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Rigby K, Ulman J, Probst H, Jacques L, Appleyard R. CommEmorating the Last Event: calling time on the end of treatment Bell following RAdioThErapy? The CELEBRATE study. Radiography (Lond) 2024; 30:920-925. [PMID: 38631102 DOI: 10.1016/j.radi.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/05/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION In the UK it is commonplace for patients completing radiotherapy to be invited to ring a bell as a form of celebration. The project aimed to explore the experiences of the end of treatment bell from the perspective of patients who had received treatment for cancer, and therapeutic radiographers who treat patients. The study also aimed to consider possible alternative methods of commemorating the EoT, considering the needs of patients, family members and healthcare professionals. METHODS Online focus groups were held with patients (n = 5) and therapeutic radiographers (n = 4) in December 2020; a joint online event (n = 6) was held in March 2022. They were all facilitated by two members of the research team. Thematic analysis was used for data analysis. RESULTS Participants' views and experiences were mixed; however, there was a consensus that alternative forms of commemoration should be available to meet patients' diverse needs. Features of a specification were considered and suggestions made for alternative practices, with a focus upon patients' transition needs after radiotherapy has ended. CONCLUSION The results indicate that departments should consider the harms as well as the benefits conferred by the EoT bell and explore alternative ways to mark an episode of treatment. IMPLICATIONS FOR PRACTICE A one-size-fits-all approach is not appropriate in relation to marking the end of an episode of treatment.
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Affiliation(s)
- K Rigby
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Broomgrove Road, Sheffield, S10 2BP, United Kingdom. https://twitter.com/@KeeleyRosbottom
| | - J Ulman
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Broomgrove Road, Sheffield, S10 2BP, United Kingdom
| | - H Probst
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Broomgrove Road, Sheffield, S10 2BP, United Kingdom
| | - L Jacques
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Broomgrove Road, Sheffield, S10 2BP, United Kingdom
| | - R Appleyard
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Broomgrove Road, Sheffield, S10 2BP, United Kingdom
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Williams M, Cowley ES, Valley TM, Farooque A, Shultz Z, Godecker A, Askins J, Jacques L. An online alternative: a qualitative study of virtual abortion values clarification workshops. Med Educ Online 2023; 28:2258004. [PMID: 37722670 PMCID: PMC10512894 DOI: 10.1080/10872981.2023.2258004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Following the U.S. Supreme Court Dobbs decision, access to abortion education is increasingly regionally dependent. Participation in values clarification workshops on abortion can improve abortion knowledge and reduce stigma. Traditionally, values clarification workshops occur in person, yet medical education increasingly utilizes online learning. We sought to understand how a virtual platform impacted medical students and Obstetrics and Gynecology (ObGyn) residents' experience with a values clarification workshop on abortion. METHODS We conducted values clarification workshops over Zoom with medical students and ObGyn residents at four midwestern teaching hospitals from January 2021-December 2021 during the COVID-19 pandemic. We held semi-structured interviews with participants and facilitators to learn about how the virtual format impacted their experience with the workshop. Four researchers analyzed transcripts using an inductive approach to generate codes then themes. RESULTS We interviewed 24 medical students, 13 ObGyn residents, and five workshop facilitators. Participants and facilitators found the virtual platform to have both unique advantages and disadvantages. Four central themes were identified: 1) Screen as a barrier: participants noted obstacles to conversation and intimacy. 2) Emotional safety: participants felt comfortable discussing sensitive topics. 3) Ease of access: participants could access virtual workshops regardless of location. 4) Technology-specific features: Zoom features streamlined aspects of the workshop and allowed for anonymous contributions to discussion. CONCLUSIONS Our findings suggest that a virtual platform can be a convenient and effective way to deliver values clarification workshops on abortion, and this technology could be leveraged to expand access to this training in areas without trained facilitators.
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Affiliation(s)
- Margaret Williams
- Dept of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, USA
| | - Elise S. Cowley
- Microbiology Doctoral Training Program, University of Wisconsin-Madison, Madison, USA
- Dept of Bacteriology, University of Wisconsin-Madison, Madison, USA
| | - Taryn M. Valley
- Dept of Anthropology, University of Wisconsin-Madison, Madison, USA
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Alma Farooque
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Zoey Shultz
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, USA
| | - Amy Godecker
- Dept of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, USA
| | - Jacquelyn Askins
- Dept of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, USA
| | - Laura Jacques
- Dept of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, USA
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Zhu I, Miller K, Mirchia K, Payne E, Pak J, Jacques L, Braunstein SE, Pekmezci M, Liu SJ, Vasudevan H. Malignant Peripheral Nerve Sheath Tumors Activate Distinct Immunosuppressive Pathways Following Radiotherapy and are Associated with Immune Depletion In Vivo. Int J Radiat Oncol Biol Phys 2023; 117:S168. [PMID: 37784420 DOI: 10.1016/j.ijrobp.2023.06.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with neurofibromatosis type I, caused by NF1 loss, develop benign plexiform neurofibromas (pNF) in their peripheral nervous system (PNS). Malignant transformation of pNFs into malignant peripheral nerve sheath tumors (MPNSTs) occurs following CDKN2A/B and SUZ12 loss, a process associated with radiotherapy (RT). However, the molecular mechanisms underlying RT responses by different PNS cell types remain unclear. We hypothesized normal peripheral nerve cells, pNFs, and MPNSTs harbor distinct RT responses. MATERIALS/METHODS Patient derived NF1 WT immortalized peripheral nerve cells (iPNs), NF1 mutant pNF cells, and NF1/CDKN2AB/SUZ12 mutant MPNST cells were used to study RT responses in vitro. CRISPRi was used to assess the functional effects of candidate gene repression. In vitro viability was measured by cell counts. Transcriptomic signatures were measured by bulk RNA-sequencing and integrated with single-cell RNA sequencing (scRNA-seq) data from patient-derived pNF and MPNST resection specimens. RESULTS Radiation dose response curves revealed pNF cells (IC50 0.61 Gy) were more radiosensitive than MPNST cells (4.15 Gy). WT iPNs, NF1 deficient iPNs, and pNFs cells displayed no difference in cell viability (p = 0.67; t-test) following initiation of 2 Gy x 5 fractions, while MPNST cells were significantly more viable (p = 0.02; t-test). Principal component analysis of bulk RNA-sequencing data at 5 or 14 days following 2 Gy x 5 fractions revealed cell line of origin accounted for the greatest inter-sample variation (64.9% variance), with additional components separating samples based on radiation presence and timing. Using the most variable genes in PCA space to identify markers of RT response, iPNs and pNFs upregulated pro-apoptotic pathways (BAD, DAPK3) at 5 days post-radiation while MPNST cells alone upregulated pro-survival growth factor signaling). At 14 days post radiation, MPNST cells uniquely upregulated TGFβ signaling and interferon response circuits. Incorporation of scRNA-seq data revealed enrichment of growth factor signaling and TGFβ signatures in MPNSTs compared to pNF. Moreover, MPNST harbored significantly fewer immune cells than pNFs (p = 0.008, t-test), suggesting cell-autonomous signaling and crosstalk with the microenvironment are both critical to MPNST radioresistance. CONCLUSION Our data indicate additional genetic hits beyond NF1 loss may be required for RT-associated malignant transformation of pNFs and radioresistance in MPNSTs. Analysis of transcriptomic responses to RT suggests that upregulated growth factor signaling and TGFβ-associated immunosuppression are distinct features of MPNST. Future work will focus on CRISPRi screens to unbiasedly nominate functional modifiers of RT response in NF1/CDKN2AB deficient tumors, which may be broadly useful in cancer.
