, University of Muenster, Muenster, Germany
| | - K K Wu
- The University of Texas Medical School at Houston, Texas, USA
| | - J H Morrissey
- Oklahoma Medical Research Foundation, Oklahoma City, USA
| | - T W Meade
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J C Martin
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J D Imeson
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - J A Cooper
- The Medical Research Council Epidemiology and Medical Care Unit, London, England
| | - A Finch
- The University of Texas Medical School at Houston, Texas, USA
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21
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Abstract
SummaryEstimates of the components of variation of a number of coagulation factor assays are presented and are compared with those for other haematological and biochemical variables. They have been derived from a study in which fourteen volunteers gave blood samples approximately bi-monthly for three years. The systematic between-batch variation w7as generally only a small component of the total variation. However, the proportion of the total variation due to differences between people ranged from about 15% in the case of two measures of antithrombin III to about 85% for cholesterol and haemoglobin. For factor VII activity and fibrinogen, the figure was just over 70%. These estimates of the components of variation are not generally available in the literature. In view of the increasing interest in the role of coagulation factors in the pathogenesis of arterial disease, estimates of this kind are needed both for the interpretation of observed relationships as well as for planning sample sizes for future studies.
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Affiliation(s)
- S G Thompson
- The MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Watford Road, Harrow, Middlesex, UK
| | - J C Martin
- The MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Watford Road, Harrow, Middlesex, UK
| | - T W Meade
- The MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Watford Road, Harrow, Middlesex, UK
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22
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Edenfield WJ, Martin JC, O'Rourke MA, Cull EH, Chung KY. Improving care delivery for patients with rare cancers: A phase II trial of durvalumab in combination with tremilumimab in subjects with advanced rare tumors in a large community health care system. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18535] [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: 11/20/2022] Open
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23
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Gluck WL, Martin JC, Edenfield WJ, Chung KY, Arguello D. Prolonged response of widely metastatic HER2-positive colon cancer to trastuzumab therapy. Colorectal Cancer 2017. [DOI: 10.2217/crc-2017-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Emerging evidence suggests a small subset of late-stage colon cancer driven by HER2, a biomarker routinely evaluated in select breast and gastric cancers, may respond to HER2-targeted therapy. Herein, we describe a 49-year-old male with widely metastatic colon cancer originating in the sigmoid colon. After failing standard therapy, a biopsy specimen of the tumor was evaluated for novel biomarkers using molecular profiling. After identification of ERBB2 (HER2) amplification using in situ hybridization, the patient subsequently received a trial of trastuzumab monotherapy and experienced a dramatic and durable response. This report builds on our understanding of using precision oncology to improve survival in metastatic colon cancer.
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Affiliation(s)
- W Larry Gluck
- Greenville Health System, Institute for Translational Oncology Research, Greenville, SC, USA
| | - Julie C Martin
- Greenville Health System, Institute for Translational Oncology Research, Greenville, SC, USA
| | - W Jeffrey Edenfield
- Greenville Health System, Institute for Translational Oncology Research, Greenville, SC, USA
| | - Ki Y Chung
- Greenville Health System, Institute for Translational Oncology Research, Greenville, SC, USA
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24
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Martin JC, Moran LJ, Teede HJ, Ranasinha S, Lombard CB, Harrison CL. Exploring Diet Quality between Urban and Rural Dwelling Women of Reproductive Age. Nutrients 2017; 9:E586. [PMID: 28594351 PMCID: PMC5490565 DOI: 10.3390/nu9060586] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 05/31/2017] [Accepted: 06/05/2017] [Indexed: 11/29/2022] Open
Abstract
Health disparities, including weight gain and obesity exist between urban and rural dwelling women. The primary aim was to compare diet quality in urban and rural women of reproductive age, and secondary analyses of the difference in macronutrient and micronutrient intake in urban and rural women, and the predictors of diet quality. Diet quality was assessed in urban (n = 149) and rural (n = 394) women by a modified version of the Dietary Guideline Index (DGI) energy, macronutrient and micronutrient intake from a food frequency questionnaire (FFQ) and predictors of diet quality. Diet quality did not significantly differ between urban and rural women (mean ± standard deviation (SD), 84.8 ± 15.9 vs. 83.9 ± 16.5, p = 0.264). Rural women reported a significantly higher intake of protein, fat, saturated fat, monounsaturated fat, cholesterol and iron and a higher score in the meat and meat alternatives component of the diet quality tool in comparison to urban women. In all women, a higher diet quality was associated with higher annual household income (>$Australian dollar (AUD) 80,000 vs. <$AUD80,000 p = 0.013) and working status (working fulltime/part-time vs. unemployed p = 0.043). Total diet quality did not differ in urban and rural women; however, a higher macronutrient consumption pattern was potentially related to a higher lean meat intake in rural women. Women who are unemployed and on a lower income are an important target group for future dietary interventions aiming to improve diet quality.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
- Endocrinology and Diabetes Units, Monash Health, Melbourne 3004, Australia.
| | - Sanjeeva Ranasinha
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Catherine B Lombard
- Department of Nutrition and Dietetics, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia.
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25
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Goedecke PA, Winsett RP, Martin JC, Hathaway DK, Gaber AO. Development of a Web Site for Transplant Patient Education. Prog Transplant 2016; 11:208-13. [PMID: 11949464 DOI: 10.1177/152692480101100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Internet is a global communication network used by more than 17.6 million adults as a major source of current health information. Both the number of health-related Web sites and the number of Web users are increasing exponentially as well as reports indicating a growth in the number of persons who access the Internet specifically to retrieve information about organ transplantation. However, few are using this medium for posttransplant educational or psychosocial purposes. Armed with this information, as well as a commitment from the transplant team, we chose to develop a Web-based educational program to facilitate posttransplant care for our transplant recipients. The purpose of this article is to describe the planning, development, and implementation of a Web-based education program for transplant recipients.
