1
|
Prior C, Swales H, Sharman M, Reed N, Bommer N, Kent A, Glanemann B, Clarke K, Kortum A, Kelly D, Lea C, Roberts E, Rutherford L, Tamborini A, Murphy K, Batchelor DJ, Calleja S, Burrow R, Jamieson P, Best M, Borgonovi S, Calvo-Saiz I, Elgueta I, Piazza C, Gil Morales C, Hrovat A, Keane M, Kennils J, Lopez E, Spence S, Izaguirre E, Hernandez-Perello M, Lau N, Paul A, Ridyard A, Shales C, Shelton E, Farges A, Specchia G, Espada L, Fowlie SJ, Tappin S, Van den Steen N, Sparks TH, Allerton F. Diagnostic findings in sinonasal aspergillosis in dogs in the United Kingdom: 475 cases (2011-2021). J Small Anim Pract 2024. [PMID: 38679786 DOI: 10.1111/jsap.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/28/2024] [Accepted: 03/31/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES To describe the diagnostic tests used and their comparative performance in dogs diagnosed with sinonasal aspergillosis in the United Kingdom. A secondary objective was to describe the signalment, clinical findings and common clinicopathologic abnormalities in sinonasal aspergillosis. MATERIALS AND METHODS A multi-centre retrospective survey was performed involving 23 referral centres in the United Kingdom to identify dogs diagnosed with sinonasal aspergillosis from January 2011 to December 2021. Dogs were included if fungal plaques were seen during rhinoscopy or if ancillary testing (via histopathology, culture, cytology, serology or PCR) was positive and other differential diagnoses were excluded. RESULTS A total of 662 cases were entered into the database across the 23 referral centres. Four hundred and seventy-five cases met the study inclusion criteria. Of these, 419 dogs had fungal plaques and compatible clinical signs. Fungal plaques were not seen in 56 dogs with turbinate destruction that had compatible clinical signs and a positive ancillary test result. Ancillary diagnostics were performed in 312 of 419 (74%) dogs with observed fungal plaques permitting calculation of sensitivity of cytology as 67%, fungal culture 59%, histopathology 47% and PCR 71%. CLINICAL SIGNIFICANCE The sensitivities of ancillary diagnostics in this study were lower than previously reported challenging the clinical utility of such tests in sinonasal aspergillosis. Treatment and management decisions should be based on a combination of diagnostics including imaging findings, visual inspection, and ancillary testing, rather than ancillary tests alone.
Collapse
Affiliation(s)
- C Prior
- Willows Veterinary Centre and Referral Service, Part of Linnaeus Veterinary Limited, Solihull, UK
| | - H Swales
- Moorview Referrals, Cramlington, UK
| | | | - N Reed
- Veterinary Specialists Scotland, Livingston, UK
| | - N Bommer
- Veterinary Specialists Scotland, Livingston, UK
| | - A Kent
- Blaise Veterinary Referral Hospital, Birmingham, UK
| | | | - K Clarke
- Davies Veterinary Specialists, Hitchin, UK
| | - A Kortum
- Cambridge Veterinary School, Cambridge, UK
| | - D Kelly
- Southern Counties Veterinary Specialists, Ringwood, UK
| | - C Lea
- Southern Counties Veterinary Specialists, Ringwood, UK
| | - E Roberts
- Bristol Veterinary Specialists, Bristol, UK
| | | | | | - K Murphy
- Rowe Veterinary Referrals, Bristol, UK
| | - D J Batchelor
- School of Veterinary Science, University of Liverpool, Neston, UK
| | - S Calleja
- Lumbry Park Veterinary Specialists, Hampshire, UK
| | - R Burrow
- Northwest Veterinary Specialists, Runcorn, UK
| | - P Jamieson
- VetsNow 24/7 Emergency & Specialty Hospital, Glasgow, UK
| | - M Best
- Eastcott Veterinary Referrals, Swindon, UK
| | | | | | - I Elgueta
- VetsNow 24/7 Emergency & Specialty Hospital, Glasgow, UK
| | - C Piazza
- Scarsdale Vets Pride Veterinary Centre, Derby, UK
| | | | - A Hrovat
- Scarsdale Vets Pride Veterinary Centre, Derby, UK
| | - M Keane
- School of Veterinary Science, University of Liverpool, Neston, UK
| | - J Kennils
- Langford Veterinary Services Ltd, Langford, UK
| | - E Lopez
- Langford Veterinary Services Ltd, Langford, UK
| | - S Spence
- North Downs Specialist Referrals, Surrey, UK
| | - E Izaguirre
- North Downs Specialist Referrals, Surrey, UK
| | | | - N Lau
- Davies Veterinary Specialists, Hitchin, UK
| | - A Paul
- Anderson Moores Veterinary Specialists, Hampshire, UK
| | - A Ridyard
- University of Glasgow Small Animal Hospital, Glasgow, UK
| | - C Shales
- Willows Veterinary Centre and Referral Service, Part of Linnaeus Veterinary Limited, Solihull, UK
| | - E Shelton
- The Royal Veterinary College, London, UK
| | - A Farges
- University of Glasgow Small Animal Hospital, Glasgow, UK
| | - G Specchia
- Scarsdale Vets Pride Veterinary Centre, Derby, UK
| | - L Espada
- University of Glasgow Small Animal Hospital, Glasgow, UK
| | - S J Fowlie
- Southfields Veterinary Specialists, Essex, UK
| | - S Tappin
- Dick White Referrals, Cambridge, UK
| | | | - T H Sparks
- Waltham Petcare Science Institute, Leicestershire, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Part of Linnaeus Veterinary Limited, Solihull, UK
| |
Collapse
|
2
|
Elshatlawy M, Sampson J, Clarke K, Bayliss R. EML4-ALK biology and drug resistance in non-small cell lung cancer: a new phase of discoveries. Mol Oncol 2023; 17:950-963. [PMID: 37149843 PMCID: PMC10257413 DOI: 10.1002/1878-0261.13446] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/05/2023] [Accepted: 05/05/2023] [Indexed: 05/08/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK) can be driven to oncogenic activity by different types of mutational events such as point-mutations, for example F1174L in neuroblastoma, and gene fusions, for example with echinoderm microtubule-associated protein-like 4 (EML4) in non-small cell lung cancer (NSCLC). EML4-ALK variants result from different breakpoints, generating fusions of different sizes and properties. The most common variants (Variant 1 and Variant 3) form cellular compartments with distinct physical properties. The presence of a partial, probably misfolded beta-propeller domain in variant 1 confers solid-like properties to the compartments it forms, greater dependence on Hsp90 for protein stability and higher cell sensitivity to ALK tyrosine kinase inhibitors (TKIs). These differences translate to the clinic because variant 3, on average, worsens patient prognosis and increases metastatic risk. Latest generation ALK-TKIs are beneficial for most patients with EML4-ALK fusions. However, resistance to ALK inhibitors can occur via point-mutations within the kinase domain of the EML4-ALK fusion, for example G1202R, reducing inhibitor effectiveness. Here, we discuss the biology of EML4-ALK variants, their impact on treatment response, ALK-TKI drug resistance mechanisms and potential combination therapies.
Collapse
Affiliation(s)
- Mariam Elshatlawy
- Faculty of Biological Sciences, School of Molecular and Cellular BiologyUniversity of LeedsUK
| | - Josephina Sampson
- Faculty of Biological Sciences, School of Molecular and Cellular BiologyUniversity of LeedsUK
- Astbury Centre for Structural Molecular BiologyUniversity of LeedsUK
| | - Katy Clarke
- Leeds Cancer Center, St.James' University HospitalLeeds Teaching Hospitals NHS TrustUK
| | - Richard Bayliss
- Faculty of Biological Sciences, School of Molecular and Cellular BiologyUniversity of LeedsUK
- Astbury Centre for Structural Molecular BiologyUniversity of LeedsUK
| |
Collapse
|
3
|
Talenfeld C, Lansing A, Clarke K, Wright G, Lee D, Ghosh S, Raza S, Zhang Y, McClure T. Abstract No. 542 Microwave Ablation versus Cryoablation for T1a Renal Cell Carcinoma: A Systematic Literature Review and Meta-Analysis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.400] [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: 02/26/2023] Open
|
4
|
Balasubramanian M, Ghanbarzadegan A, Sohn W, Killedar A, Sivaprakash P, Holden A, Norris S, Wilson A, Pogson B, Liston G, Chor L, Yaacoub A, Masoe A, Clarke K, Chen R, Milat A, Schneider C CH. Primary school mobile dental program in New South Wales, Australia: protocol for the evaluation of a state government oral health initiative. BMC Public Health 2023; 23:363. [PMID: 36803579 PMCID: PMC9940088 DOI: 10.1186/s12889-023-15241-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Socioeconomically disadvantaged children are disproportionately affected by oral disease. Mobile dental services help underserved communities overcome barriers to accessing health care, including time, geography, and trust. The NSW Health Primary School Mobile Dental Program (PSMDP) is designed to provide diagnostic and preventive dental services to children at their schools. The PSMDP is mainly targeted toward high-risk children and priority populations. This study aims to evaluate the program's performance across five local health districts (LHDs) where the program is being implemented. METHODS The evaluation will use routinely collected administrative data, along with other program-specific data sources, from the district public oral health services to conduct a statistical analysis that determines the reach and uptake of the program, its effectiveness, and the associated costs and cost-consequences. The PSMDP evaluation program utilises data from Electronic Dental Records (EDRs) and other data sources, including patient demographics, service mix, general health, oral health clinical data and risk factor information. The overall design includes cross-sectional and longitudinal components. The design combines comprehensive output monitoring across the five participating LHDs and investigates the associations between socio-demographic factors, service patterns and health outcomes. Time series analysis using difference-in-difference estimation will be conducted across the four years of the program, involving services, risk factors, and health outcomes. Comparison groups will be identified via propensity matching across the five participating LHDs. An economic analysis will estimate the costs and cost-consequences for children who participate in the program versus the comparison group. DISCUSSION The use of EDRs for oral health services evaluation research is a relatively new approach, and the evaluation works within the limitations and strengths of utilising administrative datasets. The study will also provide avenues to improve the quality of data collected and system-level improvements to better enable future services to be aligned with disease prevalence and population needs.