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Affiliation(s)
- I Zhu
- University of California, San Francisco, San Francisco, CA
| | - K Miller
- University of California, San Francisco, San Francisco, CA
| | - K Mirchia
- University of California, San Francisco, San Francisco, CA
| | - E Payne
- University of California, San Francisco, San Francisco, CA
| | - J Pak
- University of California, San Francisco, San Francisco, CA
| | - L Jacques
- University of California San Francisco, SAN FRANCISCO, CA
| | - S E Braunstein
- University of California San Francisco, Department of Radiation Oncology, San Francisco, CA
| | - M Pekmezci
- University of California San Francisco, Department of Pathology, San Francisco, CA
| | - S J Liu
- University of California San Francisco, Department of Radiation Oncology, San Francisco, CA
| | - H Vasudevan
- University of California, San Francisco, Department of Radiation Oncology, San Francisco, CA
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Lands M, Carpenter E, Valley T, Jacques L, Higgins J. "Am I the Only One Who Feels Like This?": Needs Expressed Online by Abortion Seekers. Soc Work 2023; 68:103-111. [PMID: 36795036 PMCID: PMC10074479 DOI: 10.1093/sw/swad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/13/2022] [Accepted: 05/12/2022] [Indexed: 06/18/2023]
Abstract
In the United States, abortion is safe and common, but highly stigmatized and frequently targeted by legislation that aims to restrict access. Numerous obstacles impede access to abortion care, including logistical barriers like cost and transportation, limited clinic availability, and state-mandated waiting periods. Accurate abortion information can also be hard to access. To overcome these barriers, many people seeking abortion turn to anonymous online forums, including Reddit, for information and support. Examining this community provides a unique perspective on the questions, thoughts, and needs of people considering or undergoing an abortion. The authors web scraped 250 posts from subreddits that contain abortion-related posts, then coded deidentified posts using a combined deductive/inductive approach. The authors identified a subset of these codes in which users were giving/seeking information and advice on Reddit, then engaged in a targeted analysis of the needs expressed in these posts. Three interconnected needs emerged: (1) need for information, (2) need for emotional support, and (3) need for community around the abortion experience. In this study map the authors reflected these needs onto key social work practice areas and competencies; taken alongside support from social work's governing bodies, this research suggests that social workers would be beneficial additions to the abortion care workforce.
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Affiliation(s)
- Madison Lands
- MSW, MPH, is research program manager, Collaborative for Reproductive Equity, Department of Obstetrics and Gynecology, University of Wisconsin-Madison, 1010 Mound Street, Madison, WI 75371, USA
| | - Emma Carpenter
- PhD, MSW, is postdoctoral fellow, Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Taryn Valley
- MA, is an MD-PhD student, Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Laura Jacques
- MD, is assistant professor, Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jenny Higgins
- PhD, MPH, is professor, Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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Valley TM, Zander M, Jacques L, Higgins JA. 'The Biggest Problem With Access': Provider Reports of the Effects of Wisconsin 2011 Act 217 Medication Abortion Legislation. WMJ 2023; 122:15-19. [PMID: 36940116 PMCID: PMC10149116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
BACKGROUND Abortion legislation in the United States determines people's access to services, including the abortion modality of their choice. In 2012, Wisconsin legislators passed Act 217, banning telemedicine for medication abortion and requiring the same physician to be physically present when patients signed state-mandated abortion consent forms and to administer abortion medications over 24 hours later. OBJECTIVE No research documented real-time outcomes of 2011 Act 217 in Wisconsin; this study documents providers' descriptions of the effects of Wisconsin abortion regulations on providers, patients, and abortion care in the state. METHODS We interviewed 22 Wisconsin abortion care providers (18 physicians and 4 staff members) about how Act 217 affected abortion provision. We coded transcripts using a combined deductive and inductive approach, then identified themes about how this legislation affects patients and providers. RESULTS Providers interviewed universally reported that Act 217 negatively affected abortion care, with the same-physician requirement especially increasing risk to patients and demoralizing providers. Interviewees emphasized the lack of medical need for this legislation and explained that Act 217 and the previously enacted 24-hour waiting period worked synergistically to decrease access to medication abortion, disproportionately affecting rural and low-income Wisconsinites. Finally, providers felt Wisconsin's legislative ban on telemedicine medication abortion should be lifted. CONCLUSION Wisconsin abortion providers interviewed underscored how Act 217, alongside previous regulations, limited medication abortion access in the state. This evidence helps build a case for the harmful effects of non-evidence-based abortion restrictions, which is crucial considering recent deferral to state law after the fall of Roe v Wade in 2022.
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Affiliation(s)
- Taryn M Valley
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
- Department of Anthropology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Meghan Zander
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Laura Jacques
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Jenny A Higgins
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Valley TM, Cowley ES, Farooque A, Shultz ZB, Williams M, Askins J, Godecker A, Jacques L. "We had to put ourselves in their shoes": Experiences of Medical Students and ObGyn Residents with a Values Clarification Workshop on Abortion. medRxiv 2023:2023.02.16.23286043. [PMID: 36824897 PMCID: PMC9949217 DOI: 10.1101/2023.02.16.23286043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Purpose Values clarification workshops on abortion have been shown to increase support for abortion among healthcare workers. However, few studies have examined the impact of values clarification workshops on abortion among medical trainees. This study aimed to understand medical student and obstetrics and gynecology (ObGyn) residents' experiences with a virtual values clarification workshop on abortion. Methods Clerkship year medical students and ObGyn residents at four midwestern teaching hospitals were invited to be interviewed about their experiences in a virtual values clarification workshop on abortion from January 2021 through December 2021. A single interviewer conducted interviews via Zoom using a standardized interview guide. Participants were asked to provide feedback and discuss their experiences in the workshop. Four qualitatively trained evaluators coded the interview transcripts in NVivo, using an inductive approach to establish consensus codes then themes. Results This study interviewed 37 trainees, including 24 medical students and 13 ObGyn residents, as well as five facilitators, between November 2021 and February 2022. Three themes emerged in both trainee groups. First, participants found the workshops helped trainees clarify and understand their own views on abortion through thought exploration, peer validation, and reflection on their views' potential societal impacts. Second, through the workshop, participants reflected on others' opinions on abortion and better understood the spectrum of beliefs their peers held. Finally, participants found the workshops helped them explore and develop their professional identity as physicians-in-training, through practicing communication skills and building trust and mutual respect among peers. Conclusions Medical trainees found values clarification workshops on abortion to be valuable, helping them establish their own beliefs about abortion, contextualize these beliefs among their peers', and practice professionalism. These findings indicate that values clarification workshops can play a key role in helping medical trainees discuss abortion and prepare for their professional future.
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Affiliation(s)
- Taryn M. Valley
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, 1010 Mound St., Madison, WI 53715 USA
- Department of Anthropology, University of Wisconsin-Madison, 1180 Observatory St., Madison, WI, 53706, USA
| | - Elise S. Cowley
- Department of Bacteriology, University of Wisconsin-Madison, 1550 Linden Dr., Madison, WI, 53706 USA
- Microbiology Doctoral Training Program, University of Wisconsin-Madison, 1550 Linden Dr., Madison, WI, 53706 USA
| | - Alma Farooque
- University of Wisconsin-Madison, School of Medicine and Public Health, 750 Highland Ave, Madison, WI, 53726 USA
| | - Zoey B. Shultz
- University of Wisconsin-Madison, School of Medicine and Public Health, 750 Highland Ave, Madison, WI, 53726 USA
| | - Margaret Williams
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, 1010 Mound St., Madison, WI 53715 USA
| | - Jacquelyn Askins
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, 1010 Mound St., Madison, WI 53715 USA
| | - Amy Godecker
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, 1010 Mound St., Madison, WI 53715 USA
| | - Laura Jacques
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, 1010 Mound St., Madison, WI 53715 USA
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Jacques L, Valley T, Zhao S, Rivera N, Lands M, Higgins JA. P032Covid-19 abortion experiences on reddit: A qualitative study. Contraception 2022. [PMCID: PMC9671646 DOI: 10.1016/j.contraception.2022.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Nackers K, Tatar R, Cowan E, Zakowski L, Stewart K, Ahrens S, Jacques L, Chheda S. First, do no harm: impact of the transition to an integrated curriculum on medical knowledge acquisition of the transitional cohort. Med Educ Online 2022; 27:2007561. [PMID: 34813397 PMCID: PMC8635576 DOI: 10.1080/10872981.2021.2007561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/11/2021] [Accepted: 11/14/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Many medical schools are moving toward integrated curricula in response to the 2010 Carnegie report. However, there is often apprehension that student performance on standard assessment metrics of medical knowledge acquisition could suffer during the transition period. Therefore, we sought to analyze the impact of curriculum redesign on the medical knowledge acquisition of the transitional cohort, as measured by NBME subject exam scores. METHODS The University of Wisconsin School of Medicine and Public Health Legacy curriculum followed a standard 2 + 2 medical school educational model, including traditional, department-based, third-year clinical clerkships. In the new ForWard curriculum, students enter clinical rotations one semester earlier, and those core clinical experiences are organized within four integrated blocks combining traditional clerkship specialties. This retrospective program evaluation compares NBME subject exam scores between the final cohort of Legacy third-year students (2016-17) and first cohort of ForWard students (2018) for the Adult Ambulatory Medicine, Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery exams. RESULTS NBME subject exam mean scores ranged from 75.5-79.4 for the Legacy cohort and 74.9-78.7 for the ForWard cohort, with no statistically significant differences in scores identified for each individual exam analyzed. Results remained constant when controlled for student demographic variables. DISCUSSION Faculty and students may worry about impacts to the transitional cohort during curriculum redesign, however our results suggest no substantive negative effects to acquisition of medical knowledge during transition to an integrated curriculum. Further monitoring is necessary to examine whether medical knowledge acquisition remains stable or changes after the integrated curriculum is established.