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Affiliation(s)
- P A Goedecke
- College of Nursing, University of Tennessee, Memphis, Tenn., USA
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26
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Dutour A, Abdesselam I, Ancel P, Kober F, Mrad G, Darmon P, Ronsin O, Pradel V, Lesavre N, Martin JC, Jacquier A, Lefur Y, Bernard M, Gaborit B. Exenatide decreases liver fat content and epicardial adipose tissue in patients with obesity and type 2 diabetes: a prospective randomized clinical trial using magnetic resonance imaging and spectroscopy. Diabetes Obes Metab 2016; 18:882-91. [PMID: 27106272 DOI: 10.1111/dom.12680] [Citation(s) in RCA: 153] [Impact Index Per Article: 19.1] [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: 02/15/2016] [Revised: 04/11/2016] [Accepted: 04/20/2016] [Indexed: 12/24/2022]
Abstract
AIM To conduct a prospective randomized trial to investigate the effect of glucagon-like peptide-1 (GLP-1) analogues on ectopic fat stores. METHODS A total of 44 obese subjects with type 2 diabetes uncontrolled on oral antidiabetic drugs were randomly assigned to receive exenatide or reference treatment according to French guidelines. Epicardial adipose tissue (EAT), myocardial triglyceride content (MTGC), hepatic triglyceride content (HTGC) and pancreatic triglyceride content (PTGC) were assessed 45 min after a standardized meal with 3T magnetic resonance imaging and proton magnetic resonance spectroscopy before and after 26 weeks of treatment. RESULTS The study population had a mean glycated haemoglobin (HbA1c) level of 7.5 ± 0.2% and a mean body mass index of 36.1 ± 1.1 kg/m(2) . Ninety five percent had hepatic steatosis at baseline (HTGC ≥ 5.6%). Exenatide and reference treatment led to a similar improvement in HbA1c (-0.7 ± 0.3% vs. -0.7 ± 0.4%; p = 0.29), whereas significant weight loss was observed only in the exenatide group (-5.5 ± 1.2 kg vs. -0.2 ± 0.8 kg; p = 0.001 for the difference between groups). Exenatide induced a significant reduction in EAT (-8.8 ± 2.1%) and HTGC (-23.8 ± 9.5%), compared with the reference treatment (EAT: -1.2 ± 1.6%, p = 0.003; HTGC: +12.5 ± 9.6%, p = 0.007). No significant difference was observed in other ectopic fat stores, PTGC or MTGC. In the group treated with exenatide, reductions in liver fat and EAT were not associated with homeostatic model assessment of insulin resistance index, adiponectin, HbA1c or fructosamin change, but were significantly related to weight loss (r = 0.47, p = 0.03, and r = 0.50, p = 0.018, respectively). CONCLUSION Our data indicate that exenatide is an effective treatment to reduce liver fat content and epicardial fat in obese patients with type 2 diabetes, and these effects are mainly weight loss dependent.
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Affiliation(s)
- A Dutour
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
| | - I Abdesselam
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - P Ancel
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
| | - F Kober
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - G Mrad
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
| | - P Darmon
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
| | - O Ronsin
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
| | - V Pradel
- Aix Marseille Université, Marseille, France
- Statistics Department, Assistance Publique Hôpitaux Marseille, CHU Sainte Marguerite, Marseille, France
| | - N Lesavre
- Aix Marseille Université, Marseille, France
- Centre d'investigation Clinique, 1409, Assistance Publique Hôpitaux de Marseille, CHU Nord, Marseille, France
| | - J C Martin
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
| | - A Jacquier
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
- Radiology Department, CHU La Timone, Marseille, France
| | - Y Lefur
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - M Bernard
- Aix Marseille Université, Marseille, France
- Centre de Résonance Magnétique Biologique et Médicale, CNRS UMR 7339, Marseille, France
| | - B Gaborit
- Inserm U1062, Inra U1260, Faculté de Médecine, 13385, Marseille, France
- Aix Marseille Université, Marseille, France
- Department of Endocrinology, Metabolic Diseases and Nutrition, Pole Endo, Marseille, France
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Llopis M, Cassard AM, Wrzosek L, Boschat L, Bruneau A, Ferrere G, Puchois V, Martin JC, Lepage P, Le Roy T, Lefèvre L, Langelier B, Cailleux F, González-Castro AM, Rabot S, Gaudin F, Agostini H, Prévot S, Berrebi D, Ciocan D, Jousse C, Naveau S, Gérard P, Perlemuter G. Intestinal microbiota contributes to individual susceptibility to alcoholic liver disease. Gut 2016; 65:830-9. [PMID: 26642859 DOI: 10.1136/gutjnl-2015-310585] [Citation(s) in RCA: 346] [Impact Index Per Article: 43.3] [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: 08/19/2015] [Accepted: 11/01/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE There is substantial inter-individual diversity in the susceptibility of alcoholics to liver injury. Alterations of intestinal microbiota (IM) have been reported in alcoholic liver disease (ALD), but the extent to which they are merely a consequence or a cause is unknown. We aimed to demonstrate that a specific dysbiosis contributes to the development of alcoholic hepatitis (AH). DESIGN We humanised germ-free and conventional mice using human IM transplant from alcoholic patients with or without AH. The consequences on alcohol-fed recipient mice were studied. RESULTS A specific dysbiosis was associated with ALD severity in patients. Mice harbouring the IM from a patient with severe AH (sAH) developed more severe liver inflammation with an increased number of liver T lymphocyte subsets and Natural Killer T (NKT) lymphocytes, higher liver necrosis, greater intestinal permeability and higher translocation of bacteria than mice harbouring the IM from an alcoholic patient without AH (noAH). Similarly, CD45+ lymphocyte subsets were increased in visceral adipose tissue, and CD4(+)T and NKT lymphocytes in mesenteric lymph nodes. The IM associated with sAH and noAH could be distinguished by differences in bacterial abundance and composition. Key deleterious species were associated with sAH while the Faecalibacterium genus was associated with noAH. Ursodeoxycholic acid was more abundant in faeces from noAH mice. Additionally, in conventional mice humanised with the IM from an sAH patient, a second subsequent transfer of IM from an noAH patient improved alcohol-induced liver lesions. CONCLUSIONS Individual susceptibility to ALD is substantially driven by IM. It may, therefore, be possible to prevent and manage ALD by IM manipulation.