Collapse
Affiliation(s)
- M Balasubramanian
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia ,grid.1014.40000 0004 0367 2697Health Care Management, College of Business Government and Law, Flinders University, Adelaide, Australia ,grid.1010.00000 0004 1936 7304Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - A Ghanbarzadegan
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia ,grid.1013.30000 0004 1936 834XPopulation Oral Health, Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.1010.00000 0004 1936 7304Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - W Sohn
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - A Killedar
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia
| | - P Sivaprakash
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia
| | - A Holden
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.416088.30000 0001 0753 1056Sydney Dental Hospital, Sydney Local Health District, NSW Health, St Leonards, NSW Australia
| | - S Norris
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia
| | - A Wilson
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia
| | - B Pogson
- grid.416088.30000 0001 0753 1056Centre for Oral Health Strategy, NSW Ministry of Health, St Leonards, NSW Australia
| | - G Liston
- grid.416088.30000 0001 0753 1056Centre for Oral Health Strategy, NSW Ministry of Health, St Leonards, NSW Australia
| | - L Chor
- grid.416088.30000 0001 0753 1056Centre for Oral Health Strategy, NSW Ministry of Health, St Leonards, NSW Australia
| | - A Yaacoub
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia ,grid.413243.30000 0004 0453 1183Nepean Blue Mountains Local Health District, NSW Ministry of Health, Penrith, NSW Australia
| | - A Masoe
- grid.416088.30000 0001 0753 1056Centre for Oral Health Strategy, NSW Ministry of Health, St Leonards, NSW Australia
| | - K Clarke
- grid.416088.30000 0001 0753 1056Centre for Oral Health Strategy, NSW Ministry of Health, St Leonards, NSW Australia
| | - R Chen
- grid.416088.30000 0001 0753 1056Centre for Oral Health Strategy, NSW Ministry of Health, St Leonards, NSW Australia
| | - A Milat
- grid.416088.30000 0001 0753 1056Centre for Epidemiology and Evidence, NSW Ministry of Health, St Leonards, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Carmen Huckel Schneider C
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, Australia.
| |
Collapse
|
5
|
Stentiford GD, Peeler EJ, Tyler CR, Bickley LK, Holt CC, Bass D, Turner AD, Baker-Austin C, Ellis T, Lowther JA, Posen PE, Bateman KS, Verner-Jeffreys DW, van Aerle R, Stone DM, Paley R, Trent A, Katsiadaki I, Higman WA, Maskrey BH, Devlin MJ, Lyons BP, Hartnell DM, Younger AD, Bersuder P, Warford L, Losada S, Clarke K, Hynes C, Dewar A, Greenhill B, Huk M, Franks J, Dal-Molin F, Hartnell RE. A seafood risk tool for assessing and mitigating chemical and pathogen hazards in the aquaculture supply chain. Nat Food 2022; 3:169-178. [PMID: 37117966 DOI: 10.1038/s43016-022-00465-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/19/2022] [Indexed: 04/30/2023]
Abstract
Intricate links between aquatic animals and their environment expose them to chemical and pathogenic hazards, which can disrupt seafood supply. Here we outline a risk schema for assessing potential impacts of chemical and microbial hazards on discrete subsectors of aquaculture-and control measures that may protect supply. As national governments develop strategies to achieve volumetric expansion in seafood production from aquaculture to meet increasing demand, we propose an urgent need for simultaneous focus on controlling those hazards that limit its production, harvesting, processing, trade and safe consumption. Policies aligning national and international water quality control measures for minimizing interaction with, and impact of, hazards on seafood supply will be critical as consumers increasingly rely on the aquaculture sector to supply safe, nutritious and healthy diets.
Collapse
Affiliation(s)
- G D Stentiford
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK.
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK.
| | - E J Peeler
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - C R Tyler
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
- Biosciences, University of Exeter, Exeter, UK
| | - L K Bickley
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
- Biosciences, University of Exeter, Exeter, UK
| | - C C Holt
- Department of Botany, University of British Columbia, Vancouver, British Columbia, Canada
| | - D Bass
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - A D Turner
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - C Baker-Austin
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - T Ellis
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - J A Lowther
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - P E Posen
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - K S Bateman
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - D W Verner-Jeffreys
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - R van Aerle
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - D M Stone
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - R Paley
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - A Trent
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - I Katsiadaki
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
- Centre for Sustainable Aquaculture Futures, University of Exeter, Exeter, UK
| | - W A Higman
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - B H Maskrey
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - M J Devlin
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - B P Lyons
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - D M Hartnell
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - A D Younger
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK
| | - P Bersuder
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - L Warford
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - S Losada
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - K Clarke
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - C Hynes
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - A Dewar
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - B Greenhill
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - M Huk
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - J Franks
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - F Dal-Molin
- Lowestoft Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK
| | - R E Hartnell
- Weymouth Laboratory, Centre for Environment, Fisheries and Aquaculture Science (Cefas), Weymouth, UK.
| |
Collapse
|
6
|
Kerr M, Dennis KMJH, Carr CA, Fuller W, Berridge G, Rohling S, Aitken CL, Lopez C, Fischer R, Miller JJ, Clarke K, Tyler DJ, Heather LC. Diabetic mitochondria are resistant to palmitoyl CoA inhibition of respiration, which is detrimental during ischemia. FASEB J 2021; 35:e21765. [PMID: 34318967 PMCID: PMC8662312 DOI: 10.1096/fj.202100394r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 01/07/2023]
Abstract
The bioactive lipid intermediate palmitoyl CoA (PCoA) can inhibit mitochondrial ADP/ATP transport, though the physiological relevance of this regulation remains unclear. We questioned whether myocardial ischemia provides a pathological setting in which PCoA regulation of ADP/ATP transport would be beneficial, and secondly, whether the chronically elevated lipid content within the diabetic heart could make mitochondria less sensitive to the effects of PCoA. PCoA acutely decreased ADP‐stimulated state 3 respiration and increased the apparent Km for ADP twofold. The half maximal inhibitory concentration (IC50) of PCoA in control mitochondria was 22 µM. This inhibitory effect of PCoA on respiration was blunted in diabetic mitochondria, with no significant difference in the Km for ADP in the presence of PCoA, and an increase in the IC50 to 32 µM PCoA. The competitive inhibition by PCoA was localised to the phosphorylation apparatus, particularly the ADP/ATP carrier (AAC). During ischemia, the AAC imports ATP into the mitochondria, where it is hydrolysed by reversal of the ATP synthase, regenerating the membrane potential. Addition of PCoA dose‐dependently prevented this wasteful ATP hydrolysis for membrane repolarisation during ischemia, however, this beneficial effect was blunted in diabetic mitochondria. Finally, using 31P‐magnetic resonance spectroscopy we demonstrated that diabetic hearts lose ATP more rapidly during ischemia, with a threefold higher ATP decay rate compared with control hearts. In conclusion, PCoA plays a role in protecting mitochondrial energetics during ischemia, by preventing wasteful ATP hydrolysis. However, this beneficial effect is blunted in diabetes, contributing to the impaired energy metabolism seen during myocardial ischemia in the diabetic heart.
Collapse
Affiliation(s)
- M Kerr
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - K M J H Dennis
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - C A Carr
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - W Fuller
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - G Berridge
- Target Discovery Institute, University of Oxford, Oxford, UK
| | - S Rohling
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - C L Aitken
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - C Lopez
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - R Fischer
- Target Discovery Institute, University of Oxford, Oxford, UK
| | - J J Miller
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.,Department of Physics, University of Oxford, Oxford, UK.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - K Clarke
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - D J Tyler
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK.,Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - L C Heather
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| |
Collapse
|
7
|
Sun F, Mason H, Franks K, Teo M, Dickinson P, Clarke K, Jain P. PO-1204 Adjuvant immunotherapy after concurrent chemoradiotherapy for stage 3 NSCLC, outcomes from a large cancer centre. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
8
|
Mason H, Jain P, Sun F, Teo M, Franks K, Clarke K. Uptake and outcomes of adjuvant durvalumab following concurrent chemoradiotherapy in unresected stage 3 non-small-cell lung cancer. Lung Cancer 2021. [DOI: 10.1016/s0169-5002(21)00296-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
9
|
Saha A, Beasley M, Hatton N, Dickinson P, Franks K, Clarke K, Jain P, Teo M, Murray P, Lilley J. Can dosimetry affect local control and survival in patients with early-stage lung cancer treated with Stereotactic Ablative Radiotherapy (SABR)? An analysis of the UK's largest cohort of lung SABR patients. Acta Oncol 2021; 60:505-512. [PMID: 33491521 DOI: 10.1080/0284186x.2021.1874617] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE/OBJECTIVES A recent study has shown that tight conformity of lung Stereotactic Ablative Radiotherapy (SABR) plans might worsen loco-regional control and can predict distant metastases. The study aims to report overall survival (OS), progression-free survival (PFS), local recurrence free survival (LRFS), and dosimetry of early-stage lung cancer patients treated with SABR and to try to explore any dosimetric predictor of outcomes. MATERIAL AND METHODS Patients treated in our institute (May 2009-August 2018) were included. Electronic medical records were reviewed for baseline characteristics, treatment details, and outcomes. Dosimetric data were extracted from Xio and Monaco software. Patients were treated according to the United Kingdom (UK) SABR consortium guidelines. Kaplan-Meier's analysis with log-rank test was used for survival analysis. The univariate and multivariable Cox regression model was used for correlating dosimetric variables and outcomes. RESULTS We treated 1266 patients with median age of 75 years and 47.4% were male. Median follow up was 56 months. Median OS was 36 months with 1, 2, and 5 years OS of 84.2%, 64.5%, and 31.5%, respectively. Median for PFS and LRFS was not reached. One, 2, and 5 years PFS were 87.4%, 78.4%, and 72.5%, respectively. One, 2, and 5 years LRFS were 98.2%, 95.1%, and 92.5%, respectively. Planning target volume (PTV), dose to 99% volume of PTV (D99), and R50 (volume receiving the 50% dose/volume (PTV)) were significantly associated with OS. PTV, mean lung dose (MLD), V20 (volume of lung minus gross tumour volume (GTV) receiving 20 Gy), V12.5 (volume of lung minus GTV receiving 12.5 Gy), and dose fractionation were significantly associated with PFS. Nothing was associated with LRFS on univariate analysis. R100 of >1.1 was associated with better OS, PFS, and LRFS compared to R100 ≤ 1.1. CONCLUSION SABR achieves good clinical outcomes in patients with early-stage lung cancer; even in elderly patients with multiple comorbidities. In the largest UK early lung cancer cohort treated with SABR, we found that dosimetry correlates with clinical outcomes. Further validation of these results is needed to guide future optimisation of SABR delivery.