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Affiliation(s)
- Kirstin Nackers
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Eileen Cowan
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Laura Zakowski
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Katharina Stewart
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sarah Ahrens
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Laura Jacques
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Shobhina Chheda
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Cowley ES, Jacques L, Powell AM, Al-Niaimi A, Pop-Vicas A. Characterization of bacterial composition of surgical site infections after gynecologic surgery. Am J Obstet Gynecol 2022; 227:345-347. [PMID: 35248576 DOI: 10.1016/j.ajog.2022.02.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Elise S Cowley
- Department of Bacteriology, University of Wisconsin-Madison, Madison, WI; Microbiology Doctoral Training Program, University of Wisconsin-Madison, Madison, WI
| | - Laura Jacques
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
| | - Anna M Powell
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Ahmed Al-Niaimi
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Aurora Pop-Vicas
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI.
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Romano M, Alunni-Fabbroni M, Barbone G, Bartzsch S, Bouchet A, Bunk O, Dinkel J, Djonov V, Eckhardt A, Giannini C, Giese A, Hirner-Eppeneder H, Hlushchuk R, Jacques L, Laissue J, Miettinen A, Mittone A, Ricke J, Ruf V, Sancey L, Wright M, Bravin A, Coan P. Spacial Fractionation A MULTISCALE AND MULTI-TECHNIQUE APPROACH FOR THE CHARACTERIZATION OF THE EFFECTS OF SPATIALLY FRACTIONATED X-RAY FLASH IRRADIATION IN LUNGS AND BRAINS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01549-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Vasudevan H, LaStella S, Sale M, Casey-Clyde T, Lucas C, Magill S, Liu S, Chen W, Braunstein S, Reddy A, Perry A, Jacques L, Pekmezci M, Raleigh D, McCormick F. Genomic Analysis and Biochemical Investigation Reveal Mechanisms of Schwann Cell Transformation and Treatment Resistance in Malignant Peripheral Nerve Sheath Tumors (MPNSTs). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Higgins JA, Lands M, Valley T, Carpenter E, Jacques L. POSTER ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jacques L, Carpenter E, Valley T, Alvarez B, Higgins J. Medication or surgical abortion? An exploratory study of patient decision making on a popular social media platform. Am J Obstet Gynecol 2021; 225:344-347. [PMID: 34022196 DOI: 10.1016/j.ajog.2021.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/30/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Jacques
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, McConnell Hall, Fourth Floor, 1010 Mound St., Madison, WI 53715.
| | - Emma Carpenter
- Texas Policy Evaluation Project, University of Texas at Austin, Austin, TX
| | - Taryn Valley
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; Department of Anthropology, University of Wisconsin-Madison, Madison, WI
| | - Barbara Alvarez
- The Information School, University of Wisconsin-Madison, Madison, WI
| | - Jenny Higgins
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI; Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, WI
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Antony KM, Adams JH, Jacques L, Hetzel S, Chappell RJ, Gnadt SE, Tevaarwerk AJ. Lidocaine patches for postcesarean pain control in obese women: a pilot randomized controlled trial. Am J Obstet Gynecol MFM 2021; 3:100281. [DOI: 10.1016/j.ajogmf.2020.100281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023]
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Jacques L, Heinlein M, Ralph J, Pan A, Nugent M, Kaljo K, Farez R. Complication rates of dilation and evacuation and labor induction in second-trimester abortion for fetal indications: A retrospective cohort study. Contraception 2020; 102:83-86. [PMID: 32360665 DOI: 10.1016/j.contraception.2020.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To compare complication rates of dilation and evacuation (D&E) to mifepristone and misoprostol labor induction for second trimester abortion for fetal indications. STUDY DESIGN We performed a retrospective cohort study comparing complication rates with D&E and labor induction abortion for fetal indications at 14 weeks 0 days through 23 weeks and 6 days gestation between January 1, 2009, and August 31, 2017. We extracted demographic, procedural, and outcome data, focusing specifically on complications of maternal hemorrhage, infection, emergency department visit, hospital readmission, retained tissue requiring dilation and curettage (D&C), manual placental removal, or thromboembolism. We compared complication rates between the D&E and induction groups using univariate and multivariate analyses. RESULTS We included outcomes from 75 (48%) D&E and 81 (52%) labor induction abortions. We identified any complication in 1 (1%) and 7 (7%) of patients, respectively (p = 0.12). The only complication in the D&E group was hemorrhage with an estimated blood loss of 1000 mL not requiring transfusion. Labor induction complications included retained tissue requiring manual removal (n = 2) or D&C (n = 1) and hemorrhage (n = 2). CONCLUSION There was no difference in complication rates between the D&E group and the labor induction group. IMPLICATIONS This study compared outcomes between D&E and labor induction using mifepristone and misoprostol for second trimester abortion. Our complication rate for labor induction using mifepristone and misoprostol, and particularly our rate of retained placenta requiring D&C, was lower than what has been previously reported for second trimester labor induction termination using other methods. This study suggests there is a benefit for the routine use of mifepristone with misoprostol for second trimester labor induction. Additionally, the low rate of major complications in this study for both D&E and labor induction further validates the safety of both procedures for second trimester abortion.
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Affiliation(s)
- Laura Jacques
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
| | - Megan Heinlein
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Jessika Ralph
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Amy Pan
- Section of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Melodee Nugent
- Section of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Kristina Kaljo
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
| | - Rahmouna Farez
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
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Jacques L, Christophe H, Isabelle E, Laurent A, Gael G, Jean-Marc G, Sophie G, Thomas A, Alain V, Pierre C, Quero L. EP-1451 Impact of tobacco smoking on patient's outcome after (chemo)-radiotherapy for anal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31871-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mertens P, André B, Helene S, Jacques L. Treatment of neuropathic pain in patients with spinal cord lesions by intrathecal ziconotide (ITZ). Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Saintot C, André J, Hentgen C, Jacques L, Barrans A. Meningitis and septic shock caused by Streptococcus dysgalactiae subsp. equisimilis. Med Mal Infect 2018; 48:221-222. [DOI: 10.1016/j.medmal.2017.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/12/2017] [Indexed: 11/16/2022]
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Jacques L, Foeller M, Farez R, Kaljo K, Nugent M, Simpson P, Klatt T. Safety of peripherally inserted central catheters during pregnancy: a retrospective study. J Matern Fetal Neonatal Med 2017; 31:1166-1170. [PMID: 28413891 DOI: 10.1080/14767058.2017.1311314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE We investigated the incidence of complications associated with peripherally inserted central line catheters, inserted using a standardized technique, during pregnancy and the postpartum period. MATERIALS AND METHODS A retrospective case series was performed that included all pregnant and postpartum women who received peripherally inserted central catheters (PICCs) at a single institution between 2006 and 2014. Patient demographics and data on infectious, mechanical and thrombotic complications were collected. Some patients required more than one line insertion during the same pregnancy. In these instances, only the first line placement for each subject was included in the analysis of complications. RESULTS One hundred and forty-six catheters were inserted in 112 pregnant and postpartum patients. The total incidence of complications was 17% (19/112). Specific complications included infection (n = 4, 3.6%), mechanical (n = 5, 4.4%), deep venous thrombosis (n = 2, 1.8%) and other (n = 8, 7.1%). Demographics of the complication and no complication groups were similar. CONCLUSIONS In contrast with previous studies, we report a complication rate associated with peripheral line use in pregnant and postpartum women that appears similar to that in non-pregnant populations.