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Affiliation(s)
- M Llopis
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - A M Cassard
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France
| | - L Wrzosek
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France
| | - L Boschat
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - A Bruneau
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - G Ferrere
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France
| | - V Puchois
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France
| | - J C Martin
- Faculté de Médecine, Aix-Marseille University, Marseille, France INSERM, UMR1062 NORT, Marseille, France
| | - P Lepage
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - T Le Roy
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - L Lefèvre
- INRA, UMR 1313, GABI-LGS Plateforme ICE, Jouy-en-Josas, France
| | - B Langelier
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - F Cailleux
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France
| | - A M González-Castro
- Department of Gastroenterology, Digestive System Research Unit, Hospital University Vall d'Hebron and VHIR, UAB, Spain
| | - S Rabot
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - F Gaudin
- IPSIT, IFR141, Faculté de Pharmacie, Univ Paris-Sud, Châtenay-Malabry, France
| | - H Agostini
- AP-HP, Hôpital Bicêtre, Unité de recherche clinique Paris-Sud, Kremlin-Bicêtre, France
| | - S Prévot
- Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France AP-HP, Anatomie-pathologique, Hôpital Antoine-Béclère, Clamart, France
| | - D Berrebi
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France AP-HP, Anatomie et de Cytologie Pathologiques, Hôpital Robert Debré, Paris, France
| | - D Ciocan
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France AP-HP, Hepatogastroenterology and Nutrition, Hôpital Antoine-Béclère, Clamart, France
| | - C Jousse
- Université Clermont Auvergne, Institut de Chimie de Clermont-Ferrand UMR CNRS 6296, Clermont-Ferrand, France
| | - S Naveau
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France AP-HP, Hepatogastroenterology and Nutrition, Hôpital Antoine-Béclère, Clamart, France
| | - P Gérard
- INRA, UMR1319 Micalis, Jouy-en-Josas, France AgroParisTech, UMR Micalis, Jouy-en-Josas, France
| | - G Perlemuter
- INSERM UMR996-Inflammation, Chemokines and Immunopathology, Clamart, France Univ Paris-Sud, Univ Paris-Saclay, DHU Hepatinov, Labex Lermit, CHU Bicêtre, Kremlin-Bicêtre, France AP-HP, Hepatogastroenterology and Nutrition, Hôpital Antoine-Béclère, Clamart, France
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Martin JC, Bériou G, Heslan M, Bossard C, Jarry A, Abidi A, Hulin P, Ménoret S, Thinard R, Anegon I, Jacqueline C, Lardeux B, Halary F, Renauld JC, Bourreille A, Josien R. IL-22BP is produced by eosinophils in human gut and blocks IL-22 protective actions during colitis. Mucosal Immunol 2016; 9:539-49. [PMID: 26329427 DOI: 10.1038/mi.2015.83] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 07/31/2015] [Indexed: 02/06/2023]
Abstract
Crohn's disease and ulcerative colitis, the two major forms of inflammatory bowel diseases (IBDs), are characterized by high levels of IL-22 production. Rodent studies revealed that this cytokine is protective during colitis but whether this is true in IBDs is unclear. We show here that levels of the soluble inhibitor of IL-22, interleukin 22-binding protein (IL-22BP), are significantly enhanced during IBDs owing to increased numbers of IL-22BP-producing eosinophils, that we unexpectedly identify as the most abundant source of IL-22BP protein in human gut. In addition, using IL-22BP-deficient rats, we confirm that endogenous IL-22BP is effective at blocking protective actions of IL-22 during acute colitis. In conclusion, our study provides new important insights regarding the biology of IL-22 and IL-22BP in the gut and indicates that protective actions of IL-22 are likely to be suboptimal in IBDs thus making IL-22BP a new relevant therapeutic target.
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Affiliation(s)
- J C Martin
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
- Université de Nantes, Faculté de Médecine, Nantes, France
- CHU Nantes, Laboratoire d'Immunologie, Nantes, France
| | - G Bériou
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - M Heslan
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - C Bossard
- Université de Nantes, Faculté de Médecine, Nantes, France
- EA4273 Biometadys, Faculté de Médecine, Université de Nantes, Nantes, France
- CHU Nantes, Laboratoire d'anatomopathologie, Nantes, France
| | - A Jarry
- EA4273 Biometadys, Faculté de Médecine, Université de Nantes, Nantes, France
| | - A Abidi
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - P Hulin
- Plateforme MicroPICell, SFR santé, Nantes, France
| | - S Ménoret
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - R Thinard
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - I Anegon
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - C Jacqueline
- EA3826, Faculté de Médecine, Université de Nantes, Nantes, France
| | - B Lardeux
- Institut des Maladies de l'Appareil Digestif - IMAD, INSERM UMR913, Nantes, France
| | - F Halary
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
| | - J-C Renauld
- Ludwig Institute for Cancer Research, Brussels, Belgium
- Institut de Duve, Université catholique de Louvain, Brussels, Belgium
| | - A Bourreille
- Institut des Maladies de l'Appareil Digestif - IMAD, INSERM UMR913, Nantes, France
- Institut des Maladies de l'Appareil Digestif - IMAD, INSERM CIC-04, CHU Nantes, Nantes, France
| | - R Josien
- INSERM Center for Research in Transplantation and Immunology, UMR1064, ITUN, Nantes, France
- Université de Nantes, Faculté de Médecine, Nantes, France
- CHU Nantes, Laboratoire d'Immunologie, Nantes, France
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Martin JC, Zhou SJ, Flynn AC, Malek L, Greco R, Moran L. The Assessment of Diet Quality and Its Effects on Health Outcomes Pre-pregnancy and during Pregnancy. Semin Reprod Med 2016; 34:83-92. [PMID: 26886241 DOI: 10.1055/s-0036-1571353] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Overweight and obesity pre pregnancy or during pregnancy is associated with an increased risk for maternal obstetric and fetal complications. Diet is one modifiable risk factor that women may be motivated to improve. General healthy eating guidelines, micronutrient sufficiency and macronutrient quantity and quality are important nutrition considerations pre and during pregnancy. With regards to specific nutrients, health authorities have recommendations for folate and/or iodine supplementation; but not consistently for iron and omega-3 despite evidence for their association with health outcomes. There are modest additional requirements for energy and protein, but not fat or carbohydrate, in mid-late pregnancy. Diet indices and dietary pattern analysis are additional tools or methodologies used to assess diet quality. These tools have been used to determine dietary intakes and patterns and their association with pregnancy complications and birth outcomes pre or during pregnancy. Women who may unnecessarily resist foods due to fear of food contamination from listeriosis and methylmercury may limit their diet quality and a balanced approached is required. Dietary intake may also vary according to certain population characteristics. Additional support for women who are younger, less educated, overweight and obese, from socially disadvantaged areas, smokers and those who unnecessarily avoid healthy foods, is required to achieve a higher quality diet and optimal lifestyle peri conception.