Collapse
Affiliation(s)
- Animesh Saha
- Department of Oncology, Apollo Gleneagles Cancer Hospital, Kolkata, India
| | - Matthew Beasley
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Nathaniel Hatton
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Peter Dickinson
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Kevin Franks
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Katy Clarke
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Pooja Jain
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Mark Teo
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - Patrick Murray
- Department of Oncology, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| | - John Lilley
- Department of Medical Physics, Leeds Teaching Hospitals, NHS trust, Leeds, UK
| |
Collapse
|
10
|
Saha A, Beasley M, Hatton N, Dickinson P, Franks K, Clarke K, Jain P, Teo M, Murray P, Lilley J. Clinical and dosimetric predictors of radiation pneumonitis in early-stage lung cancer treated with Stereotactic Ablative radiotherapy (SABR) - An analysis of UK's largest cohort of lung SABR patients. Radiother Oncol 2021; 156:153-159. [PMID: 33333139 DOI: 10.1016/j.radonc.2020.12.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/17/2020] [Accepted: 12/07/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Stereotactic Ablative Radiotherapy (SABR) is the standard treatment for early-stage medically inoperable lung cancer. Predictors of radiation pneumonitis (RP) in patients treated with SABR are poorly defined. In this study, we investigate clinical and dosimetric parameters, which can predict symptomatic RP in early-stage lung cancer patients treated with SABR. MATERIALS AND METHODS Patients treated with lung SABR between May 2009 and August 2018, in a single United Kingdom (UK) radiotherapy center were included. The patient's baseline characteristics, treatment details, and toxicity were retrieved from the electronic medical record. Dosimetric data was extracted from Xio and Monaco treatment planning systems. Patients were treated according to the UK SABR consortium guidelines. RP was graded retrospectively using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, based on available clinical and imaging information. Univariate and multivariate binary logistic regression was performed to determine predictive factors for grade ≥ 2 radiation pneumonitis, using Statistical Package for the Social Sciences (SPSS) statistics version 21 software. The goodness of fit was assessed using the Hosmer and Lemeshow test. The optimal diagnostic threshold was tested using the Receiver operating characteristics (ROC) curve. The chi-square test was carried out to test the different risk factors against the likelihood of developing grade ≥ 2 pneumonitis. RESULTS A total of 1266 patients included in the analysis. The median age of patients was 75 years. Six hundred sixty-six patients (52.6%) were female. Median follow up was 56 months. Sixty-five percent of patients received 55 Gy in 5 fractions. Forty-three percent of patients had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 and 16.2% had PS of 3. The Median Charlson comorbidity index was 6 (range 2-11). Median Standardized Uptake Value (SUV) max of the tumor was 6.5. Four hundred two patients (31.8%) had confirmed histological diagnosis; other patients were treated based on a radiological diagnosis. The median tumor size was 20 mm (range 4 mm-63 mm). Median Planning Target Volume (PTV) was 30.3 cc. Median values of R100, R50, and D2cm were 1.1, 5.6, 32.8 Gy. The median value of mean lung dose, V20, and V12.5 were 3.9 Gy, 5 %and 9.3% respectively. Eighty-five (6.7%) patients developed symptomatic RP (grade ≥ 2) with only 5(0.4%) developing grade 3 RP. Five percent of patients developed rib fractures but only 28% of these were symptomatic. On univariate analysis lower lobe tumor location, larger tumor size, PTV, mean lung dose, lung V20Gy, and V12.5 Gy were significantly associated with grade ≥ 2 RP. On multivariate analysis, only mean lung dose was associated with grade ≥ 2 pneumonitis. ROC curve analysis showed optimal diagnostic threshold for tumour size, PTV, mean lung dose, V20 and V12.5; are 22.5 mm ((Area Under Curve (AUC)-0.565)), 27.15 cc (AUC-0.58), 3.7 Gy (AUC-0.633), 4.6% (AUC-0.597), 9.5% (AUC-0.616). The incidence of ≥grade 2 RP was significantly high for values higher than the ROC threshold. CONCLUSION SABR treatment resulted in a very low rate of grade 3 pneumonitis. Lower lobe tumor location, larger tumor size, PTV, mean lung dose, V20, and V12.5 were found to be significant predictors of symptomatic radiation pneumonitis.
Collapse
Affiliation(s)
- Animesh Saha
- Department of Oncology, Apollo Gleneagles Cancer Hospital, Kolkata, India.
| | - Matthew Beasley
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Nathaniel Hatton
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Peter Dickinson
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Kevin Franks
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Katy Clarke
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Pooja Jain
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Mark Teo
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - Patrick Murray
- Department of Oncology, St James's University Hospital, Leeds, UK
| | - John Lilley
- Department of Medical Physics, St James's University Hospital, Leeds, UK
| |
Collapse
|
11
|
Hatton N, Saha A, Beasley M, Franks K, Clarke K, Jain P, Teo M, Murray P, Lilley J, Dickinson P. MA03.09 Can Clinical Variables be used to Provide Better Follow up in Stereotactic Ablative Radiotherapy (SABR) Treated Lung Cancers? J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
12
|
Sun F, Jain P, Murray P, Clarke K, Dickinson P, Teo M, Saha A, Franks K. PO-1017: Poor Diffusing Capacity for Carbon Monoxide (DLCO) is associated with worse survival post SABR. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
13
|
Littlejohns A, Janjua T, Murray P, Jain P, Clarke K, Dickinson P, Teo M, Saha A, Franks K, Sun F. PO-1016: Efficacy and safety profile of Stereotactic Ablative Radiotherapy (SABR) for multiple lung primaries. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01033-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
14
|
Saha A, Hatton N, Beasley M, Franks K, Jain P, Teo M, Clarke K, Dickinson P, Murray P, Lilley J. PO-1007: Predictors of radiation pneumonitis in early stage lung cancer treated with SABR. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
15
|
Parikh S, Jain P, Clarke K, Franks K, Teo M, Dickinson P, Young A, Murray P. 1378P Is 30-day mortality after systemic anticancer therapy in lung cancer in the era of varied treatments still relevant? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
16
|
Coates MD, Seth N, Clarke K, Abdul-Baki H, Mahoney N, Walter V, Regueiro MD, Ramos-Rivers C, Koutroubakis IE, Bielefeldt K, Binion DG. Opioid Analgesics Do Not Improve Abdominal Pain or Quality of Life in Crohn's Disease. Dig Dis Sci 2020; 65:2379-2387. [PMID: 31758431 PMCID: PMC7831884 DOI: 10.1007/s10620-019-05968-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/16/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Abdominal pain and opioid analgesic use are common in Crohn's disease (CD). AIMS We sought to identify factors associated with abdominal pain in CD and evaluate the impact of opioid analgesics on pain and quality-of-life scores in this setting. METHODS We performed a longitudinal cohort study using a prospective, consented IBD natural history registry from a single academic center between 2009 and 2013. Consecutive CD patients were followed for at least 1 year after an index visit. Data were abstracted regarding pain experience (from validated surveys), inflammatory activity (using endoscopic/histologic findings), laboratory studies, coexistent psychiatric disorders, medical therapy, opioid analgesic, and tobacco use. RESULTS Of 542 CD patients (56.6% women), 232 (42.8%) described abdominal pain. Individuals with pain were more likely to undergo surgery and were more frequently prescribed analgesics and/or antidepressants/anxiolytics. Elevated ESR (OR 1.79; 95%CI 1.11-2.87), coexistent anxiety/depression (OR 1.87; 95%CI 1.13-3.09), smoking (OR 2.08; 95%CI 1.27-3.40), and opioid use (OR 2.46; 95%CI 1.33-4.57) were independently associated with abdominal pain. Eighty patients (14.8%) were prescribed opioids, while 31 began taking them at or after the index visit. Patients started on opioids demonstrated no improvement in abdominal pain or quality-of-life scores on follow-up compared to patients not taking opioids. CONCLUSIONS Abdominal pain is common in CD and is associated with significant opioid analgesic utilization and increased incidence of anxiety/depression, smoking, and elevated inflammatory markers. Importantly, opioid use in CD was not associated with improvement in pain or quality-of-life scores. These findings reinforce the limitations of currently available analgesics in IBD and support exploration of alternative therapies.