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Affiliation(s)
- Laura Jacques
- a Department of Obstetrics and Gynecology , Medical College of Wisconsin , Milwaukee , WI , USA
| | - Megan Foeller
- a Department of Obstetrics and Gynecology , Medical College of Wisconsin , Milwaukee , WI , USA
| | - Rahmouna Farez
- a Department of Obstetrics and Gynecology , Medical College of Wisconsin , Milwaukee , WI , USA
| | - Kristina Kaljo
- a Department of Obstetrics and Gynecology , Medical College of Wisconsin , Milwaukee , WI , USA
| | - Melodee Nugent
- b Section of Quantitative Health Sciences Department of Pediatrics , Medical College of Wisconsin, Translational and Biomedical Research Center , Children's Research Institute , Milwaukee , WI , USA
| | - Pippa Simpson
- b Section of Quantitative Health Sciences Department of Pediatrics , Medical College of Wisconsin, Translational and Biomedical Research Center , Children's Research Institute , Milwaukee , WI , USA
| | - Timothy Klatt
- a Department of Obstetrics and Gynecology , Medical College of Wisconsin , Milwaukee , WI , USA
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Jacques L, Kaljo K, Treat R, Davis J, Farez R, Lund M. Intersecting gender, evaluations, and examinations: Averting gender bias in an obstetrics and gynecology clerkship in the United States. Educ Health (Abingdon) 2016; 29:25-9. [PMID: 26996795 DOI: 10.4103/1357-6283.178926] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether gender bias was present in the final third-year medical student obstetrics/gynecology clerkship performance evaluation completed by faculty and resident physicians. METHODS This was a retrospective cohort study of third-year medical students over the course of ten years (2004 - 2014) at a private medical school in the northern US state of Wisconsin. Each student's performance during their required 6-week obstetrics/gynecology clerkship was assessed by a combination of the student's scores on a clinical performance evaluation and on a standardized national subject examination. The clinical performance evaluations are comprised of 10 domains, each using a 9-point Likert scale and completed by faculty and resident physicians. All clerkships at our institution use the same evaluation form, which was designed and validated by the medical education statistics department. Final obstetrics/gynecology clerkship average clinical evaluation scores (Scale 1-9) and obstetrics/gynecology standardized national subject examination scores (Percentile 1-99) were compared to see if a gender based difference between subject examination and performance evaluation scores existed. RESULTS 1,976 student records were analyzed. Mean standardized national subject exam scores were significantly higher for females [74.4 (8.1)] than males [72.9 (8.2)] (Possible range 1-99) with Cohen's d = 0.2 (P = 0.001). The average female score on the clinical evaluation was mean (SD) = 7.4 (0.9), compared to an average clinical evaluation score of 7.2 (1.0) for males (P = 0.001) (range 1-9). Performance on the standardized national subject exam was significantly correlated (r = 0.3, P = 0.001) with clinical evaluation scores, and when split by gender the strength of the correlation remained. DISCUSSION Medical student performance on the standardized national subject exam correlated with clinical evaluations independent of gender. Women had higher scores on both the subject examination and the clinical performance evaluations. There was no evidence of gender bias in the students' clinical evaluation scores.
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Affiliation(s)
- Laura Jacques
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Wisconsin, USA
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Ba OLV, Caremel R, Aharony S, Loutochin O, Barbe M, Jacques L, Tuite G, Ruggieri M, Campeau L, Corcos J. [Not Available]. Prog Urol 2015; 25:847. [PMID: 26544457 DOI: 10.1016/j.purol.2015.08.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - R Caremel
- Department of Urology, Lady Davis Research Institute and McGill University, Montréal, Canada
| | - S Aharony
- Department of Urology, Lady Davis Research Institute and McGill University, Montréal, Canada
| | - O Loutochin
- Department of Urology, Lady Davis Research Institute and McGill University, Montréal, Canada
| | - M Barbe
- Department of Anatomy and Cell Biology, Temple University, Philadelphia, États-Unis
| | - L Jacques
- Department of Neurosurgery, Lady Davis Research Institute and McGill University, Montréal, Canada
| | - G Tuite
- Neuroscience Institute, All Children's Hospital/Johns Hopkins Medicine, Saint Petersburg, États-Unis
| | - M Ruggieri
- Department of Pharmacology, Temple University, Philadelphia, États-Unis
| | - L Campeau
- Department of Urology, Lady Davis Research Institute and McGill University, Montréal, Canada
| | - J Corcos
- Department of Urology, Lady Davis Research Institute and McGill University, Montréal, Canada
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Biardeau X, Biardeau X, Lam van Ba O, Caremel R, Aharony S, Lotouchin O, Barbe M, Tuite G, Jacques L, Ruggieri M, Campeau L, Corcos J. [Not Available]. Prog Urol 2015; 25:847. [PMID: 26544456 DOI: 10.1016/j.purol.2015.08.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- X Biardeau
- Service d'urologie, hôpital Claude-Huriez, CHU de Lille, Lille, France
| | - X Biardeau
- Department of Urology, McGill University, Montreal, Canada
| | - O Lam van Ba
- Department of Urology, McGill University, Montreal, Canada
| | - R Caremel
- Department of Urology, McGill University, Montreal, Canada
| | - S Aharony
- Department of Urology, McGill University, Montreal, Canada
| | - O Lotouchin
- Department of Urology, McGill University, Montreal, Canada
| | - M Barbe
- Department of Anatomy and Cell Biology, Temple University, Philadelphia, États-Unis
| | - G Tuite
- Neuroscience Institute, All Children's Hospital/John Hopkins Medicine, Saint Petersburg, États-Unis
| | - L Jacques
- Department of Neurosurgery, McGill University, Montreal, Canada
| | - M Ruggieri
- Department of Anatomy and Cell Biology, Temple University, Philadelphia, États-Unis
| | - L Campeau
- Department of Urology, McGill University, Montreal, Canada
| | - J Corcos
- Department of Urology, McGill University, Montreal, Canada
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Delmotte A, Jacques L, Kumar K, Poon K, Monlezun O, Roulaud M, Prevost A, Munson R, Guetarni F, Bataille B, Rigoard P. The Franco-Canadian multicolumn spinal cord stimulation prospective study: A subgroup analysis focusing on the decisive role of lead positioning. Neurochirurgie 2015; 61 Suppl 1:S83-9. [DOI: 10.1016/j.neuchi.2014.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 06/23/2014] [Accepted: 06/29/2014] [Indexed: 11/26/2022]
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Plante C, Goudreau S, Jacques L, Tessier F. Agreement between survey data and Régie de l'assurance maladie du Québec (RAMQ) data with respect to the diagnosis of asthma and medical services use for asthma in children. ACTA ACUST UNITED AC 2014. [DOI: 10.24095/hpcdp.34.4.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction
The goal of this study was to assess the agreement between the results of a respiratory health survey conducted in Montréal on children aged 6 months to 12 years and the Régie de l'assurance maladie du Québec (RAMQ, Quebec health insurance board) database in terms of the diagnosis of asthma and medical services use. A secondary aim was to evaluate the effect of the survey method used (Internet-based survey or telephone survey).
Methods
We assessed whether a diagnosis of asthma was made for 7922 children. In addition, we compared the use of medical services for asthma (emergency department visits and hospitalizations) in the 12 months preceding the survey for the 402 children considered to have asthma, using 2 groups of respiratory diagnoses and 2 data linkage periods. The agreement between the 2 data sources was evaluated using the kappa statistic (κ) and sensitivity and specificity, as well as percentages of agreement, overreporting and under-reporting with respect to health services use.
Results
Moderate agreement was found between the 2 data sources (survey and RAMQ data) in terms of the diagnosis of asthma (κ = 0.54 and κ = 0.60 depending on the definition used). Specificity was high (93% and 96%), but sensitivity varied (50% and 65%). Respondents over-reported health services use, resulting in moderate kappa values (0.49 for emergency department visits and 0.48 for hospitalizations). However, when more diagnoses were included in the definition and when the linkage period was extended (15 rather than 12 months), the kappa values increased (0.59 for emergency department visits and 0.64 for hospitalizations) and sensitivity and specificity were high. Slightly higher agreement was obtained for the Internet-based survey relative to the telephone survey.
Conclusion
The findings validate the use of survey data with respect to the diagnosis of pediatric asthma and major health services use for this disease.