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Affiliation(s)
- Julie C Martin
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Shao J Zhou
- School of Agriculture, Food and Wine, Women's & Children's Health Research institute, University of Adelaide, Glen Osmond, SA, Australia
| | - Angela C Flynn
- Division of Women's Health, King's College London, London, United Kingdom
| | - Lenka Malek
- Global Food Studies, Faculty of the Professions, University of Adelaide, Adelaide, South Australia, Australia
| | - Rebecca Greco
- The Robinson Research Institute, University of Adelaide, North Adelaide, South Australia, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
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30
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Martin JC, Savige GS, Mitchell EKL. Health knowledge and iodine intake in pregnancy. Aust N Z J Obstet Gynaecol 2014; 54:312-6. [DOI: 10.1111/ajo.12201] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 02/15/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Julie C. Martin
- Remedy Healthcare; South Melbourne Victoria Australia
- Department of Rural and Indigenous Health; School of Rural Health; Monash University; Moe Victoria Australia
| | - Gayle S. Savige
- Department of Epidemiology and Preventive Medicine; Monash University; The Alfred Centre; Melbourne Victoria Australia
- Department of Rural and Indigenous Health; School of Rural Health; Monash University; Moe Victoria Australia
| | - Eleanor K. L. Mitchell
- Department of Rural and Indigenous Health; School of Rural Health; Monash University; Moe Victoria Australia
- School of Rural Health - East Gippsland; Monash University; Bairnsdale Victoria Australia
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31
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Stephenson JJ, Nemunaitis J, Joy AA, Martin JC, Jou YM, Zhang D, Statkevich P, Yao SL, Zhu Y, Zhou H, Small K, Bannerji R, Edelman MJ. Randomized phase 2 study of the cyclin-dependent kinase inhibitor dinaciclib (MK-7965) versus erlotinib in patients with non-small cell lung cancer. Lung Cancer 2013; 83:219-23. [PMID: 24388167 DOI: 10.1016/j.lungcan.2013.11.020] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 11/15/2013] [Accepted: 11/24/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Dinaciclib (MK-7965, formerly SCH 727965), a novel, small-molecule inhibitor of cyclin-dependent kinases, has been shown to induce apoptosis in preclinical studies of human tumor cell lines, including non-small cell lung cancer (NSCLC) cells. Erlotinib, an epidermal growth factor receptor inhibitor, is approved for the treatment of advanced NSCLC as second- or third-line therapy. This phase 2, randomized, multicenter, open-label study compared dinaciclib with erlotinib in patients with previously treated NSCLC. MATERIALS AND METHODS The study was comprised of 2 parts: in part 1, patients were randomized to either intravenous (IV) dinaciclib (50 mg/m2) or oral erlotinib (150 mg) using an adaptive Bayesian design that adjusted the randomization ratio in favor of the more active arm, and in part 2, patients who had progressed on erlotinib were permitted to cross over to receive dinaciclib at the same dosage as in part 1. Patients were followed until disease progression or death, initiation of nonstudy cancer treatment, discontinuation, or withdrawal of consent. The primary efficacy end point was time-to-progression (TTP) in part 1 and objective response rate (ORR) in part 2. RESULTS Based on Kaplan-Meier estimates, the median TTP was 1.49 months (95% confidence interval [CI]: 1.31, 2.63) following initial treatment with dinaciclib, compared with 1.58 months (95% CI: 1.38, 2.83) with erlotinib. No objective responses were observed following initial treatment with dinaciclib. Common severe (grade 3 or 4) drug-related adverse effects included neutropenia, leukopenia, vomiting, and diarrhea. CONCLUSIONS Dinaciclib, administered IV, was well tolerated at the 50 mg/m2 dose, but does not have activity as monotherapy in previously treated NSCLC. Evaluation of dinaciclib in combination with other agents for other indications including breast cancer and multiple myeloma is in progress.
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Affiliation(s)
- Joe J Stephenson
- Institute for Translational Oncology Research, 900 West Faris Road, 3rd Floor, Greenville, SC 29605, USA
| | - John Nemunaitis
- Mary Crowley Cancer Research Centers, 1700 Pacific Avenue, Dallas, TX 75201, USA
| | - Anil A Joy
- Cross Cancer Institute, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada
| | - Julie C Martin
- Institute for Translational Oncology Research, 900 West Faris Road, 3rd Floor, Greenville, SC 29605, USA
| | - Ying-Ming Jou
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Da Zhang
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Paul Statkevich
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Siu-Long Yao
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Yali Zhu
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Honghong Zhou
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Karen Small
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Rajat Bannerji
- Merck & Co., Inc., 1 Merck Drive, Whitehouse Station, NJ 08889, USA
| | - Martin J Edelman
- University of Maryland Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD 21201, USA.
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Leong CH, McDermott WJ, Elmer SJ, Martin JC. Chronic eccentric cycling improves quadriceps muscle structure and maximum cycling power. Int J Sports Med 2013; 35:559-65. [PMID: 24234011 DOI: 10.1055/s-0033-1358471] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An interesting finding from eccentric exercise training interventions is the presence of muscle hypertrophy without changes in maximum concentric strength and/or power. The lack of improvements in concentric strength and/or power could be due to long lasting suppressive effects on muscle force production following eccentric training. Thus, improvements in concentric strength and/or power might not be detected until muscle tissue has recovered (e. g., several weeks post-training). We evaluated alterations in muscular structure (rectus-femoris, RF, and vastus lateralis, VL, thickness and pennation angles) and maximum concentric cycling power (Pmax) 1-week following 8-weeks of eccentric cycling training (2×/week; 5-10.5 min; 20-55% of Pmax). Pmax was assessed again at 8-weeks post-training. At 1 week post-training, RF and VL thickness increased by 24±4% and 13±2%, respectively, and RF and VL pennation angles increased by 31±4% and 13±1%, respectively (all P<0.05). Compared to pre-training values, Pmax increased by 5±1% and 9±2% at 1 and 8 weeks post-training, respectively (both P<0.05). These results demonstrate that short-duration high-intensity eccentric cycling can be a time-effective intervention for improving muscular structure and function in the lower body of healthy individuals. The larger Pmax increase detected at 8-weeks post-training implies that sufficient recovery might be necessary to fully detect changes in muscular power after eccentric cycling training.
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Affiliation(s)
- C H Leong
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah, United States
| | - W J McDermott
- Sport Science and Research, The Orthopedic Specialty Hospital, Murray, Utah, United States
| | - S J Elmer
- Department of Exercise Science and STEM, University of Maine, Orono, Maine, United States
| | - J C Martin
- Department of Exercise and Sport Science, University of Utah, Salt Lake City, Utah, United States
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Delplanque B, Du Q, Agnani G, Le Ruyet P, Martin JC. A dairy fat matrix providing alpha-linolenic acid (ALA) is better than a vegetable fat mixture to increase brain DHA accretion in young rats. Prostaglandins Leukot Essent Fatty Acids 2013; 88:115-20. [PMID: 22884780 DOI: 10.1016/j.plefa.2012.07.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/24/2012] [Accepted: 07/12/2012] [Indexed: 11/18/2022]
Abstract
Achieving an appropriate DHA status in the neonatal brain is an important goal of neonatal nutrition. We evaluated how alpha-linolenic acid (ALA), provided for six weeks after weaning by different dietary fat matrix, improved brain DHA content of young male rats born from deficient-dams. The level of ALA achieved was based on the fat composition of usual infant vegetable formula. A palm oil-blend diet thus providing 1.5%ALA was compared to dairy fat-blend-based diets that provided either 1.5%ALA or 2.3%ALA, or a rapeseed oil diet providing 8.3%ALA (n-6/n-3 ratio were, respectively 10,10,5,2.5). The 1.5%ALA-dairy-fat-blend was superior to 1.5%ALA-palm-oil-blend to restore values of brain DHA, while the 2.3%ALA-dairy-fat-blend exhibited a further increase and reached the values obtained with pure rapeseed diet (8.3%ALA). Dairy-fat-blends enriched with ALA appear to be an interesting strategy for achieving optimal DHA levels in the brain of post-weaning rats. Providing dairy fat as well as a reduction of the LA/ALA ratio should be reconsidered to design infant formula.
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Affiliation(s)
- B Delplanque
- UMR 8195 CNPS-Centre de Neurosciences Paris-Sud, NMPA-Neuroendocrinologie Moléculaire de la Prise Alimentaire, Université Paris-Sud XI, Orsay F-91405, France.