Collapse
Affiliation(s)
- M. D. Coates
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
| | - N. Seth
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Texas Southwestern, Houston, TX, USA
| | - K. Clarke
- Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
| | - H. Abdul-Baki
- Division of Gastroenterology and Hepatology, Department of Medicine, Allegheny Health System, Pittsburgh, PA, USA
| | - N. Mahoney
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - V. Walter
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - M. D. Regueiro
- Division of Gastroenterology and Hepatology, Department of Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - C. Ramos-Rivers
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - I. E. Koutroubakis
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - K. Bielefeldt
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - D. G. Binion
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| |
Collapse
|
17
|
Steer C, Alidina A, Webb N, Long D, Forbes D, Underhill C, Eek R, Clarke K, Shahrokni A. FEASIBILITY OF THE ELECTRONIC RAPID FITNESS ASSESSMENT (ERFA) IN AN AUSTRALIAN REGIONAL CANCER CENTER. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31217-2] [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: 10/25/2022]
|
18
|
Jackson CGCA, Deva S, Bayston K, McLaren B, Barlow P, Hung N, Clarke K, Segelov E, Chao TY, Dai MS, Yen HT, Cutler D, Kramer D, Zhi J, Chan WK, Kwan MFR, Hung CT. An international randomized cross-over bio-equivalence study of oral paclitaxel + HM30181 compared with weekly intravenous (IV) paclitaxel in patients with advanced solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
19
|
Faulds J, Whately-Smith C, Clarke K. Transfusion requirement and length of stay of anaemic surgical patients associated with a patient blood management service: a single-Centre retrospective study. Transfus Med 2019; 29:311-318. [PMID: 31327171 DOI: 10.1111/tme.12617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 07/18/2018] [Revised: 05/08/2019] [Accepted: 06/28/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess the value of patient blood management (PBM) in the detection and management of preoperative anaemia before elective surgery. BACKGROUND PBM is recognised as the standard of care, with diagnosis and management of preoperative anaemia being the key components of PBM. No formal assessment of the value of PBM anaemia screening and correction before scheduled surgery had been made at our hospital. METHODS We conducted a retrospective study in a tertiary-care, academic hospital of consecutive records of elective surgery (n = 25 641). We excluded minor surgeries. We identified anaemic patients who had been assessed by PBM or not (non-PBM). We calculated transfusion incidence and hospital length of stay (LOS) across all surgical specialities. RESULTS During the 1-year study period, 15 245 patients were eligible for inclusion; 311 patients (2·0%) were transfused, and 83·3% of transfusions were in anaemic patients. Transfusion incidence was 9·2% in anaemic PBM-assessed patients and 17·4% in non-PBM patients. For haemoglobin (Hb) <100 g L-1 , the transfusion incidence was 22·1% [95% confidence interval (CI) 15·5-30·6%] in PBM and 40·0% (95% CI 35·1-45·0%) in non-PBM patients, and for Hb 100-119 g L-1 , it was 4·7% (95% CI 2·8-7·5%) and 7·9% (95% CI 6·3-9·8%), respectively. Overall mean LOS was 2·1 days [standard deviation (SD) 6·0]. Mean LOS with Hb <100 g L-1 was 6·7 days (SD 14·8) in PBM-assessed patients and 12·4 days (SD 19·5) in non-PBM patients and was 3·1 (SD 5·2) and 6·2 (SD 9·5) days, respectively, for Hb 100-119 g L-1 . CONCLUSION Anaemic elective surgery patients assessed by patient blood management (PBM) had a markedly lower transfusion risk and shorter LOS than anaemic patients not assessed by PBM.
Collapse
Affiliation(s)
- J Faulds
- Patient Blood Management, Royal Cornwall Hospital NHS Trust, Cornwall, UK
| | | | - K Clarke
- Department of Haematology, Royal Cornwall Hospital NHS Trust, Cornwall, UK
| |
Collapse
|
20
|
Sharma D, Slevin F, Clarke K, Franks K, Snee M, Jain P. Regional retrospective analysis of outcomes of EGFR mutated non-squamous non-small cell lung cancer (NSCLC) patients in West Yorkshire. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz063.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
21
|
Giannoudis A, Clarke K, Zakaria R, Vareslija D, Farahani M, Rainbow L, Platt-Higgins A, Ruthven S, Brougham K, Rudland PS, Jenkinson MD, Young L, Falciani F, Palmieri C. Abstract P6-05-02: Identification of microRNAs differentially expressed in brain metastasis secondary to breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-05-02] [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: Despite sequential improvements in the adjuvant treatment of breast cancer (BC), recurrence and metastasis remains a major clinical problem and in particular, brain metastasis (BCBM). A number of microRNAs (miRNAs) have been linked to the metastatic process in BC, but to date there is limited work on the microRNAs involved in BCBM. The current study aim to identify differentially expressed miRNAs within primary breast cancer who did not recur (BCNR) versus primary BC cases which did recur (BCR) and their matched BCBM cases.
Methods: Formalin-fixed paraffin-embedded (FFPE) material was collected of 12 primary BCNRs from the Liverpool tissue bank and of 40 paired primary BCR samples and their matched BCBM from the Walton Research Tissue Bank and RCSI National Breast Cancer Bioresource. miRNA was extracted (Qiagen miRNeasy FFPE kit) and profiled using the NanoString™ nCounter™ miRNA Expression Assay (Human v3 miRNA). The differentially expressed miRNAs between BCNR versus BCR and BCR versus their matched BCBM were identified by significance of microarray analysis (SAM) on the MeV4.9 software. Pathway analysis was performed using the DIANA-mirPath v3.0 software and the Ingenuity Pathway Analysis (IPA) to identify a network of genes/pathways regulated by the differentially expressed miRNAs.
Results: 12 BCNR and 30 matched pairs of BCR and BCBM passed the quality control and normalisation processes. Principal component analysis (PCA) performed on 166 miRNAs after QC/normalisation clearly distinguishes the BCNR and the primary BCR from the matched BCBM cases, whereas SAM revealed 58 differentially expressed miRNAs with a 10% FDR (false discovery rate) and an absolute log2 fold-change (FC) >1 between BCNR and BCR and 11 between the matched BCs and BCBMs. Pathway clustering revealed that these differentially expressed miRNAs (10% FDR, log2FC>1) within both BCNR vs BCR and BCR vs BCBM cohorts are highly enriched for genes involved in extracellular matrix (ECM)-receptor interactions, proteoglycans, adherens junctions, TGF-β, p53 and Hippo signalling. IPA identified a network of genes, implicated in the processes of breast cancer invasion and metastasis, regulated by the identified miRNAs, such as, TWIST, MET, TP53, MYC, EZH2, ZEB1, TAGLN and BIRC5. Four of the significantly differentially expressed miRNAs, hsa-miR-132-3p, hsa-miR-199a-5p, hsa-miR-150-5p and hsa-miR-155-5p were present within both cohorts (BCNR vs BCR and BCR vs BCBM) and regulate genes involved in Hippo and TGF-β signalling (DIANA-mirPath v3.0 analysis: p=5.23x10-08 and p=2.67x10-07 respectively).
Conclusion: The current study, utilising a large cohort of paired BCR and BCBM cases, provides novel insight into the molecular mechanisms and role of miRNAs in BCBM. Four miRNAs (hsa-miR-132-3p, hsa-miR-199a-5p, hsa-miR-150-5p and hsa-miR-155-5p) in particular could be potentially used to identify patients with increased risk of developing brain metastasis and help facilitate the development of specific treatments for BCBM, which to date have proved elusive. The miRNAs identified require further exploration as potential biomarkers as well as novel therapeutic targets.
Citation Format: Giannoudis A, Clarke K, Zakaria R, Vareslija D, Farahani M, Rainbow L, Platt-Higgins A, Ruthven S, Brougham K, Rudland PS, Jenkinson MD, Young L, Falciani F, Palmieri C. Identification of microRNAs differentially expressed in brain metastasis secondary to breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-05-02.
Collapse
Affiliation(s)
- A Giannoudis
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - K Clarke
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - R Zakaria
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - D Vareslija
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - M Farahani
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - L Rainbow
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - A Platt-Higgins
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - S Ruthven
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - K Brougham
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - PS Rudland
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - MD Jenkinson
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - L Young
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - F Falciani
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| | - C Palmieri
- University of Liverpool, Institute of Translational Medicine, Liverpool, United Kingdom; University of Liverpool, Institute of Integrative Biology, Liverpool, United Kingdom; The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; RCSI Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; Royal Liverpool University Hospital, Liverpool, United Kingdom; The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, Bebington, Wirral, United Kingdom
| |
Collapse
|
22
|
Sun F, Littlejohns A, Fakih O, Clarke K, Franks K, Snee M, Dickinson P, Jain P. An audit of sequential chemoradiotherapy for non-small cell lung cancer (NSCLC) at the Leeds Cancer Centre (LCC). Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30231-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
23
|
Jalali A, Lee M, Semira C, Banks S, Wong HL, Ananda S, Lipton L, Shapiro J, Cooray P, Clarke K, Burge M, Wong R, Shapiro J, McLachlan SA, Harris M, Croagh D, Tebbutt N, Gibbs P, Lee B. Use of folfirinox chemotherapy in an Australasian population of pancreatic cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
24
|
Ellenger K, Flatley M, Spencer K, Clarke K, Franks K, Jain P. P2.04-21 Real World Experience of Immune Checkpoint Inhibitors In NSCLC: Our First 10 Months Experience at Leeds Cancer Centre, UK. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
25
|
Buckman JEJ, Underwood A, Clarke K, Saunders R, Hollon SD, Fearon P, Pilling S. Risk factors for relapse and recurrence of depression in adults and how they operate: A four-phase systematic review and meta-synthesis. Clin Psychol Rev 2018; 64:13-38. [PMID: 30075313 PMCID: PMC6237833 DOI: 10.1016/j.cpr.2018.07.005] [Citation(s) in RCA: 182] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/16/2018] [Accepted: 07/21/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE To review and synthesise prognostic indices that predict subsequent risk, prescriptive indices that moderate treatment response, and mechanisms that underlie each with respect to relapse and recurrence of depression in adults. RESULTS AND CONCLUSIONS Childhood maltreatment, post-treatment residual symptoms, and a history of recurrence emerged as strong prognostic indicators of risk and each could be used prescriptively to indicate who benefits most from continued or prophylactic treatment. Targeting prognostic indices or their "down-stream" consequences will be particularly beneficial because each is either a cause or a consequence of the causal mechanisms underlying risk of recurrence. The cognitive and neural mechanisms that underlie the prognostic indices are likely addressed by the effects of treatments that are moderated by the prescriptive factors. For example, psychosocial interventions that target the consequences of childhood maltreatment, extending pharmacotherapy or adapting psychological therapies to deal with residual symptoms, or using cognitive or mindfulness-based therapies for those with prior histories of recurrence. Future research that focuses on understanding causal pathways that link childhood maltreatment, or cognitive diatheses, to dysfunction in the neocortical and limbic pathways that process affective information and facilitate cognitive control, might result in more enduring effects of treatments for depression.