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Affiliation(s)
- C Plante
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
| | - S Goudreau
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
| | - L Jacques
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montréal, Quebec, Canada
- Clinique de médecine du travail et de l'environnement, Montreal Chest Institute and Hôpital Notre-Dame, Montréal, Quebec, Canada
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| | - F Tessier
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
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Busse WW, Bateman ED, O'Byrne PM, Lötvall J, Woodcock A, Medley H, Forth R, Jacques L. Once-daily fluticasone furoate 50 mcg in mild-to-moderate asthma: a 24-week placebo-controlled randomized trial. Allergy 2014; 69:1522-30. [PMID: 25040613 PMCID: PMC4329337 DOI: 10.1111/all.12480] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Inhaled glucocorticosteroids (ICS) are the mainstay of treatment in asthma. Fluticasone furoate (FF) is a novel, once-daily ICS asthma therapy. This study investigated the efficacy and safety of FF 50 mcg in patients with mild-to-moderate persistent asthma. METHODS A 24-week, multicenter, randomized, placebo-controlled and active-controlled, double-blind, double-dummy, parallel-group phase III study. Three hundred and fifty-one patients (aged ≥12 years; uncontrolled by non-ICS therapy) were randomized to treatment (1 : 1 : 1) with once-daily FF 50 mcg dosed in the evening, twice-daily fluticasone propionate (FP) 100 mcg or placebo. The primary endpoint was change from baseline in evening trough forced expiratory volume in 1 s (FEV1 ) at Week 24. Secondary endpoints were change from baseline in the percentage of rescue-free 24-h periods (powered endpoint), change from baseline in evening and morning peak expiratory flow, change from baseline in the percentage of symptom-free 24-h periods and number of withdrawals due to lack of efficacy. RESULTS Evening trough FEV1 at Week 24 was not statistically significantly increased with FF 50 mcg once-daily (37 ml [95% CI: -55, 128]; P = 0.430), but was with FP 100 mcg twice daily (102 ml [10, 194]; P = 0.030), vs placebo. No consistent trends were observed across other endpoints, including the powered secondary endpoint. No safety concerns were raised for either active treatment. CONCLUSIONS FP 100 mcg twice daily improved evening trough FEV1 in patients with mild-to-moderate persistent asthma, but FF 50 mcg once daily did not demonstrate a significant effect. Secondary endpoints showed variable results. No safety concerns were identified for FF or FP.
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Affiliation(s)
- W W Busse
- Department of Medicine, University of WisconsinMadison, WI, USA
| | - E D Bateman
- Department of Medicine, University of Cape TownCape Town, South Africa
| | - P M O'Byrne
- Michael G DeGroote School of MedicineHamilton, ON, Canada
| | - J Lötvall
- Krefting Research Centre, University of GothenburgGothenburg, Sweden
| | - A Woodcock
- Institute of Inflammation and Repair, University of ManchesterManchester, UK
| | - H Medley
- Respiratory Medicines Development Centre, GlaxoSmithKlineLondon, UK
| | - R Forth
- Quantitative Sciences Division, GlaxoSmithKlineResearch Triangle Park, NC, USA
| | - L Jacques
- Respiratory Medicines Development Centre, GlaxoSmithKlineLondon, UK
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Plante C, Goudreau S, Jacques L, Tessier F. Agreement between survey data and Régie de l'assurance maladie du Québec (RAMQ) data with respect to the diagnosis of asthma and medical services use for asthma in children. Chronic Dis Inj Can 2014; 34:256-262. [PMID: 25408185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The goal of this study was to assess the agreement between the results of a respiratory health survey conducted in Montréal on children aged 6 months to 12 years and the Régie de l'assurance maladie du Québec (RAMQ, Quebec health insurance board) database in terms of the diagnosis of asthma and medical services use. A secondary aim was to evaluate the effect of the survey method used (Internet-based survey or telephone survey). METHODS We assessed whether a diagnosis of asthma was made for 7922 children. In addition, we compared the use of medical services for asthma (emergency department visits and hospitalizations) in the 12 months preceding the survey for the 402 children considered to have asthma, using 2 groups of respiratory diagnoses and 2 data linkage periods. The agreement between the 2 data sources was evaluated using the kappa statistic (κ) and sensitivity and specificity, as well as percentages of agreement, overreporting and under-reporting with respect to health services use. RESULTS Moderate agreement was found between the 2 data sources (survey and RAMQ data) in terms of the diagnosis of asthma (κ = 0.54 and κ = 0.60 depending on the definition used). Specificity was high (93% and 96%), but sensitivity varied (50% and 65%). Respondents over-reported health services use, resulting in moderate kappa values (0.49 for emergency department visits and 0.48 for hospitalizations). However, when more diagnoses were included in the definition and when the linkage period was extended (15 rather than 12 months), the kappa values increased (0.59 for emergency department visits and 0.64 for hospitalizations) and sensitivity and specificity were high. Slightly higher agreement was obtained for the Internet-based survey relative to the telephone survey. CONCLUSION The findings validate the use of survey data with respect to the diagnosis of pediatric asthma and major health services use for this disease.
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Affiliation(s)
- C Plante
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
| | - S Goudreau
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
| | - L Jacques
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada; Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, Montréal, Quebec, Canada; Clinique de médecine du travail et de l'environnement, Montreal Chest Institute and Hôpital Notre-Dame, Montréal, Quebec, Canada; Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| | - F Tessier
- Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montréal, Quebec, Canada
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Jacques L, Renna T. 904 A RETROSPECTIVE STUDY OF LONG TERM CONTINUOUS INTRATHECAL INFUSIONS OF OPIOID AND/OR BUPIVACAINE IN REFRACTORY NON‐MALIGNANT PAIN. Eur J Pain 2012. [DOI: 10.1016/s1090-3801(09)60907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L. Jacques
- Montreal Neurological Institute, Montreal, Canada
| | - T. Renna
- Montreal Neurological Institute, Montreal, Canada
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Gilchrist FJ, Brady M, Gallop K, Wild DJ, Tabberer M, Jacques L, Lenney W. P79 Do children describe the benefits of inhaled asthma therapy in the same way as adults? Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Catherine DT, Corinne D, Cyrille C, Muriel R, Sandrine T, Jacques L, Veronique T, Celine C, Marie-Helene BC, Rene R. 191 Multifaceted intervention to decrease the rate of severe postpartum haemorrhage: the pithagore6 cluster-randomised controlled trial. BMJ Qual Saf 2010. [DOI: 10.1136/qshc.2010.041624.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Corinne D, Catherine D, Sandrine T, Cyrille C, Jacques L, Marie Helene BC, Rene R. 155 Clinical audit: a useful tool for severe postpartum haemorrhage? BMJ Qual Saf 2010. [DOI: 10.1136/qshc.2010.041616.1] [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: 11/04/2022]
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Al‐Jehani H, Jacques L. 844 NEUROMODULATION FOR AXIAL BACK PAIN; IS TRIPOLAR LEADS IN SPINAL CORD STIMULATION THE ANSWER? INITIAL SERIES AT A SINGLE INSTITUTION. Eur J Pain 2009. [DOI: 10.1016/s1090-3801(09)60847-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- H. Al‐Jehani
- Montreal Neurological Institute/Hospital Mcgill University, Montreal, Canada
| | - L. Jacques
- Montreal Neurological Institute/Hospital Mcgill University, Montreal, Canada
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Affiliation(s)
- S Cadell
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - G Ho
- Department of Psychology, Simon Fraser University, British Columbia, Canada
| | - L Jacques
- School of Nursing, University of British Columbia, British Columbia, Canada
| | - K Wilson
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada
| | - B Davies
- Department of Health Care Nursing, University of California, San Francisco, California, USA
| | - R Steele
- School of Nursing, York University, Toronto, Ontario, Canada
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Barnes NC, Jacques L, Goldfrad C, Bateman ED. Initiation of maintenance treatment with salmeterol/fluticasone propionate 50/100 microg bd versus fluticasone propionate 100 microg bd alone in patients with persistent asthma: integrated analysis of four randomised trials. Respir Med 2007; 101:2358-65. [PMID: 17689947 DOI: 10.1016/j.rmed.2007.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 06/04/2007] [Accepted: 06/14/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To identify the asthma patients, on short-acting beta2-agonists alone, who would benefit from initial maintenance therapy (IMT) with salmeterol/fluticasone (SFC) propionate 50/100 microg bd compared with fluticasone propionate (FP) 100 microg bd alone. The results of an integrated analysis of data from four previous trials are presented. METHODS The four original trials were randomised, double-blind, parallel group studies and included patients who had received IMT with SFC 50/100 microg bd or FP 100 microg bd. Patients were >or=12 years with a 6 month history of asthma and >or=15% reversibility in FEV1. Patients had either not received inhaled corticosteroids in the preceding month or were steroid naïve. Patients were assessed to determine whether any GINA-defined asthma characteristics or combination of asthma characteristics could predict those individuals who would achieve well controlled asthma status with IMT with SFC rather than with inhaled steroid alone. Patients with persistent asthma were assessed based on GINA-defined baseline asthma characteristics and well controlled asthma status in response to each treatment was investigated according to combinations of these baseline features. Subsequently, a further range of endpoints, including asthma symptoms, rescue medication use and asthma control, were analysed over weeks 1-12 for the combinations of features where the treatment difference in well controlled asthma status was greatest. RESULTS The results of the initial analyses demonstrated that patients exhibiting two or three features of uncontrolled asthma at baseline were more likely to achieve well controlled asthma when treated with SFC than with FP alone, the most significant difference being observed in patients with three baseline features (odds ratio 2.60, 95% CI: 1.87, 3.62, p<0.001). Patients with one baseline feature showed no difference between the FP and SFC groups. Further analyses on data from patients with two or three baseline asthma features, showed that treatment with SFC resulted in significantly greater improvements in mean morning PEF, percentage symptom-free days, nights with no awakenings and rescue-free days compared with FP. In addition, asthma control was achieved earlier in patients in the SFC group. SFC and FP were well tolerated as shown previously in the four individual trials. CONCLUSIONS Patients on short-acting beta2-agonists alone with two or three features of uncontrolled asthma (moderate to severe airflow limitation/daily symptoms/daily rescue medication use) are most likely to achieve better control, earlier, with SFC 50/100 microg bd initial maintenance treatment compared with FP 100 microg bd alone.