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Bindels LB, Porporato P, Dewulf EM, Verrax J, Neyrinck AM, Martin JC, Scott KP, Buc Calderon P, Feron O, Muccioli GG, Sonveaux P, Cani PD, Delzenne NM. Gut microbiota-derived propionate reduces cancer cell proliferation in the liver. Br J Cancer 2012; 107:1337-44. [PMID: 22976799 PMCID: PMC3494429 DOI: 10.1038/bjc.2012.409] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Metabolites released by the gut microbiota may influence host metabolism and immunity. We have tested the hypothesis that inulin-type fructans (ITF), by promoting microbial production of short-chain fatty acids (SCFA), influence cancer cell proliferation outside the gut. Methods: Mice transplanted with Bcr-Abl-transfected BaF3 cells, received ITF in their drinking water. Gut microbiota was analysed by 16S rDNA polymerase chain reaction (PCR)–denaturing gradient gel electrophoresis (DGGE) and qPCR. Serum Short-chain fatty acids were quantified by UHPLC-MS. Cell proliferation was evaluated in vivo, by molecular biology and histology, and in vitro. Results: Inulin-type fructans treatment reduces hepatic BaF3 cell infiltration, lessens inflammation and increases portal propionate concentration. In vitro, propionate reduces BaF3 cell growth through a cAMP level-dependent pathway. Furthermore, the activation of free fatty acid receptor 2 (FFA2), a Gi/Gq-protein-coupled receptor also known as GPR43 and that binds propionate, lessens the proliferation of BaF3 and other human cancer cell lines. Conclusion: We show for the first time that the fermentation of nutrients such as ITF into propionate can counteract malignant cell proliferation in the liver tissue. Our results support the interest of FFA2 activation as a new strategy for cancer therapeutics. This study highlights the importance of research focusing on gut microbes–host interactions for managing systemic and severe diseases such as leukaemia.
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Affiliation(s)
- L B Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium
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Chassard C, Dapoigny M, Scott KP, Crouzet L, Del'homme C, Marquet P, Martin JC, Pickering G, Ardid D, Eschalier A, Dubray C, Flint HJ, Bernalier-Donadille A. Functional dysbiosis within the gut microbiota of patients with constipated-irritable bowel syndrome. Aliment Pharmacol Ther 2012; 35:828-38. [PMID: 22315951 DOI: 10.1111/j.1365-2036.2012.05007.x] [Citation(s) in RCA: 239] [Impact Index Per Article: 19.9] [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] [Received: 08/26/2011] [Revised: 09/20/2011] [Accepted: 01/12/2012] [Indexed: 12/08/2022]
Abstract
BACKGROUND The role of the gut microbiota in patho-physiology of irritable bowel syndrome (IBS) is suggested by several studies. However, standard cultural and molecular methods used to date have not revealed specific and consistent IBS-related groups of microbes. AIM To explore the constipated-IBS (C-IBS) gut microbiota using a function-based approach. METHODS The faecal microbiota from 14 C-IBS women and 12 sex-match healthy subjects were examined through a combined strictly anaerobic cultural evaluation of functional groups of microbes and fluorescent in situ hybridisation (16S rDNA gene targeting probes) to quantify main groups of bacteria. Starch fermentation by C-IBS and healthy faecal samples was evaluated in vitro. RESULTS In C-IBS, the numbers of lactate-producing and lactate-utilising bacteria and the number of H(2) -consuming populations, methanogens and reductive acetogens, were at least 10-fold lower (P < 0.05) compared with control subjects. Concomitantly, the number of lactate- and H(2) -utilising sulphate-reducing population was 10 to 100 fold increased in C-IBS compared with healthy subjects. The butyrate-producing Roseburia - E. rectale group was in lower number (0.01 < P < 0.05) in C-IBS than in control. C-IBS faecal microbiota produced more sulphides and H(2) and less butyrate from starch fermentation than healthy ones. CONCLUSIONS A major functional dysbiosis was observed in constipated-irritable bowel syndrome gut microbiota, reflecting altered intestinal fermentation. Sulphate-reducing population increased in the gut of C-IBS and were accompanied by alterations in other microbial groups. This could be responsible for changes in the metabolic output and enhancement in toxic sulphide production which could in turn influence gut physiology and contribute to IBS pathogenesis.
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Affiliation(s)
- C Chassard
- INRA, UR Microbiology Unit, Clermont-Ferrand Research Centre, Saint Genès-Champanelle, France
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Ramanathan RK, Stephenson JJ, Weiss GJ, Pestano LA, Lowe A, Hiscox A, Leos RA, Martin JC, Kirkpatrick L, Richards DA. A phase I trial of PX-12, a small-molecule inhibitor of thioredoxin-1, administered as a 72-hour infusion every 21 days in patients with advanced cancers refractory to standard therapy. Invest New Drugs 2011; 30:1591-6. [PMID: 21863237 DOI: 10.1007/s10637-011-9739-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 08/16/2011] [Indexed: 12/27/2022]
Abstract
PURPOSE This phase I trial assessed the safety, dose limiting toxicity (DLT) and pharmacodynamics of PX-12 in adult patients with advanced refractory cancers. METHODS PX-12 was administered to sequential cohorts as a 72-h infusion utilizing a portable infusion pump on days 1, 2, and 3 of a 21-day cycle at a starting dose level of 300 mg/m(2)/day and escalating dose levels till DLT was observed. Plasma thioredoxin (Trx-1), vascular endothelial growth factor (VEGF) and FGF-2 (fibroblast growth factor) levels were measured predose and during infusion of PX-12. RESULTS Patients (n = 14) were enrolled to the following dose cohorts, 300 mg/m(2) (n = 3), 400 mg/m(2) (n = 10) and 500 mg/m(2) (n = 1). Common grade 1/2 toxicities included fatigue, taste alteration and odor caused by expired drug metabolite. DLTs were one episode each of grade 3 hypoxia at the 400 mg/m(2) and grade 3 reversible pneumonitis at the 500 mg/m(2) dose levels. Best response was stable disease in a patient with rectal cancer. Predose Trx-1 levels (n = 12) ranged from 5.1 to 30.0 ng/mL (median 12.6 ng/mL). CONCLUSION PX-12 administered at 400 mg/m(2)/day by 72-hour infusion appears safe and tolerable. Inhibition of thioredoxin is a strategy worth evaluation with next generation of inhibitors.
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Abstract
Fluorescence lifetimes of single Rhodamine 6G molecules on silica surfaces were measured with pulsed laser excitation, time-correlated single photon counting, and near-field scanning optical microscopy (NSOM). The fluorescence lifetime varies with the position of a molecule relative to a near-field probe. Qualitative features of lifetime decreases are consistent with molecular excited state quenching effects near metal surfaces. The technique of NSOM provides a means of altering the environment of a single fluorescent molecule and its decay kinetics in a repeatable fashion.