Collapse
Affiliation(s)
- J E J Buckman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - A Underwood
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - K Clarke
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - R Saunders
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - S D Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - P Fearon
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - S Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| |
Collapse
|
26
|
Levelt E, Swarbrick D, Gulsin GS, Athithan L, Singh A, Khan JN, Graham-Brown MPM, Davies MJ, Karamitsos T, Clarke K, Neubauer S, McCann GP. P3690Male gender adversely affects the phenotypic expression of diabetic heart disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3690] [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)
- E Levelt
- University of Leeds, Leeds, United Kingdom
| | - D Swarbrick
- University of Leicester, Leicester, United Kingdom
| | - G S Gulsin
- University of Leicester, Leicester, United Kingdom
| | - L Athithan
- University of Leicester, Leicester, United Kingdom
| | - A Singh
- University of Leicester, Leicester, United Kingdom
| | - J N Khan
- University of Leicester, Leicester, United Kingdom
| | | | - M J Davies
- University of Leicester, Leicester, United Kingdom
| | - T Karamitsos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Clarke
- University of Oxford, Oxford, United Kingdom
| | - S Neubauer
- University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom
| | - G P McCann
- University of Leicester, Leicester, United Kingdom
| |
Collapse
|
27
|
Besselaar AMHPVD, Rijn CJJV, Taberner DA, Goodman LJ, Poller L, Clarke K. Heat Stability of Two Candidate International Reference Preparations for Recombinant Human Tissue Factor. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1657640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryAdequate heat stability of international reference preparations (IRP) for thromboplastin (tissue factor) is an essential requirement. Accelerated degradation testing was performed by three laboratories on two candidate IRP for recombinant human tissue factor.Heat treatment of these candidates resulted in slight shortening of the PT, contrasting with heat-induced prolongation of the PT observed with a conventional human brain derived IRP.Heat stability of these candidates was improved when compared with the stability of previous recombinant human tissue factor preparations.The PT-ratio did not change significantly when the candidates were stored for 28 days at 44° C. It’ can therefore be concluded that both candidates are acceptable with regard to stability.
Collapse
Affiliation(s)
- A M H P van den Besselaar
- The Haemostasis and Thrombosis Research Centre, Department of Haematology, University Hospital Leiden, The Netherlands
| | - C J J van Rijn
- The Haemostasis and Thrombosis Research Centre, Department of Haematology, University Hospital Leiden, The Netherlands
| | - D A Taberner
- The Thrombosis Reference Centre, Withington Hospital, Manchester, UK
| | - L J Goodman
- The Thrombosis Reference Centre, Withington Hospital, Manchester, UK
| | - L Poller
- The Department of Pathological Sciences, The University of Manchester, Manchester, UK
| | - K Clarke
- The Department of Pathological Sciences, The University of Manchester, Manchester, UK
| |
Collapse
|
28
|
Abstract
Summary
Objectives: This paper aims to contribute to a longstanding interest in documents and paperwork in healthcare work through an examination of everyday work with patient records in a clinic.
Methods: An ethnographic study of record keeping practices in a deliberate self harm clinic was conducted to consider the role that document work plays in the development of trust in the routine social interactions of a working division of labor.
Results and conclusions: Issues of trust are seen to play central roles within the complexities of organizational working and some consequent implications for the deployment and use of electronic medical record systems are considered.
Collapse
|
29
|
Bissonnette JP, Yap ML, Clarke K, Shessel A, Higgins J, Vines D, Atenafu EG, Becker N, Leavens C, Bezjak A, Jaffray DA, Sun A. Serial 4DCT/4DPET imaging to predict and monitor response for locally-advanced non-small cell lung cancer chemo-radiotherapy. Radiother Oncol 2018; 126:347-354. [DOI: 10.1016/j.radonc.2017.11.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/07/2017] [Accepted: 11/27/2017] [Indexed: 12/12/2022]
|
30
|
Sun F, Coen O, Appleton E, Zeniou A, Clarke K, Franks K, Snee M, Dickinson P, Jain P. P2.08-003 An Audit of Concurrent Chemoradiotherapy for Non-Small Cell Lung Cancer at the Leeds Cancer Centre (LCC). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Coen O, El Badri S, Hatfield P, Franks K, Jain P, Snee M, Clarke K. P2.01-060 Outcomes Following Gamma Knife Radiosurgery in Patients with Non-Small Cell Lung Cancer with Brain Metastases. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
32
|
Murray P, Clarke K, Franks K, Dickinson P, Lilley J, Snee M, Jain P. P1.05-030 Lung SABR for Early Stage Lung Cancer: Outcomes and Toxicity of 803 Patients Treated at the Leeds Cancer Centre. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
33
|
Daubon T, Leon C, Clarke K, Falciani F, Bikfalvi A, Bjerkvig R. P06.08 Thrombospondin-1 is a master regulator of glioblastoma vascularization and infiltration. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
34
|
Clarke K, Hartswood M, Procter R, Rouncefield M, Slack R, Williams R. Improving ‘knife to skin time’: process modelling and new technology in medical work. Health Informatics J 2016. [DOI: 10.1177/146045820200800107] [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: 11/17/2022]
Abstract
As healthcare becomes information intensive technology increasingly plays an important role in managing patient care; information gathering and dissemination; and co-ordinating work. One approach to ensuring resources, staff and systems are allocated and used efficiently is process modelling. This paper presents some findings from the Dependability Interdisciplinary Research Collaboration (DIRC) project, on ‘process modelling’ as an aspect of managerial activity and the work involved in both creating and implementing process maps or models. Our ethnographic investigations document some of the problems in developing process maps of medical activity as part of a desire to ‘improve knife to skin time’. We suggest that process maps are not systematic, rational, scientific deductions of the most efficient process. Process maps are locally sensible versions of best practice, and problems may arise where such locally sensible versions are exported throughout an organization to other settings where other relevances may apply.
Collapse
Affiliation(s)
- K. Clarke
- CSCW Research Centre, Department of Computing, Lancaster University, UK,
| | - M. Hartswood
- Institute for Communicating and Collaborative Systems, Division of Informatics, University of Edinburgh, UK,
| | - R. Procter
- Institute for Communicating and Collaborative Systems, Division of Informatics, University of Edinburgh, UK,
| | - M. Rouncefield
- CSCW Research Centre, Department of Computing, Lancaster University, UK,
| | - R. Slack
- Institute for Communicating and Collaborative Systems, Division of Informatics, University of Edinburgh, UK
| | - R. Williams
- Institute for Communicating and Collaborative Systems, Division of Informatics, University of Edinburgh, UK
| |
Collapse
|
35
|
Murray L, Karakaya E, Hinsley S, Naisbitt M, Lilley J, Snee M, Clarke K, Musunuru HB, Ramasamy S, Turner R, Franks K. Lung stereotactic ablative radiotherapy (SABR): dosimetric considerations for chest wall toxicity. Br J Radiol 2016; 89:20150628. [PMID: 26760508 DOI: 10.1259/bjr.20150628] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate chest wall pain in patients with peripheral early stage lung cancer treated with stereotactic ablative radiotherapy (SABR), and to identify factors predictive of Common Terminology Criteria of Adverse Events Grade 2 + chest wall pain. METHODS Patients who received 55 Gy in five fractions were included. A chest wall structure was retrospectively defined on planning scans, and chest wall dosimetry and tumour-related factors recorded. Logistic regression was performed to identify factors predictive of ≥Grade 2 chest wall pain. RESULTS 182 patients and 187 tumours were included. There were 20 (10.9%) episodes of ≥Grade 2 chest wall pain. Multivariate logistic regression demonstrated that the maximum dose received by 1 cm(3) of chest wall (Dmax1 cm(3)) and tumour size were significant predictors of ≥Grade 2 chest wall pain [Dmax1 cm(3) odds ratio : 1.104, 95% confidence interval : 1.012-1.204, p = 0.025; tumour size (mm) odds ratio : 1.080, 95% confidence interval : 1.026-1.136, p = 0.003]. This model was an adequate fit to the data (Hosmer and Lemeshow test non-significant) and a fair discriminator for chest wall pain (area under receiver-operating characteristic curve: 0.74). Using the multivariate logistic regression model, parameters for Dmax1 cm(3) are provided, which predict <10% and <20% risks of ≥Grade 2 chest wall pain for different tumour sizes. CONCLUSION Grade 2+ chest wall pain is an uncommon side effect of lung SABR. Larger tumour size and increasing Dmax1 cm(3) are significant predictors of ≥Grade 2 chest wall pain. When planning lung SABR, it is prudent to try to avoid hot volumes in the chest wall, particularly for larger tumours. ADVANCES IN KNOWLEDGE This article demonstrates that Grade 2 or greater chest wall pain following lung SABR is more common when the tumour is larger in size and the Dmax1 cm(3) of the chest wall is higher. When planning lung SABR, the risk of chest wall pain may be reduced if maximum doses are minimized, particularly for larger tumours.