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Affiliation(s)
- N C Barnes
- Department of Respiratory Medicine, The London Chest Hospital, Bonner Road, London E2 9JX, UK.
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Delage R, Jacques L, Massinga-Loembe M, Poulin J, Bilodeau D, Mignault C, Leblond PF, Darveau A. Persistent polyclonal B-cell lymphocytosis: further evidence for a genetic disorder associated with B-cell abnormalities. Br J Haematol 2001; 114:666-70. [PMID: 11552996 DOI: 10.1046/j.1365-2141.2001.02975.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Persistent polyclonal B-cell lymphocytosis (PPBL) is an intriguing disorder diagnosed predominantly in women, usually cigarette smokers, characterized by an increase in the number of polyclonal B lymphocytes. Abnormality of the B-cell population is also evidenced by the presence of multiple bcl-2/Ig gene rearrangements and the finding of an additional long arm chromosome 3q+ (i3)(q10) within a significant proportion of B cells. The physiopathology of PPBL is unknown but its association with the HLA DR7 phenotype suggests a possible genetic disorder. To further determine whether PPBL has a genetic predisposition, we have undertaken an extensive study in a large family of a patient diagnosed with PPBL. Three individuals among the first-degree relatives presented all the criteria for a diagnosis of PPBL. A slight increase in serum IgM without evidence of B-cell proliferation was shown in two additional siblings. Multiple bcl-2/Ig gene rearrangements, a typical feature of PPBL, were identified in 8/10 individuals among first-degree relatives. A statistically significant association was found between the presence of these rearrangements and of a paternal HLA haplotype. We conclude that PPBL has a familial occurrence suggesting an underlying genetic defect. The development of the complete syndrome probably relies on unidentified additional co-factors.
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Affiliation(s)
- R Delage
- Centre d'Hématologie et d'Immunologie Clinique, Hôpital du St-Sacrement, Laval University, 1050 Chemin Ste-Foy, Quebec, Canada.
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Piette G, Hundt M, Jacques L, Lapointe M. Influence of extraction temperature on amounts and quality of rendered chicken fat recovered from ground or homogenized skin. Poult Sci 2001; 80:496-500. [PMID: 11297289 DOI: 10.1093/ps/80.4.496] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A study was undertaken to determine the influence of extraction process on recovery and quality of fat from chicken skin. In order to do so, 20-kg batches of skin were ground (9.5 mm plate) or homogenized in a colloidal mill (0.2-mm knife set), then heated to 50 or 80 C to rupture fat cells. The fat was recovered by centrifugation and was evaluated for composition, appearance, and stability. A maximum amount of fat (89.6% of the fat initially contained in skin) was recovered from homogenized skin heated to 80 C, whereas heating ground skin to 50 C yielded the lowest fat recovery (51.5% of skin fat content). In general, fat composition and appearance were little affected by extraction conditions, with the exception that the fat extracted from homogenized skin contained more (P < or = 0.001) unsaponifiable cell membrane constituents (0.17 to 0.20%), including antioxidant tocopherol fractions (10.3 microg/ml), than the fat extracted from ground skin (0.08% and 7.5 to 8.3 microg/ml, respectively). This difference likely contributed to the greater oxidative stability of the fat extracted from homogenized skin, which was observed in Schaal oven tests.
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Affiliation(s)
- G Piette
- Agriculture and Agri-Food Canada, Food Research and Development Centre, St-Hyacinthe, Quebec.
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Abstract
Rathke's cleft cysts are developmental abnormalities of the craniopharyngeal duct composed of retained stratified ciliated cuboidal cells of the respiratory type. Incidentally found in the pars intermedia in 13% to 33% of routine autopsies, they are discovered in growing numbers on CT and MRI scans. From 1991 to 1999, 9 cases of Rathke's cleft cysts were encountered by the senior authors, 4 of which were treated surgically (3 by using a transsphenoidal approach and one by using a transcranial subfrontal approach). Of the 3 patients treated with a transsphenoidal approach, 2 presented with symptoms mimicking sphenoid sinusitis and were initially referred for otolaryngologic evaluation. The clinical, pathologic, and radiologic features, as well as management and follow-up of those 2 patients, are reviewed. There has been only one previous case report of Rathke's cleft cysts presenting as sinusitis. Nevertheless, the otolaryngologist should be aware of this condition because it may present with other significant symptomatic extracranial extensions.
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Affiliation(s)
- R Nader
- Department of Neurosurgery, SMBD-Jewish General Hospital, McGill University, 3755 Cote Ste-Catherine, Montreal, Quebec, Canada, H3T 1E2
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Abstract
We conducted a population-based case-control study to evaluate the relation between exposure to drinking water contaminants (total and specific trihalomethanes and certain metals and nitrates) and childhood acute lymphoblastic leukemia. We compared 491 cases 0-9 years of age with 491 controls. We developed a municipality-exposure matrix based on municipal and provincial historical data, a tapwater survey in 227 homes, and information about residential history. We used average level of exposure and cumulative average over the period as exposure indices, and we measured risk for the pregnancy period as well as for the postnatal period. We show that risks were generally not increased for the prenatal period nor with average levels of exposure. Postnatal cumulative exposure for total trihalomethanes at above the 95th percentile of the distribution for cases and controls was associated with an odds ratio of 1.54 (95% confidence interval = 0.78-3.03); for that same period, risk associated with exposure to chloroform was increased (odds ratio = 1.63; 95% confidence interval = 0.84-3.19) as well as that for exposure to zinc (odds ratio = 2.48; 95% confidence interval = 0.99-6.24). Risks were also increased for exposure to cadmium and arsenic, but not for other metals nor for nitrates.
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Affiliation(s)
- C Infante-Rivard
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
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Piette G, Hundt M, Lapointe M, Jacques L. Effect of low extraction temperatures on microbiological quality of rendered chicken fat recovered from skin. Poult Sci 2000; 79:1499-502. [PMID: 11055859 DOI: 10.1093/ps/79.10.1499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Ground or finely homogenized skin, inoculated with circa 7 log10 cfu/g of an Acinetobacter sp., Brochothrix thermosphacta, Candida tropicalis, Debaryomyces hansenii, Enterobacter agglomerans, Enterococcus faecalis, a Lactobacillus sp., or Pseudomonas fluorescens, or not inoculated, was heated to 50 or 80 C to release fat from adipocytes, and the released fat was separated by centrifugation. Extraction at 80 C resulted in nearly complete inactivation of indigenous and inoculated flora, resulting in microbiological counts generally below detection level in skin residue and rendered fat. In contrast, large numbers of organisms (3.69 to 7.28 log10 cfu/g) survived the 50 C extraction process. Even though the majority (91.5 to 99.9%) of these organisms remained in the residual skin at the time of fat separation, some organisms were also found occasionally in fat at concentrations of 2.85 to 3.74 log10 cfu/g. Therefore, an additional step such as flash pasteurization is recommended for safety, should extraction temperatures below 80 C be selected.
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Affiliation(s)
- G Piette
- Agriculture and Agri-Food Canada, Food Research and Development Centre, St-Hyacinthe, Quebec.