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Abstract
AIM Positive net work produced during cyclic contractions is partially limited by relaxation kinetics, which to date, have not been directly investigated. Therefore, the purpose of this investigation was to determine the influence of relaxation kinetics on cyclic work. METHODS Soleus muscles of four cats were isolated and subjected to a series of work loops (0.5, 1, 1.5 and 2 Hz cycle frequencies) during which stimulation terminated prior to the end of the shortening phase to allow for complete muscle relaxation and matched discrete sinusoidal shortening contractions during which stimulation remained on until the completion of the shortening phase. Muscle length changes during these protocols were centred on optimum length and were performed across muscle lengths that represented walking gait. RESULTS When muscle excursions were centred on L(o) relaxation kinetics decreased muscular work by 2.8 + or - 0.8%, 12.1 + or - 4.1%, 27.9 + or - 4.5% and 40.1 + or - 5.9% for 0.5, 1, 1.5 and 2 Hz respectively. However, relaxation kinetics did not influence muscular work when muscle excursions represented walking gait. In addition, muscular work produced at muscle lengths associated with walking gait was less than the work produced across L(o) (55.7 + or - 20.0%, 53.5 + or - 21.0%, and 50.1 + or - 22.0% for 0.5, 1 and 1.5 Hz respectively). CONCLUSION These results imply that relaxation kinetics are an important factor that limit the ability of muscle to produce work; however, the influence of relaxation kinetics on physiological function may depend on the relation between the optimum length and natural excursion of a muscle.
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Affiliation(s)
- J McDaniel
- Department of Exercise and Sport Science, The University of Utah, Salt Lake City, UT, USA.
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Jett JH, Martin JC, Habbersett RC. Techniques for flow cytometer alignment. Curr Protoc Cytom 2008; Chapter 1:Unit 1.10. [PMID: 18770661 DOI: 10.1002/0471142956.cy0110s06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This unit provides essential knowledge for correctly using any flow cytometer to ensure that data collected are accurate and reliable. Two levels of system alignment are described: routine alignment checks and complete alignment, both of which can be applied to a variety of instrument configurations.
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Affiliation(s)
- J H Jett
- Los Alamos National Laboratory, Los Alamos, New Mexico, USA
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Miyazaki K, Martin JC, Marinsek-Logar R, Flint HJ. Degradation and utilization of xylans by the rumen anaerobe Prevotella bryantii (formerly P. ruminicola subsp. brevis) B(1)4. Anaerobe 2007; 3:373-81. [PMID: 16887612 DOI: 10.1006/anae.1997.0125] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/1997] [Accepted: 08/18/1997] [Indexed: 11/22/2022]
Abstract
Freshly harvested whole cells from cultures of P. bryantii B(1)4 grown with oat spelt xylan (OSX) as an energy source showed less than 25% of the enzyme activity against OSX, and less than 15% of the activity against birchwood xylan (BWX) and carboxymethylcellulose, that was detectable in sonicated cell preparations. This indicates that much of this hydrolytic activity is either periplasmic, membrane-associated or intracellular and may be concerned with the processing of transported oligosaccharides.P. bryantii B(1)4 cultures were able to utilise up to 45% and 51% of the total pentose present in OSX and BWX, respectively, after 24 h, but could utilize 84% of a water-soluble fraction of BWX. Analysis of the xylan left undegraded after incubation with P. bryantii showed that while xylose and arabinose were removed to a similar extent, uronic acids were utilized to a greater extent than xylose. Predigestion of xylans with two cloned xylanases from the cellulolytic rumen anaerobe Ruminococcus flavefaciens gave little increase in overall pentose utilization suggesting that external P. bryantii xylanases are as effective as the cloned R. flavefaciens enzymes in releasing products that can be utilised by P. bryantii cells. The xylanase system of P. bryantiiis able to efficiently utilise not only xylo-oligosaccharides but also larger water-soluble xylan fragments.
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Affiliation(s)
- K Miyazaki
- Kyoto Prefectural University, Shimogamo, Sakyo-Ku, Japan
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Pöllinger A, Martin JC, Freund T, Hamm B, Bick U. Nahinfrarot Laser-Computertomographie der Brust: Erste klinische Erfahrungen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977131] [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]
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Tobias JH, Hutchinson AP, Hunt LP, McCloskey EV, Stone MD, Martin JC, Thompson PW, Palferman TG, Bhalla AK. Use of clinical risk factors to identify postmenopausal women with vertebral fractures. Osteoporos Int 2007; 18:35-43. [PMID: 16951907 DOI: 10.1007/s00198-006-0209-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [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] [Received: 04/27/2006] [Accepted: 07/18/2006] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Previous studies have been unable to identify risk factors for prevalent vertebral fractures (VF), which are suitable for use in selection strategies intended to target high-risk sub-groups for diagnostic assessment. However, these studies generally consisted of large epidemiology surveys based on questionnaires and were only able to evaluate a limited number of risk factors. Here, we investigated whether a stronger relationship exists with prevalent VF when conventional risk factors are combined with additional information obtained from detailed one-to-one assessment. METHODS Women aged 65-75 registered at four geographically distinct GP practices were invited to participate (n=1,518), of whom 540 attended for assessment as follows: a questionnaire asking about risk factors for osteoporosis such as height loss compared to age 25 and history of non-vertebral fracture (NVF), the get-up-and-go test, Margolis back pain score, measurement of wall-tragus and rib-pelvis distances, and BMD as measured by the distal forearm BMD. A lateral thoraco-lumbar spine X-ray was obtained, which was subsequently scored for the presence of significant vertebral deformities. RESULTS Of the 509 subjects who underwent spinal radiographs, 37 (7.3%) were found to have one or more VF. Following logistic regression analysis, the four most predictive clinical risk factors for prevalent VF were: height loss (P=0.006), past NVF (P=0.004), history of back pain (P=0.075) and age (P=0.05). BMD was also significantly associated with prevalent VF (P=0.002), but its inclusion did not affect associations with other variables. Factors elicited from detailed one-to-one assessment were not related to the risk of one or more prevalent VFs. The area under ROC curves derived from these regressions, which suggested that models for prevalent VF had modest predictive accuracy, were as follows: 0.68 (BMD), 0.74 (four clinical risk factors above) and 0.78 (clinical risk factors + BMD). Analyses were repeated in relation to the subgroup of 13 patients with two or more VFs, which revealed that in this instance, the Margolis back pain score and rib-pelvis distance were associated with the presence of multiple VFs (P=0.022 and 0.026, respectively). Moreover, the predictive value as reflected by the ROC curve area was improved: 0.80 (BMD), 0.88 (the four most predictive clinical risk factors consisting of the height loss, past NVF, Margolis back pain score and rib-pelvis distance) and 0.91 (clinical risk factors + BMD). CONCLUSIONS Evaluation of additional risk factors from detailed one-to-one assessment does not improve the predictive value of risk factors for one or more prevalent vertebral deformities in postmenopausal women. However, the use of factors such as the Margolis back pain score and rib-pelvis distance may be helpful in identifying postmenopausal women at high risk of multiple prevalent VFs.