Collapse
Affiliation(s)
- Louise Murray
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Ebru Karakaya
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Samantha Hinsley
- 2 Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Mitchell Naisbitt
- 3 Department of Medical Physics, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - John Lilley
- 3 Department of Medical Physics, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Michael Snee
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Katy Clarke
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Hima B Musunuru
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Satiavani Ramasamy
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Rob Turner
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - Kevin Franks
- 1 Department of Clinical Oncology, St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| |
Collapse
|
36
|
Abstract
Stocks of red blood cells (RBC) are held to ideally match supply and demand; hold too great a stock and unnecessary wastage occurs; too low a stock results in delay or lack of blood for the patient. Blood is a precious resource and its supply needs to be managed effectively. The aim was to identify how RBC units are wasted and propose laboratory-based reduction measures that would not compromise the clinical requirements of the patient. Wastage of RBC was investigated using a 'dashboard' query of a laboratory information management system. By employing service improvement tools, proposals were made to reduce unnecessary RBC waste while ensuring an adequate supply to the patient. The efficacy of those proposals was examined using the same dashboard to compare similar periods before and after their introduction. The reduction in RBC wastage for all groups during an eight month period (December to July) was from 6.4% (5.3% non-AB or B RhD-positive) pre-implementation to 4.4% (2.5% non-AB/B RhD-positive) post-implementation. Group O RhD-negative wastage reduced from 10.4% to 4.4% after introduction of waste-saving proposals. However, there was an increase in staff time required to introduce the changes and in associated Group and Screen testing (3.4 to 3.8 per unit issued). RBC wastage was significantly reduced (P<0.0001) by 32.8% (52%, non-AB/B RhD-positive), saving approximately 225 RBC units per annum. Financially, increased associated costs did not negate the savings made by the measures introduced.
Collapse
|
37
|
Murray P, Spencer K, Dickinson P, Snee M, Jain P, Clarke K, Franks K. EP-1254: Updated outcomes for patients treated with SABR for lung cancer at the Leeds Cancer Centre. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
38
|
Segar J, Baker AF, MacKerricher W, Nagle R, Livingston R, Clarke K, Ley M, Viscusi R, Gonzalez V, LeBeau L, Chalasani P. Abstract P6-04-10: Clinicopathological and molecular characteristics of pleomorphic invasive lobular carcinoma of breast. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-04-10] [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: Pleomorphic invasive lobular carcinoma (PILC) is described as a distinct morphological variant of invasive lobular carcinoma (ILC) but its clinical behavior is not well characterized. PILCs have loss of E-cadherin similar to ILCs but have distinct morphological features like nuclear contour irregularity, a single prominent nucleolus, increased hyperchromasia and more frequent mitoses. In addition, some studies have reported that PILCs have acquired further molecular alterations such as gain of HER2/neu, amplification of c-myc and loss of p53. To the best of our knowledge there have been no studies evaluating Phosphoinositide 3 kinase/Akt/mammalian (or mechanistic) target of rapamycin (PI3K/Akt/mTOR) pathway in PILC. We hypothesize that there is increased activation of PI3K/Akt/mTOR pathway in PILC compared to ILC. Activation of the PI3k/Akt/mTOR pathway was evaluated by quantifying protein expression of phosphatase and tensin homolog (PTEN) and phosphorylated-S6 kinase1 (p-S6K1). PTEN is a negative regulator of the PI3K pathway and its loss/decreased expression (by mutation or allelic imbalance) activates downstream signaling. Loss (or decrease) of PTEN expression has been reported to be associated with PI3K pathway activation in more than 50% of ER+ breast tumors. Since PI3K pathway can be activated by other mechanisms in addition to PTEN loss, we hypothesized that evaluation of pS6K1 may predict activation of this pathway more than PTEN protein expression alone.
Methods: We conducted a retrospective translational study at the University of Arizona Cancer Center. Our Pathology database was searched to identify PILCs from 2012-2014. Two investigators reviewed the pathology reports independently and abstracted clinocopathological data. Formalin-fixed paraffin embedded (FFPE) primary PILCs were stained for PTEN and pS6K1 expression. Expression of PTEN and pS6K1 was quantified by long score methodology as low (≤ 10), moderate (11-50) or high (≥ 50) expression.
Results: We identified 19 patients with PILC. All tumors were either moderately (n=10) or poorly differentiated (n=9). Estrogen receptor (ER) was positive in all, progesterone receptor (PR) was positive in 11(52%) and HER2 was negative in all tumors. Proliferation index (Ki67) was elevated in all tumors (median 32%, range 20-70%). Lymph nodes were involved with metastatic carcinoma in 7 patients (negative in 9 and unknown in 3). The 21-gene recurrence score assay (Oncotype Dx) was performed in 10 patients and demonstrated higher scores (median 23, range 6-36) with the majority being in the intermediate or high range (8/10). Expression of PTEN and p-S6K1 was quantified on 10 FFPE tumor tissues. PTEN expression was high in all while pS6K1 was high in 8 and low in 2 tumors.
Conclusion: PILCs are a biologically distinct group of ILC. Clinicopathological characteristics suggest they would have a more clinically aggressive behavior (higher grade, high proliferative index and 21 gene recurrence score). In addition, our results indicate that PI3k/Akt/mTOR pathway in activated in majority of these tumors and that PTEN is not the key regulator of this pathway. Genomic profiling is currently underway to further analyze other causes of pathway activation.
Citation Format: Segar J, Baker AF, MacKerricher W, Nagle R, Livingston R, Clarke K, Ley M, Viscusi R, Gonzalez V, LeBeau L, Chalasani P. Clinicopathological and molecular characteristics of pleomorphic invasive lobular carcinoma of breast. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-04-10.
Collapse
Affiliation(s)
- J Segar
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - AF Baker
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - W MacKerricher
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - R Nagle
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - R Livingston
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - K Clarke
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - M Ley
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - R Viscusi
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - V Gonzalez
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - L LeBeau
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| | - P Chalasani
- University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ
| |
Collapse
|
39
|
Mehmood Q, Sun A, Becker N, Higgins J, Marshall A, Le LW, Vines DC, McCloskey P, Ford V, Clarke K, Yap M, Bezjak A, Bissonnette JP. Predicting Radiation Esophagitis Using 18F-FDG PET During Chemoradiotherapy for Locally Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2015; 11:213-21. [PMID: 26718880 DOI: 10.1016/j.jtho.2015.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 07/31/2015] [Revised: 10/09/2015] [Accepted: 10/10/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Treatment of locally advanced non-small cell lung cancer with chemoradiotherapy (CRT) is limited by development of toxicity in normal tissue, including radiation esophagitis (RE). Increasingly, (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is being used for adaptive planning. Our aim was to assess changes in esophageal FDG uptake during CRT and relate the changes to the onset and severity of RE. METHODS This prospective study in patients with stage II-III non-small cell lung cancer involved serial four-dimensional computed tomography and PET scans during CRT (60-74Gy). RE was recorded weekly using the Common Terminology Criteria for Adverse Events (v4.0), and imaging was performed at weeks 0, 2, 4, and 7. Changes in the esophagus's peak standard uptake value (SUVpeak) were analyzed for each time point and correlated with grade of RE using the Wilcoxon rank-sum test. The volume of esophagus receiving 50 Gy (V50) and volume of esophagus receiving 60 Gy (V60) were correlated with the development of RE, and the C-statistic (area under the curve [AUC]) was calculated to measure predictivity of grade 3 RE. RESULTS RE developed in 20 of 27 patients (74%), with grade 3 reached in 6 (22%). A significant percentage increase in SUVpeak in the patients with RE was noted at week 4 (p = 0.01) and week 7 (p = 0.03). For grade 3 RE, a significant percentage increase in SUVpeak was noted at week 2 (p = 0.01) and week 7 (p = 0.03) compared with that for less than grade 3 RE. Median V50 (46.3%) and V60 (33.4%) were significantly higher in patients with RE (p = 0.04). The AUC measurements suggested that the percentage change in SUVpeak at week 2 (AUC = 0.69) and V50 (AUC = 0.67) and V60 (AUC = 0.66) were similarly predictive of grade 3 RE. CONCLUSIONS Serial FDG-PET images during CRT show significant increases in SUVpeak for patients in whom RE develops. The changes at week 2 may predict those at risk for the development of grade 3 RE and may be informative for adaptive planning and early intervention.
Collapse
Affiliation(s)
- Qurrat Mehmood
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Alexander Sun
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada.
| | - Nathan Becker
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Jane Higgins
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Andrea Marshall
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Lisa W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Douglass C Vines
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada
| | - Paula McCloskey
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Victoria Ford
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Katy Clarke
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Mei Yap
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Andrea Bezjak
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - Jean-Pierre Bissonnette
- Princess Margaret Cancer Centre, Radiation Medicine Program, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Ontario, Canada
| |
Collapse
|
40
|
Ricciardi S, Miluzio A, Brina D, Clarke K, Bonomo M, Aiolfi R, Guidotti LG, Falciani F, Biffo S. Eukaryotic translation initiation factor 6 is a novel regulator of reactive oxygen species-dependent megakaryocyte maturation. J Thromb Haemost 2015; 13:2108-18. [PMID: 26391622 DOI: 10.1111/jth.13150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 09/05/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Ribosomopathies constitute a class of inherited disorders characterized by defects in ribosome biogenesis and function. Classically, bone marrow (BM) failure is a clinical symptom shared between these syndromes, including Shwachman-Bodian-Diamond syndrome (SBDS). Eukaryotic translation initiation factor 6 (eIF6) is a critical translation factor that rescues the quasilethal effect of the loss of the SBDS protein. OBJECTIVES To determine whether eIF6 activity is necessary for BM development. METHODS We used eIF6(+/-) mice and primary BM megakaryocytes to investigate the involvement of eIF6 in the regulation of hematopoiesis. RESULTS We provide evidence that reduced eIF6 expression negatively impacts on megakaryopoiesis. We show that inhibition of eIF6 leads to a reduction in cell size and mean ploidy level of megakaryocytes and a delay in megakaryocyte maturation by blocking the G1 /S transition. Consistent with this phenotype, only few megakaryocyte-forming proplatelets were found in eIF6(+/-) cells. We also discovered that, in eIF6(+/-) cells, the steady-state abundance of mitochondrial respiratory chain complex I-encoding mRNAs is decreased, resulting in decreased reactive oxygen species (ROS) production. Intriguingly, connectivity map analysis showed that eIF6-mediated changes overlap with specific translational inhibitors. eIF6 is a translation factor acting downstream of insulin/phorbol 12-myristate 13-acetate (PMA) stimulation. PMA treatment significantly restored eIF6(+/-) megakaryocyte maturation, indicating that activation of eIF6 is essential for the rescue of the phenotype. CONCLUSIONS Taken together, our results show a role for eIF6-driven translation in megakaryocyte development, and unveil the novel connection between translational control and ROS production in this cell subset.