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Saint-Amour M, Tremblay C, Jacques L, Weber JP. [Biological monitoring of exposure to polycyclic aromatic hydrocarbons among people living nearby an aluminum smelter in the province of Québec]. Rev Epidemiol Sante Publique 2000; 48:439-48. [PMID: 11084524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The objective of the study is to estimate the exposure to pyrene, an indicator of polycyclic aromatic hydrocarbons (PAHs) in the general environment, by using the internal dose of 1-hydroxypyrene (1-OHP) among people living nearby an aluminium smelter in the Montérégie area, Province of Québec, Canada. METHODS This cross-sectional study was done in November and December 1998. Participants were randomly selected according to their environmental exposure to PAHs and were distributed according to three exposure levels (high, low, none). Altogether, 121 non smokers aged between 18 to 70 years were recruited for the study. Persons occupationally exposed to PAHs or using tar-based medications were excluded. Those with personal medical conditions that affect the metabolism of pyrene were also excluded. Urine samples were taken in the morning and analysed by gas chromatography and mass spectrometry (GC-MS) to determine the concentration of the metabolite, 1-OHP. RESULTS Among the exposed group (n=78), the geometric mean of urinary concentration of 1-OHP was 0.073 micromol/mol creatinine compared to 0.060 micromol/mol creatinine for the control group (n=40). The difference did not reach statistical significance (p=0.09). Geometric means among the three groups of exposure (high, low, none) were respectively 0.079, 0.067 and 0.060 micromol/mol creatinine (p=0.13). Accounting for personal risk factors, such as diet, passive smoke, use of wood heating and time spent at home during the three days prior to urine sampling, did not change previous results. CONCLUSION This study indicates that the environmental levels of PAH produced by this factory are low and do not contribute significantly to the body burden of PAH as measured by 1-OHP.
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Affiliation(s)
- M Saint-Amour
- Direction de la santé publique de la Montérégie, 1255, rue Beauregard, Longueuil, Québec, Canada J4K 2M3
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Abstract
Recall bias is a major concern in case-control studies in which questionnaire data are used to assess past exposure. The authors conducted a validation substudy within the framework of a parent case-control study on risk factors for acute lymphoblastic leukemia in children aged < or =9 years diagnosed in 1980-1993 in Quebec, Canada. Parental recall bias for two variables was assessed: reported distance from home to power lines compared with measured distance and reported prenatal radiographic examinations compared with hospital medical record data. For reported distance, sensitivity was 62% for a subgroup of cases living in an area in which an excess of childhood acute lymphoblastic leukemia was perceived and was attributed to power lines. However, for other cases, sensitivity (35%) was similar to that measured for hospital controls (36%) and was relatively close to that for population controls (22%). Specificity was high for all groups except cases from the area with a perceived excess. Sensitivity for reported prenatal radiographic examinations was similar for cases (64%) and population controls (71%) but was lower for hospital controls (50%). Results confirm that under special circumstances, such as those resulting from enhanced public concern, parental recall can be differential but otherwise is most often nondifferential, with low sensitivity. Choosing the best type of controls to ensure comparable recall accuracy remains difficult.
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Affiliation(s)
- C Infante-Rivard
- Department of Epidemiology and Biostatistics, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
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Abstract
The bcl-2 gene belongs to a class of oncogenes involved in the inhibition of apoptosis. Most follicular lymphomas are associated with the t(14;18) translocation that juxtaposes the bcl-2 gene located on chromosome 18 to the immunoglobulin gene locus located on chromosome 14. Consequently, the bcl-2 gene is overly expressed and leads to an accumulation of mature clonal B cells. Prolonged survival of the B cell clone appears to be the early event in tumorigenesis, creating an increased risk of cumulative mutations. Interestingly, bcl-2/Ig gene rearrangements may be identified in nearly 50% of normal individuals but the outcome of normal individuals carrying high levels of t(14;18) is not well defined. Persistent polyclonal B cell lymphocytosis (PPBL) is a unique polyclonal lymphoproliferative disorder mostly restricted to women. We have recently demonstrated that PPBL is also associated with multiple bcl-2/Ig gene rearrangements. In this report, we have extended our analysis to additional patients and demonstrated that all patients presented multiple detectable t(14;18) translocated clones. In addition, Bcl-2 protein expression was increased. Our findings, along with the clinical features of PPBL, make this disorder an exceptional model for the study of B-cell homeostasis.
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MESH Headings
- Adult
- Antigens, CD19/analysis
- B-Lymphocytes/chemistry
- B-Lymphocytes/pathology
- Biomarkers
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 14/ultrastructure
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, Pair 18/ultrastructure
- Female
- Follow-Up Studies
- Gene Expression
- Genes, Immunoglobulin
- Genes, bcl-2
- HLA-DR7 Antigen/analysis
- Humans
- Lymphocytosis/genetics
- Lymphocytosis/pathology
- Lymphoproliferative Disorders/genetics
- Lymphoproliferative Disorders/pathology
- Male
- Middle Aged
- Polymerase Chain Reaction
- Proto-Oncogene Proteins c-bcl-2/biosynthesis
- Translocation, Genetic
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Affiliation(s)
- R Delage
- Centre d'hématologie et d'immunologie clinique, Hôpital du St-Sacrement, Université Laval, Ste-Foy, Québec, Canada.
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Abstract
Persistent polyclonal B-cell lymphocytosis is a benign lymphoproliferative disorder of unknown aetiology occurring exclusively in women, characterized by typical binucleated lymphocytes, polyclonal expansion of B cells and elevated serum IgM. Owing to the role of Bcl-2 oncogene in inhibition of apoptosis, we have investigated the presence of the bcl-2/Ig gene rearrangement. Bcl-2/Ig gene rearrangement was determined by polymerase chain reaction targeting the usual breakpoint regions of the t(14;18). Bcl-2/Ig gene rearrangement was identified in all six patients and, more importantly, multiple rearrangements were present in five patients. The frequency of the bcl-2/Ig gene rearrangement is estimated to be of one translocation in 1 x 10(2) to 1 x 10(3) peripheral blood mononuclear cells. We conclude that persistent polyclonal B-cell lymphocytosis is associated with bcl-2/Ig gene rearrangement. These findings are of clinical importance because these patients may be misdiagnosed as having a leukaemic expression of non-Hodgkin's lymphoma.
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Affiliation(s)
- R Delage
- Centre d'Hématologie et d'Immunologie Clinique, Hôpital du St-Sacrement, Laval University, Quebec, Ste-Foy, Canada
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Faurschou P, Steffensen I, Jacques L. Effect of addition of inhaled salmeterol to the treatment of moderate-to-severe asthmatics uncontrolled on high-dose inhaled steroids. European Respiratory Study Group. Eur Respir J 1996; 9:1885-90. [PMID: 8880107 DOI: 10.1183/09031936.96.09091885] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The aim of this study was to assess the efficacy and safety of inhaled salmeterol 100 micrograms b.d. (SM) versus inhaled salbutamol 400 micrograms q.d.s. (SB), both via the Diskhaler, when added to concurrent treatment, in asthmatic patients who were not controlled on high doses of inhaled steroids (> or = 1,500 micrograms beclomethasone dipropionate (BDP) or equivalent daily). This was a multicentre, parallel group, double-blind study in which 190 patients with a forced expiratory volume in one second (FEV1) or peak expiratory flow rate (PEFR) of 30-75% predicted and 15% reversibility to inhaled bronchodilator were randomized to treatment for 6 weeks. In the SM group, morning PEFR increased from 281 to 315 L-min-1 during treatment and in the SB group from 311 to 315 L.min-1 (p < 0.001). The SM group showed significantly better reduction in diurnal variation, from 39 to 22 L.min-1 during treatment, than the SB group (34 to 37 L.min-1) (p < 0.001). There was a significantly greater improvement in FEV1 in the SM group (from 1.63 to 1.85 L) than in the SB group (from 1.79 to 1.84 L). The SM group had significantly more symptom-free nights than the SB group (p < 0.001), and also more "rescue-free" nights (p = 0.04). The adverse event profile was similar in both groups. This study indicates that in asthmatic patients, not controlled on high-dose inhaled steroids, inhaled salmeterol 100 micrograms b.d. significantly improves lung function and reduces asthma symptoms.
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Affiliation(s)
- P Faurschou
- Dept of Pulmonary Medicine, Gentofte University Hospital, Hellerup, Denmark
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Costa Y, Mimoz O, Karim A, Cosseron M, Samii K, Jacques L. Etude comparative quantitative entre examen microscopique et culture des prélèvements pulmonaires distaux protégés. Med Mal Infect 1996. [DOI: 10.1016/s0399-077x(96)80085-0] [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: 11/25/2022]
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Altman C, Ladouch A, Briantais MJ, Rason T, Martin E, Jacques L, Buffet C. [Antral gastritis in chronic alcoholism. Role of cirrhosis and Helicobacter pylori]. Presse Med 1995; 24:708-10. [PMID: 7784401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Antral gastritis is frequent in alcoholics. The role of H. pylori in the pathogenesis of gastritis in these patients is not well known. The aim of our study was to study the role of H. pylori and cirrhosis in the pathogenesis of antral gastritis in alcoholic patients. METHODS Seventy-nine patients were included in the study. All underwent upper gastrointestinal tract endoscopy with antral biopsies, independently of the presence of abdominal pain, and had serological examination for H. pylori antibodies. RESULTS Cirrhosis and gastritis were present in 50 and 40 patients respectively, H. pylori serological assay and histological identification of the bacterium were positive in 35 (44%) and 19 (24%) patients respectively. Discrepancy between the 2 tests were observed more frequently in cirrhotic patients. A positive serology with a negative histologic examination for H. pylori was present for 18 cirrhotic and 4 noncirrhotic patients (p < 0.05). A gastritis without evidence of H. pylori was more frequent in cirrhotic than in noncirrhotic patients. H. pylori was histologically present in 11 of 29 cirrhotic patients and in 8 of the 11 noncirrhotic patients with a gastritis (p < 0.05). CONCLUSIONS Discrepancies between histological examination and H. pylori serology in patients with cirrhosis might be due to the inhospitable environment for H. pylori in case of portal hypertension; the positive serology could be in relation with a past infection.