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Affiliation(s)
- J H Tobias
- Department of Clinical Science at South Bristol, University of Bristol, Bristol, BS2 8HW, UK.
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Guéguen A, Goldberg M, Bonenfant S, Martin JC. Using a representative sample of workers for constructing the SUMEX French general population based job-exposure matrix. Occup Environ Med 2004; 61:586-93. [PMID: 15208374 PMCID: PMC1740811 DOI: 10.1136/oem.2003.010660] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Job-exposure matrices (JEMs) applicable to the general population are usually constructed by using only the expertise of specialists. AIMS To construct a population based JEM for chemical agents from data based on a sample of French workers for surveillance purposes. METHODS The SUMEX job-exposure matrix was constructed from data collected via a cross-sectional survey of a sample of French workers representative of the main economic sectors through the SUMER-94 survey: 1205 occupational physicians questioned 48 156 workers, and inventoried exposure to 102 chemicals. The companies' economic activities and the workers' occupations were coded according to the official French nomenclatures. A segmentation method was used to construct job groups that were homogeneous for exposure prevalence to chemical agents. The matrix was constructed in two stages: consolidation of occupations according to exposure prevalence; and establishment of exposure indices based on individual data from all the subjects in the sample. RESULTS An agent specific matrix could be constructed for 80 of the chemicals. The quality of the classification obtained for each was variable: globally, the performance of the method was better for less specific and therefore more easy to assess agents, and for exposures specific to certain occupations. CONCLUSIONS Software has been developed to enable the SUMEX matrix to be used by occupational physicians and other prevention professionals responsible for surveillance of the health of the workforce in France.
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Affiliation(s)
- A Guéguen
- INSERM Unité 88-IFR 69, Hôpital National de Saint-Maurice, 14, rue du Val d'Osne, 94415 Saint-Maurice Cedex, France
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Bouthegourd JC, Martin JC, Gripois D, Roseau S, Tomé D, Even PC. Fat-depleted CLA-treated mice enter torpor after a short period of fasting. Appetite 2004; 42:91-8. [PMID: 15036787 DOI: 10.1016/j.appet.2003.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2003] [Revised: 07/09/2003] [Accepted: 07/31/2003] [Indexed: 10/27/2022]
Abstract
Resting energy expenditure (Resting-EE), EE with treadmill exercise, and post-prandial thermogenesis were continuously monitored by indirect calorimetry during a 24 h recording session in control (CT) and CLA-treated (CLA) (1% CLA in the food, by weight) C57Bl/6 male mice. After 15 days of CLA treatment, the fat content of CLA mice had fallen to 20% of that in CT mice. CLA mice were able to face the energy challenge of exercise but used less lipid than CT mice. Resting-EE values fell during the post-exercise period. The thermogenic response to a calibrated test meal given 5 h after the run abolished the differences in EE and substrate oxidation between CT and CLA mice. However, 2.5 h after ingestion of the test meal onward, CT mice gradually increased their lipid oxidation to sustain resting-EE levels. In contrast, CLA mice did not increase their lipid oxidation and their resting-EE levels fell significantly until they entered into torpor. Blood leptin was low but similar in CT and CLA-treated mice suggesting that leptin is not critical to induce torpor. We suggest that the durable inhibition of lipid oxidation in fasting CLA mice was an adaptive behaviour devoted at sparing the residual adipose deposits.
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Affiliation(s)
- J C Bouthegourd
- UMR INRA/INA P-G 914, Physiologie de la Nutrition et du Comportement Alimentaire, Institut National de la Recherche Agronomique, 16, rue Claude Bernard, 75231 Paris Cedex 05, France
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Abstract
The aim of this experiment was to compare the efficiency of elite cyclists with that of trained and recreational cyclists. Male subjects (N = 69) performed an incremental exercise test to exhaustion on an electrically braked cycle ergometer. Cadence was maintained between 80 - 90 rpm. Energy expenditure was estimated from measures of oxygen uptake (VO (2)) and carbon dioxide production (VCO(2)) using stoichiometric equations. Subjects (age 26 +/- 7 yr, body mass 74.0 +/- 6.3 kg, Wpeak 359 +/- 40 W and VO(2)peak 62.3 +/- 7.0 mL/kg/min) were divided into 3 groups on the basis of their VO (2)peak (< 60.0 (Low, N = 26), 60 - 70 (Med, N = 27) and > 70 (High, N = 16) mL/kg/min). All data are mean +/- SE. Despite the wide range in aerobic capacities gross efficiency (GE) at 165 W (GE (165)), GE at the same relative intensity (GE (final)), delta efficiency (DE) and economy (EC) were similar between all groups. Mean GE (165) was 18.6 +/- 0.3 %, 18.8 +/- 0.4 % and 17.9 +/- 0.3 % while mean DE was 22.4 +/- 0.4 %, 21.6 +/- 0.4 % and 21.2 +/- 0.5 % (for Low, Medium and High, respectively). There was no correlation between GE (165), GE (final), DE or EC and VO(2)peak. Based on these data, we conclude that there are no differences in efficiency and economy between elite cyclists and recreational level cyclists.
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Affiliation(s)
- L Moseley
- Human Performance Laboratory, School of Sport and Exercise Sciences, The University of Birmingham, Edgbaston, Birmingham, United Kingdom
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Affiliation(s)
- H E Cohen
- Department of Rheumatology, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UK
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Abstract
The metabolic cost of producing submaximal cycling power has been reported to vary with pedaling rate. Pedaling rate, however, governs two physiological phenomena known to influence metabolic cost and efficiency: muscle shortening velocity and the frequency of muscle activation and relaxation. The purpose of this investigation was to determine the relative influence of those two phenomena on metabolic cost during submaximal cycling. Nine trained male cyclists performed submaximal cycling at power outputs intended to elicit 30, 60, and 90% of their individual lactate threshold at four pedaling rates (40, 60, 80, 100 rpm) with three different crank lengths (145, 170, and 195 mm). The combination of four pedaling rates and three crank lengths produced 12 pedal speeds ranging from 0.61 to 2.04 m/s. Metabolic cost was determined by indirect calorimetery, and power output and pedaling rate were recorded. A stepwise multiple linear regression procedure selected mechanical power output, pedal speed, and pedal speed squared as the main determinants of metabolic cost (R(2) = 0.99 +/- 0.01). Neither pedaling rate nor crank length significantly contributed to the regression model. The cost of unloaded cycling and delta efficiency were 150 metabolic watts and 24.7%, respectively, when data from all crank lengths and pedal speeds were included in a regression. Those values increased with increasing pedal speed and ranged from a low of 73 +/- 7 metabolic watts and 22.1 +/- 0.3% (145-mm cranks, 40 rpm) to a high of 297 +/- 23 metabolic watts and 26.6 +/- 0.7% (195-mm cranks, 100 rpm). These results suggest that mechanical power output and pedal speed, a marker for muscle shortening velocity, are the main determinants of metabolic cost during submaximal cycling, whereas pedaling rate (i.e., activation-relaxation rate) does not significantly contribute to metabolic cost.