Collapse
Affiliation(s)
- S Ricciardi
- Molecular Histology and Cell Growth Unit, National Institute of Molecular Genetics - INGM, 'Romeo ed Enrica Invernizzi', Milan, Italy
| | - A Miluzio
- Molecular Histology and Cell Growth Unit, National Institute of Molecular Genetics - INGM, 'Romeo ed Enrica Invernizzi', Milan, Italy
| | - D Brina
- Molecular Histology and Cell Growth Unit, National Institute of Molecular Genetics - INGM, 'Romeo ed Enrica Invernizzi', Milan, Italy
| | - K Clarke
- Centre for Computational Biology and Modeling, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - M Bonomo
- Centre for Computational Biology and Modeling, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - R Aiolfi
- Immunopathology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - L G Guidotti
- Immunopathology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - F Falciani
- Centre for Computational Biology and Modeling, Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - S Biffo
- Molecular Histology and Cell Growth Unit, National Institute of Molecular Genetics - INGM, 'Romeo ed Enrica Invernizzi', Milan, Italy
| |
Collapse
|
41
|
Murray L, Ramasamy S, Lilley J, Snee M, Clarke K, Musunuru HB, Needham A, Turner R, Sangha V, Flatley M, Franks K. Stereotactic Ablative Radiotherapy (SABR) in Patients with Medically Inoperable Peripheral Early Stage Lung Cancer: Outcomes for the First UK SABR Cohort. Clin Oncol (R Coll Radiol) 2015; 28:4-12. [PMID: 26474546 DOI: 10.1016/j.clon.2015.09.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/01/2015] [Accepted: 09/08/2015] [Indexed: 11/13/2022]
Abstract
AIMS To report outcomes for the first UK cohort treated for early stage peripheral lung cancer using stereotactic ablative radiotherapy (SABR). MATERIALS AND METHODS Patients were included who received SABR between May 2009 and May 2012. Electronic medical records were reviewed for baseline characteristics, treatment details and outcomes. Patients were treated according to the UK SABR Consortium Guidelines. Univariate and multivariate Cox regression was used to determine factors that influenced overall survival and local control. RESULTS In total, 273 patients received SABR for 288 lesions in the time period examined. The median follow-up was 19.7 months. The median overall survival for all patients was 27.3 months, with 1, 2 and 3 year overall survival of 78.0, 54.9 and 38.6%, respectively. The 1, 2 and 3 year rates of local control were 98.2, 95.7 and 95.7%, respectively. All patients completed the planned course of treatment and rates of Common Toxicity Criteria grade 3+ toxicity were low. On multivariate analysis, patients with Medical Research Council (MRC) breathlessness scores of 3-5 had worse overall survival compared with patients with scores of 1-2 (hazard ratio: 2.10; 95% confidence interval: 1.25-3.59) and the presence of histological diagnosis conferred improved overall survival (hazard ratio: 0.54; 95% confidence interval: 0.31-0.93), probably reflecting that patients who are considered well enough to undergo biopsy are generally fitter overall. No factors were identified that significantly influenced local control. CONCLUSIONS SABR is an effective and well-tolerated treatment option for patients with early stage peripheral lung cancer who are not suitable for surgery. No patient cohort was identified in whom SABR was considered inappropriate. This series adds to the existing positive data that support SABR for this patient group.
Collapse
Affiliation(s)
- L Murray
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - S Ramasamy
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - J Lilley
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - M Snee
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - K Clarke
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - H B Musunuru
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - A Needham
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - R Turner
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - V Sangha
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - M Flatley
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK
| | - K Franks
- St James's Institute of Oncology, Leeds Cancer Centre, Leeds, UK.
| |
Collapse
|
42
|
Chahal J, Chalasani P, Stopeck A, Clarke K, Livingston R. Intravenous thiotepa for treatment of leptomeningeal carcinomatosis: Retrospective case series. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv115.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
43
|
Mariño R, Clarke K, Manton DJ, Stranieri A, Collmann R, Kellet H, Borda A. Teleconsultation and Telediagnosis for Oral Health Assessment: An Australian Perspective. Health Informatics 2015. [DOI: 10.1007/978-3-319-08973-7_10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
44
|
O’Dwyer E, Ntusi N, Dorrell L, Wainwright E, Holloway C, Piechnik S, Clutton G, Hancock G, Ferrier V, Cox P, Badri M, Karamitos T, Clarke K, Neubauer S. Cardiac MRI demonstrates increased pericardial effusions and subclinical myocardial inflammation, as a potential cause for cardiac dysfunction in a contemporary cohort of patients with HIV. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
45
|
Perbellini F, Buchanan DA, Gomes RSM, Vieira S, Clarke K, Faggian G, Carr CA. P592The effect of a high fat diet on cardiac and adipose mesenchymal cells.:. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu098.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
46
|
Mansor L, Carr CA, Le Page L, Lund T, Aasum E, Clarke K, Tyler D, Heather L. P667Impaired chronic hypoxic response in type 2 diabetic hearts is associated with inability to downregulate PPARa. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu098.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
47
|
Secchi F, Cannao P, Pluchinotta F, Butera G, Carminati M, Sardanelli F, Lombardi M, Monney P, Piccini D, Rutz T, Vincenti G, Coppo S, Koestner S, Stuber M, Schwitter J, Romana P, Francesco S, Gianfranco B, Mario C, Francesco S, Massimo L, Alizadeh Sani Z, Vojdan-Parast M, Alimohammadi M, Sarafan-Sadeghi S, Seifi A, Fallahabadi H, Karami Tanha F, Jamshidi M, Hesamy M, Bonello B, Sorensen C, Fouilloux V, Gorincour G, Mace L, Fraisse A, Jacquier A, de Meester C, Amzulescu M, Bouzin C, Boileau L, Melchior J, Boulif J, Lazam S, Pasquet A, Vancrayenest D, Vanoverschelde J, Gerber B, Loudon M, Bull S, Bissell M, Joseph J, Neubauer S, Myerson S, Dorniak K, Hellmann M, Rawicz-Zegrzda D, W sierska M, Sabisz A, Szurowska E, Heiberg E, Dudziak M, Kwok T, Chin C, Dweck M, Hadamitzky M, Nadjiri J, Hendrich E, Pankalla C, Will A, Schunkert H, Martinoff S, Sonne C, Pepe A, Meloni A, Terrazzino F, Spasiano A, Filosa A, Bitti P, Tangari C, Restaino G, Resta M, Ricchi P, Meloni A, Tudisca C, Grassedonio E, Positano V, Piraino B, Romano N, Keilberg P, Midiri M, Pepe A, Meloni A, Positano V, Macchi S, Ambrosio D, De Marchi D, Chiodi E, Resta M, Salvatori C, Pepe A, Artang R, Bogachkov A, Botelho M, Bou-Ayache J, Vazquez M, Carr J, Collins J, Maret E, Ahlander B, Bjorklund P, Engvall J, Cimermancic R, Inage A, Mizuno N, Positano V, Meloni A, Santarelli M, Izzi G, Maddaloni D, De Marchi D, Salvatori C, Landini L, Pepe A, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Fraticelli V, Toia P, Renne S, Restaino G, Salvatori C, Rizzo M, Reinstadler S, Klug G, Feistritzer H, Aschauer A, Schocke M, Franz W, Metzler B, Melonil A, Positanol V, Roccamo G, Argento C, Benni M, De Marchil D, Missere M, Prezios P, Salvatoril C, Pepel A, Meloni A, Rossi G, Positano V, Cirotto C, Filati G, Toia P, Preziosi P, De Marchi D, Pepe A, Mongeon F, Fischer K, Teixeira T, Friedrich M, Marcotte F, Vincenti G, Monney P, Rutz T, Zenge M, Schmidt M, Nadar M, Chevre P, Rohner C, Schwitter J, Mouratoglou S, Kallifatidis A, Giannakoulas G, Grapsa J, Kamperidis V, Pitsiou G, Stanopoulos I, Hadjimiltiades S, Karvounis H, Ahmed N, Lawton C, Ghosh Dastidar A, Frontera A, Jackson A, Cripps T, Diab I, Duncan E, Thomas G, Bucciarelli-Ducci C, Kannoly S, Gosling O, Ninan T, Fulford J, Dalrymple-Haym M, Shore A, Bellenger N, Alegret J, Beltran R, Martin M, Mendoza M, Elisabetta C, Teresa C, Zairo F, Marcello N, Clorinda M, Bruna M, Vincenzo P, Alessia P, Giorgio B, Klug G, Feistritzer H, Reinstadler S, Mair J, Schocke M, Kremser C, Franz W, Metzler B, Aschauer S, Tufaro C, Kammerlander A, Pfaffenberger S, Marzluf B, Bonderman D, Mascherbauer J, Kliegel A, Sailer A, Brustbauer R, Sedivy R, Mayr H, Manessi M, Castelvecchio S, Votta E, Stevanella M, Menicanti L, Secchi F, Sardanelli F, Lombardi M, Redaelli A, Reiter U, Reiter G, Kovacs G, Greiser A, Olschewski H, Fuchsjager M, Kammerlander A, Tufaro