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Affiliation(s)
- C Altman
- Service d'Hépato-Gastroentérologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre
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Feeney T, O’Muire O, Gilmartin JJ, Manning P, Sinclair H, Clancy L, O’Connell F, Springall DR, Polak JM, Thomas VE, Fuller RW, Pride NB, Lyons RA, Leonard C, Faul J, Tormey VJ, Poulter LW, Burke CM, Pathmakanthan S, Barry MC, Wang JH, Kelly CJ, Burke PE, Sheehan SJ, Redmond HP, Bouchier-Hayes D, Abdih H, Watson RWG, Burke P, Egan JJ, Barber L, Lomax J, Fox A, Craske J, Yonan N, Rahman AN, Deiraniya AK, Carroll KB, Turner A, Woodcock AA, McNeill K, Bookless B, Gould K, Corris P, Higgenbottam T, Webb A, Woodcock A, McManus K, Miller D, Allen M, Ilstrup D, Deschamps C, Trastek V, Pairolero P, Cotter TP, Vaughan C, Kealy WP, Duggan PF, Curtain A, Bredin CP, Waite A, Maguire CP, Ryan J, O’Neill D, Coakley D, Walsh JB, Kilgallen I, O’Neill S, Ryan M, O’Connor CM, McDonnell T, Lowry RC, Buick JB, Magee TRA, O’Riordan D, Hayes J, O’Connor C, FitzGerald MX, Cosgrave C, Costello C, Deegan PC, McNicholas WT, Nugent AM, Lyons J, Gleadhill I, MacMahon J, Stevenson EC, Heaney LG, Shields MD, Cadden IS, Taylor R, Ennis M, Kharitonov SA, O’Connor J, Owens WA, O’Kane H, Cleland J, Gladstone DJ, Sarsam M, Graham ANJ, Anikin V, McGuigan JA, Curry RC, Varghese G, Keelan P, Rutherford R, O’Keeffe D, McCarthy P, Gilmartin JJ, Moore H, Balbernie E, Gilmartin JJ, Coakley R, Keane M, Costello R, Byrne P, McKeogh D, McLoughlin P, Finlay G, Concannon D, McKeown D, Kelly P, Tanner WA, Bouchier-Hayes DJ, Arumugasamy M, Yacoub K, O’Leary G, Stokes K, Geraghty J, Osborne H, O’Dwyer R, Gilliland R, Saleem SM, Aherne T, Power CK, Burke CH, Byrne A, Murphy JFA, Sharkey R, Mulloy E, Sharkey K, Long M, Birchall MA, Moorat A, Henderson J, Jacques L, Cahill P, Condron C, Royston D, Murphy J, Neill SO. Irish Thoracic Society. Ir J Med Sci 1995. [DOI: 10.1007/bf02973289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Benoît G, Yataghene Y, Bensadoun H, Costa Y, Blanchet P, el Helali N, Rason T, Jacques L, Blery M, Merrand S. [Acute pyelonephritis in women. Short-term hospitalization]. Presse Med 1993; 22:1724-8. [PMID: 8302777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
One-hundred women suffering from acute pyelonephritis were hospitalized for less than 4 days on average, in order to make a diagnosis based on bacteriology and computerized tomography (CT) and to bring fever down with a 21-day antibiotic therapy. In cases of acute pyelonephritis due to a urinary tract obstacle, endoscopic uereteral drainage was added to the antibiotic treatment. In the absence of obstacle, medical treatment was sufficient to obtain apyrexia. Fluoroquinolone therapy made it possible to reduce the hospital stay to 2 or 3 days, depending on whether the lesions observed at CT were triangular or round.
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Affiliation(s)
- G Benoît
- Service d'Urologie, Hôpital de Bicêtre, Université Paris-Sud, Le Kremlin-Bicêtre
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Monard A, Benoit G, Jacques L, Jardin A. [Frequency of adherent colibacillus in a population with acute pyelonephritis and a population with acute cystitis]. Prog Urol 1993; 3:583-9. [PMID: 8104638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Urothelial adhesion of Escherichia coli is one of the principal factors of colonisation and infection of the upper urinary tract. We compared 3 measurements of bacterial adhesion: 1) Mannose-Resistant Haemagglutination (MRHA), é) Adhesion to urothelial cells, 3) Latex particle agglutination, to test 85 strains of Escherichia coli in 42 cases of acute pyelonephritis and 43 cases of acute cystitis. These tests were positive in 73.8% to 85.7% of the acute pyelonephritis population and in 4% to 2.3% of the acute cystitis population (statistically significant difference). This study confirms the major role of strains carrying type PAP adhesion in the pathogenesis of acute pyelonephritis.
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Affiliation(s)
- A Monard
- Service de Bactériologie, Hôpital de Bicêtre, Université Paris-Sud
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49
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Novello P, Hagège H, Ducreux M, Buffet C, Choury A, Fritsch J, Liguory C, Jacques L, Etienne JP. [Septicemias after endoscopic retrograde cholangiopancreatography. Risk factors and antibiotic prophylaxis]. Gastroenterol Clin Biol 1993; 17:897-902. [PMID: 8125221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The infection following endoscopic retrograde cholangiopancreatography (ERCP) is one of the most severe complications. The aim of the present study was to assess the prevalence and the prognosis of this complication, to look for the risk factors and to define bacterial ecology in order to put forward the most appropriate antibiotherapy. Two thousand and ten patients were included in this study. Among these, 51 (2.5%) had a septic complication following ERCP. Endoscopy biliary drainage was complete in 24 cases, incomplete in 19 and lacking in 8. Transhepatic biliary drainage was carried out in 17 cases. Sixteen patients (31%) with tumor obstructions died within 30 days after ERCP. Four risk factors were isolated when comparing infected patients with other patients: the completeness of biliary obstruction (90 vs 48%, P < 0.001); multiple cannulation attempts (1.76 +/- 1.12 vs 1.25 +/- 0.70, P < 0.001); the malignant nature of the obstruction (80 vs 23%, P < 0.002) and the lack of satisfactory drainage following endoscopy (53 vs 23%, P = 0.009). Pseudomonas aeruginosa was the most frequently isolated species, both from blood cultures (30%) and bile samples (23%). The preventive therapy of septic complications following ERCP must include strict rules concerning the disinfection of endoscopic material.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Novello
- Service des Maladies du Foie et de l'Appareil Digestif, Universitaire de Bicêtre, Le Kremlin-Bicêtre
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Auroux MR, Jacques L, Mathieu D, Auer J. Is the sperm bacterial ratio a determining factor in impairment of sperm motility: an in-vitro study in man with Escherichia coli. Int J Androl 1991; 14:264-70. [PMID: 1831799 DOI: 10.1111/j.1365-2605.1991.tb01091.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The effects of urogenital infection on male fertility are controversial. The object of this study was to assess whether contact between E. coli, one of the bacteria encountered most frequently in semen cultures, and sperm was involved in decreasing motility of the sperm. Sperm from healthy donors were therefore incubated at two concentrations (1.10(7) and 4.10(7) ml-1) with bacteria (10(4) and 10(6) bacteria ml-1 respectively). Sperm motility was assessed as a function of time. The endotoxin effect was also evaluated. Aliquots of the sperm were used as controls. The motility of a population of 10(6) sperm ml-1 was reduced significantly more by the presence of 10(6) ml-1 E. coli than a sperm population four times more numerous. Since the endotoxin had no effect on sperm motility, it is possible this phenomenon is due to bacterial adherence to the sperm. From this study, it is therefore probable that the presence of E. coli in semen decreases sperm motility, but that this depends on the sperm:bacterial ratio ml semen-1.
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Affiliation(s)
- M R Auroux
- Biologie de la Reproduction et du Développement, CHU Bicêtre, Le Kremlin Bicetre, France
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