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Affiliation(s)
- J McDaniel
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina 29208, USA
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Kallarackal GU, Ansari EA, Amos N, Martin JC, Lane C, Camilleri JP. A comparative study to assess the clinical use of Fluorescein Meniscus Time (FMT) with Tear Break up Time (TBUT) and Schirmer's tests (ST) in the diagnosis of dry eyes. Eye (Lond) 2002; 16:594-600. [PMID: 12194075 DOI: 10.1038/sj.eye.6700177] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION The clinical diagnosis of dry-eye is confirmed by a suitable test of tear production and the technique commonly used today to diagnose dry eye is the Schirmer's test (ST). Although the ST is easy to perform it gives variable results, poor reproducibility and low sensitivity for detecting dry eyes. Another test, the tear break up time (TBUT) is used to assess the stability of tears which if abnormal may also cause symptomatic dry-eye. We present the results of both these tests and a new test, which shows greater sensitivity than the ST in detecting aqueous tear deficiency. The fluorescein meniscus time (FMT) is a new test developed in conjunction with one of the authors (CL) and the Department of Ophthalmology at the University Hospital of Wales. The FMT is a measure of the rate at which a fluorescent tear meniscus is formed using 2% sodium fluorescein, a stopwatch and suitable illumination with a slit lamp. METHOD An open controlled study in 62 patients and 51 controls was conducted to compare the ability of ST, FMT and TBUT to detect dry-eye in a group of patients diagnosed with rheumatoid arthritis and symptomatic dry eyes for a minimum period of 6 months. A separate control group of 15 subjects was tested on three separate occasions to assess the reproducibility of the FMT test. RESULTS All three tests showed a statistically significant difference between the patient and control populations; Mann-Whitney P < 0.001. There was a correlation between the right and left eye for all three tests in the control group (ST r(2) = 0.77, FMT r(2) = 0.98, TBUT r(2) = 0.94). This correlation was markedly reduced for FMT and TBUT in the patient population and was in keeping with the symptoms reported as being worse on one side in a proportion of the patients (FMT r(2) = 0.52, TBUT r(2) = 0.54, ST r(2) = 0.75). A correlation with age was also observed for all the three tests in the control group (ST r(2) = 0.74, FMT r(2)= 0.92, TBUT r(2) = 0.51), but not in the patient population (ST r(2) = 0.06, FMT r(2) = 0.18, TBUT r(2) = 0.03). A significant correlation was observed between the ST and FMT in both the control (ST vs FMT r(2) = 0.65) and patient population (ST vs FMT r(2) = 0.44). There was no value greater than 200 seconds for FMT recorded in the control group. Using this value to define an abnormal FMT, 85% of the patients (72% of the eyes tested) had an abnormal result. This was in contrast to 35% of patients (26% of the eyes tested) with abnormal results detected by ST. Using ANOVA and Student's paired t-test, there were no significant differences between the three sets of values recorded serially over 3 months to assess the reproducibility of the FMT. The average standard error of the mean was 2.72% and the average co-efficient of variation 4.07%. CONCLUSION Our study suggests that the FMT is a more sensitive test with good reproducibility compared to the Schirmer's test. The FMT correlates with the ST and suggests that both tests measure aqueous tear deficiency. The FMT therefore is a better alternative to ST currently being used to test aqueous tear deficiency.
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Affiliation(s)
- G U Kallarackal
- Department of Rheumatology, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK.
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Abstract
Specific bronchial challenges provide information about the relationship between inhaled dose of allergen and change in lung function, but the intermediate pathways remain largely obscure. The aim of this study was to investigate the relationships between the early asthmatic response and 1) the inhaled dose of wheat flour, 2) the concentration of wheat flour, 3) the duration of the exposure, and 4) the deactivation of inhaled allergens and mediators. Thirty-one patients with occupational asthma to wheat flour were studied. Particle aerosols were generated by a computer-controlled aerosoliser and the results were expressed as the provocative dose causing a 20% fall in forced expiratory volume in one second (FEVi) (PD20). The cumulative dose (from the beginning of the challenge), the last inhaled dose, and an estimated dose (taking into account exponential deactivation), were calculated. Twenty patients had high reactivity to flour (reaching a PD20 value). Eleven patients had intermediate reactivity (no measurable PD20 but significantly greater fall in FEV1 compared with lactose challenge). A better correlation between change in FEV1 and dose was obtained for the estimated dose than for the cumulative or last inhaled dose. The bronchial response to wheat flour can be measured by the individual specific hyperreactivity and is expressed by provocative dose of flour. However, deactivation of the allergen and mediators has to be taken into account. This problem can be addressed by using a mathematical model.
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Affiliation(s)
- D Choudat
- Cochin University Hospital, AP-HP-Université Paris 5, France.
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Lefcort H, Aguon MQ, Bond KA, Chapman KR, Chaquette R, Clark J, Kornachuk P, Lang BZ, Martin JC. Indirect effects of heavy metals on parasites may cause shifts in snail species compositions. Arch Environ Contam Toxicol 2002; 43:34-41. [PMID: 12045872 DOI: 10.1007/s00244-002-1173-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We studied the direct and indirect effects of pollution on the distributions and abundances of two closely related species of pulmonate freshwater snails. Physella columbiana is more numerous at heavy metal-polluted lakes, and Lymnaea palustris is more numerous at reference lakes. Both species are present at all sites, as are predatory bluegill sunfish (Lepomis macrochirus). The direct effects examined included the snails' growth and reproduction in both the presence and absence of heavy metals and their short-term survival when exposed to large concentrations of heavy metals. The indirect effects were the species' ability to elude capture by sunfish and the diversity and abundance of parasites within the snails. We found that heavy metals had little direct effect on growth and reproduction and that both species acquired similar levels of metals in their tissues. Interestingly, P. columbiana (the more abundant species in polluted lakes) actually exhibited higher recruitment in the absence of metals than did L. palustris (reference lakes). L. palustris has life history characteristics that favor increased growth and reduced reproduction. These characteristics resulted in decreased predation of adults by gape-limited predators and a greater ability to cope with heavy parasite burdens. P. columbiana exhibited slower growth, which resulted in increased predation although higher reproduction rates may compensate.The major effect of heavy metals on species distributions was indirect on the snails' parasites. Parasites appeared to be very susceptible to metals, and this resulted in lower parasite diversity and intensities at polluted sites for both species of snails. P. columbiana may only be able to outcompete L. palustris at polluted sites due to the indirect effects of heavy metals; the negative effect of heavy metals on parasites, and a proposed negative effect of metals on the foraging ability of sunfish that favors the faster-reproducing P. columbiana.
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Affiliation(s)
- H Lefcort
- Biology Department, Gonzaga University, Spokane, Washington 99258-0001, USA.
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