C, Pfaffenberger S, Marzluf B, Aschauer S, Babayev J, Bonderman D, Mascherbauer J, Mlynarski R, Mlynarska A, Sosnowski M, Pontone G, Bertella E, Petulla M, Russo E, Innocenti E, Baggiano A, Mushtaq S, Gripari P, Andreini D, Tondo C, Nyktari E, Izgi C, Haidar S, Wage R, Keegan J, Wong T, Mohiaddin R, Durante A, Rimoldi O, Laforgia P, Gianni U, Benedetti G, Cava M, Damascelli A, Laricchia A, Ancona M, Aurelio A, Pizzetti G, Esposito A, Margonato A, Colombo A, De Cobelli F, Camici P, Zvaigzne L, Sergejenko S, Kal js O, Kannoly S, Ripley D, Swarbrick D, Gosling O, Hossain E, Chawner R, Moore J, Shore A, Bellenger N, Aquaro G, Barison A, Masci P, Todiere G, Strata E, Barison A, Di Bella G, Monasterio F, Feistritzer H, Reinstadler S, Klug G, Kremser C, Schocke M, Franz W, Metzler B, Levelt E, Mahmod M, Ntusi N, Ariga R, Upton R, Piechnick S, Francis J, Schneider J, Stoll V, Davis A, Karamitsos T, Leeson P, Holloway C, Clarke K, Neubauer S, Karwat K, Tomala M, Miszalski-Jamka K, Mrozi ska S, Kowalczyk M, Mazur W, Kereiakes D, Nessler J, Zmudka K, Ja wiec P, Miszalski-Jamka T, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ganzoui I, Ben Miled A, Mnif N, Rodriguez Palomares J, Ortiz J, Bucciarelli-Ducci C, Tejedor P, Lee D, Wu E, Bonow R, Khanji M, Castiello T, Westwood M, Petersen S, Pepe A, Meloni A, Carulli G, Oliva E, Arcioni F, Storti S, Grassedonio E, Renne S, Missere M, Positano V, Rizzo M, Meloni A, Quota A, Smacchia M, Paci C, Positano V, Vallone A, Valeri G, Chiodi E, keilberg P, Pepe A, Barison A, De Marchi D, Gargani L, Aquaro G, Guiducci S, Pugliese N, Lombardi M, Pingitore A, Cole B, Douglas H, Rodden S, Horan P, Harbinson M, Johnston N, Dixon L, Choudhary P, Hsu C, Grieve S, Semsarian C, Richmond D, Celermajer D, Puranik R, Hinojar Baydes R, Varma N, Goodman B, Khan S, Arroyo Ucar E, Dabir D, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Ucar E, Ngah N, Kuo N, D'Cruz D, Gaddum N, Schaeffter T, Nagel E, Puntmann V, Hinojar R, Foote L, Arroyo Ucar E, Dabir D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Morocutti G, Gianfagna P, Zanuttini D, Piccoli G, Proclemer A, Nucifora G, Prati G, Vitrella G, Allocca G, Buttignoni S, Muser D, Morocutti G, Delise P, Proclemer A, Sinagra G, Silva G, Almeida A, David C, Francisco A, Magalhaes A, Placido R, Menezes M, Guimaraes T, Mendes A, Nunes Diogo A, Aneq M, Maret E, Engvall J, Douglas H, Cole B, Rodden S, Horan P, Harbinson M, Dixon L, Johnston N, Papavassiliu T, Sandberg R, Schimpf R, Schoenberg S, Borggrefe M, Doesch C, Khan S, Tamin S, Tan L, Joshi S, Khan S, Memon S, Tamin S, Tan L, Joshi S, Tangcharoen T, Prasertkulchai W, Yamwong S, Sritara P, Hinojar R, Foote L, Arroyo Ucar E, Binti Ngah N, Cruz D, Schnackenburg B, Higgins D, Schaeffter T, Nagel E, Puntmann V, Nucifora G, Muser D, Masci P, Barison A, Rebellato L, Piccoli G, Daleffe E, Zanuttini D, Facchin D, Lombardi M, Proclemer A, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M, Agoston-Coldea L, Marjanovic Z, Hadj Khelifa S, Kachenoura N, Lupu S, Soulat G, Farge-Bancel D, Mousseaux E, Ben Yaacoub-Kzadri I, Harguem S, Bennaceur R, Ben Miled A, Mnif N, Dastidar A, Ahmed N, Frontera A, Lawton C, Augustine D, McAlindon E, Bucciarelli-Ducci C, Vasconcelos M, Leite S, Sousa C, Pinho T, Rangel I, Madureira A, Ramos I, Maciel M, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Todiere G, Pisciella L, Barison A, Zachara E, Federica R, Emdin M, Aquaro G, El ghannudi S, Lefoulon A, Noel E, Germain P, Doutreleau S, Jeung M, Gangi A, Roy C, Baydes R, Ucar E, Foote L, Dabir D, Mahmoud I, Jackson T, Schaeffter T, Higgins D, Nagel E, Puntmann V, Melao F, Paiva M, Pinho T, Martins E, Vasconcelos M, Madureira A, Macedo F, Ramos I, Maciel M. These abstracts have been selected for VIEWING only as ePosters and in print. ePosters will be available on Screen A & B throughout the meeting, Print Posters at the times indicated below. Please refer to the PROGRAM for more details. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
48
|
Codreanu I, Robson MD, Rider OJ, Pegg TJ, Dasanu CA, Jung BA, Rotaru N, Clarke K, Holloway CJ. Details of left ventricular radial wall motion supporting the ventricular theory of the third heart sound obtained by cardiac MR. Br J Radiol 2014; 87:20130780. [PMID: 24641347 DOI: 10.1259/bjr.20130780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Obtaining new details of radial motion of left ventricular (LV) segments using velocity-encoding cardiac MRI. METHODS Cardiac MR examinations were performed on 14 healthy volunteers aged between 19 and 26 years. Cine images for navigator-gated phase contrast velocity mapping were acquired using a black blood segmented κ-space spoiled gradient echo sequence with a temporal resolution of 13.8 ms. Peak systolic and diastolic radial velocities as well as radial velocity curves were obtained for 16 ventricular segments. RESULTS Significant differences among peak radial velocities of basal and mid-ventricular segments have been recorded. Particular patterns of segmental radial velocity curves were also noted. An additional wave of outward radial movement during the phase of rapid ventricular filling, corresponding to the expected timing of the third heart sound, appeared of particular interest. CONCLUSION The technique has allowed visualization of new details of LV radial wall motion. In particular, higher peak systolic radial velocities of anterior and inferior segments are suggestive of a relatively higher dynamics of anteroposterior vs lateral radial motion in systole. Specific patterns of radial motion of other LV segments may provide additional insights into LV mechanics. ADVANCES IN KNOWLEDGE The outward radial movement of LV segments impacted by the blood flow during rapid ventricular filling provides a potential substrate for the third heart sound. A biphasic radial expansion of the basal anteroseptal segment in early diastole is likely to be related to the simultaneous longitudinal LV displacement by the stretched great vessels following repolarization and their close apposition to this segment.
Collapse
Affiliation(s)
- I Codreanu
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Codreanu I, Robson MD, Rider OJ, Pegg TJ, Dasanu CA, Jung BA, Clarke K, Holloway CJ. Effects of ventricular insertion sites on rotational motion of left ventricular segments studied by cardiac MR. Br J Radiol 2014; 86:20130326. [PMID: 24133098 DOI: 10.1259/bjr.20130326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Obtaining new details for rotational motion of left ventricular (LV) segments using velocity encoding cardiac MR and correlating the regional motion patterns to LV insertion sites. METHODS Cardiac MR examinations were performed on 14 healthy volunteers aged between 19 and 26 years. Peak rotational velocities and circumferential velocity curves were obtained for 16 ventricular segments. RESULTS Reduced peak clockwise velocities of anteroseptal segments (i.e. Segments 2 and 8) and peak counterclockwise velocities of inferoseptal segments (i.e. Segments 3 and 9) were the most prominent findings. The observations can be attributed to the LV insertion sites into the right ventricle, limiting the clockwise rotation of anteroseptal LV segments and the counterclockwise rotation of inferoseptal segments as viewed from the apex. Relatively lower clockwise velocities of Segment 5 and counterclockwise velocities of Segment 6 were also noted, suggesting a cardiac fixation point between these two segments, which is in close proximity to the lateral LV wall. CONCLUSION Apart from showing different rotational patterns of LV base, mid ventricle and apex, the study showed significant differences in the rotational velocities of individual LV segments. Correlating regional wall motion with known orientation of myocardial aggregates has also provided new insights into the mechanisms of LV rotational motions during a cardiac cycle. ADVANCES IN KNOWLEDGE LV insertion into the right ventricle limits the clockwise rotation of anteroseptal LV segments and the counterclockwise rotation of inferoseptal segments adjacent to the ventricular insertion sites. The pattern should be differentiated from wall motion abnormalities in cardiac pathology.
Collapse
Affiliation(s)
- I Codreanu
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Cheyne L, Esterbrook G, Viadyanathan S, Milton R, Smith G, Blaxill P, Clarke K, Snee M, Franks K, Callister MEJ. S109 The introduction of stereotactic ablative radiotherapy increases overall radical treatment rates for stage I lung cancer but does not reduce surgical resection rates–a two centre study. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|