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Bretault M, Hage M. [Medical therapy of obesity in France in 2021]. Rev Med Interne 2021; 42:519-522. [PMID: 34215456 DOI: 10.1016/j.revmed.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- M Bretault
- Service d'endrocrinologie, diabétologie, nutrition, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris (AP-HP), 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France.
| | - M Hage
- Service d'endrocrinologie, diabétologie, nutrition, hôpital Ambroise-Paré, Assistance publique-Hôpitaux de Paris (AP-HP), 9, avenue Charles-de-Gaulle, 92100 Boulogne-Billancourt, France
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Mathkour M, Michael A, Scullen T, Carsky K, Hage M, Werner C, Carr C, Keen JR, Ware ML. Symptomatic xanthogranuloma of the lateral ventricle in a pregnant patient treated with delayed resection: A case report and systematic review. Clin Neurol Neurosurg 2020; 198:106143. [PMID: 32810760 DOI: 10.1016/j.clineuro.2020.106143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
Intracranial xanthogranulomas (XG) are a rare benign histiocytic neoplasm and most often within the choroid. The majority are asymptomatic and are found incidentally on imaging or post-mortem examination or autopsy. We present a case of symptomatic XG in a pregnant patient who underwent a delayed transcortical, transventricular approach for lateral ventricle XG resection following the completion of her pregnancy. Four years post-operatively, the patient is neurologically intact and without recurrence. Our review of the literature showed differences among XG depending on location. The clinical and radiological features of XG are often indistinguishable from tumors arising from the choroid plexus and should be considered as a rare etiology in the differential of newly diagnosed intraventricular lesions.
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Affiliation(s)
- Mansour Mathkour
- Ochsner Medical Center, Department of Neurosurgery, New Orleans, United States; Tulane University, School of Medicine, New Orleans, United States.
| | - Abenet Michael
- Tulane University, School of Medicine, New Orleans, United States.
| | - Tyler Scullen
- Ochsner Medical Center, Department of Neurosurgery, New Orleans, United States; Tulane University, School of Medicine, New Orleans, United States.
| | - Katherine Carsky
- Tulane University, School of Medicine, New Orleans, United States.
| | - Madeleine Hage
- Tulane University, School of Medicine, New Orleans, United States.
| | - Cassidy Werner
- Tulane University, School of Medicine, New Orleans, United States.
| | - Christopher Carr
- Ochsner Medical Center, Department of Neurosurgery, New Orleans, United States; Tulane University, School of Medicine, New Orleans, United States.
| | - Joseph R Keen
- Ochsner Medical Center, Department of Neurosurgery, New Orleans, United States.
| | - Marcus L Ware
- Ochsner Medical Center, Department of Neurosurgery, New Orleans, United States.
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Mellion M, Ronco L, Thompson D, Hage M, Brooks S, van Brummelen E, Pagan L, Badrising U, Van Engelen B, Groeneveld G, Cadavid D. O.25Phase 1 clinical trial of losmapimod in FSHD: safety, tolerability and target engagement. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Thacher JD, Gruzieva O, Pershagen G, Neuman Å, Hage M, Wickman M, Kull I, Melén E, Bergström A. Parental smoking and development of allergic sensitization from birth to adolescence. Allergy 2016; 71:239-48. [PMID: 26475651 PMCID: PMC5063181 DOI: 10.1111/all.12792] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 11/27/2022]
Abstract
Background The relation between secondhand tobacco smoke (SHS) exposure and the development of allergic sensitization in children is unclear. The aim of this study was to determine whether maternal smoking during pregnancy and postnatal SHS exposure contributes to the development of allergic sensitization in children and adolescents up to 16 years of age. Methods We included 3316 children from a birth cohort followed up for 16 years. SHS exposure and symptoms of allergic disease were assessed using repeated parental questionnaires. Serum immunoglobulin E against eight common inhalant and six food allergens was assessed at ages 4, 8, and 16 years with ImmunoCAP. The association between SHS exposure and sensitization was explored using logistic regression and generalized estimating equations. Results Exposure to SHS in infancy without prior exposure in utero was associated with an excess risk of food sensitization at age 4 years (OR 1.47, 95% CI 1.08–2.00), with comparable ORs at ages 8 and 16 years. In longitudinal analyses, an overall association was indicated between SHS in infancy and food sensitization up to age 16 years (OR 1.24, 95% CI 0.98–1.56). Maternal smoking during pregnancy was unrelated to sensitization up to 16 years of age. When sensitization was combined with concurrent symptoms of allergic disease, SHS in infancy was associated with an overall elevated risk of eczema with sensitization (OR 1.62, 95% CI 1.20–2.18). Conclusions SHS exposure in infancy appears to increase the risk of sensitization to food allergens up to age 16 years, as well as eczema in combination with sensitization.
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Affiliation(s)
- J. D. Thacher
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - O. Gruzieva
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - G. Pershagen
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Centre for Occupational and Environmental Medicine Stockholm County Council Stockholm Sweden
| | - Å. Neuman
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Department of Women's and Children's Health Uppsala University Hospital Uppsala Sweden
| | - M. Hage
- Clinical Immunology and Allergy Unit Department of Medicine Solna Karolinska Institutet and University Hospital Stockholm Sweden
| | - M. Wickman
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Sachs’ Children's Hospital Södersjukhuset Stockholm Sweden
| | - I. Kull
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Sachs’ Children's Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Science and Education Karolinska Institutet at Södersjukhuset Stockholm Sweden
| | - E. Melén
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Sachs’ Children's Hospital Södersjukhuset Stockholm Sweden
| | - A. Bergström
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
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Colombo NBR, Rangel MP, Martins V, Hage M, Gelain DP, Barbeiro DF, Grisolia CK, Parra ER, Capelozzi VL. Caryocar brasiliense camb protects against genomic and oxidative damage in urethane-induced lung carcinogenesis. ACTA ACUST UNITED AC 2015. [PMID: 26200231 PMCID: PMC4568814 DOI: 10.1590/1414-431x20154467] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The antioxidant effects of Caryocar brasiliense Camb, commonly known
as the pequi fruit, have not been evaluated to determine their protective effects
against oxidative damage in lung carcinogenesis. In the present study, we evaluated
the role of pequi fruit against urethane-induced DNA damage and oxidative stress in
forty 8-12 week old male BALB/C mice. An in vivo comet assay was
performed to assess DNA damage in lung tissues and changes in lipid peroxidation and
redox cycle antioxidants were monitored for oxidative stress. Prior supplementation
with pequi oil or its extract (15 µL, 60 days) significantly reduced urethane-induced
oxidative stress. A protective effect against DNA damage was associated with the
modulation of lipid peroxidation and low protein and gene expression of nitric oxide
synthase. These findings suggest that the intake of pequi fruit might protect against
in vivo genotoxicity and oxidative stress.
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Affiliation(s)
- N B R Colombo
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
| | - M P Rangel
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
| | - V Martins
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
| | - M Hage
- Laboratório de Poluição Atmosférica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
| | - D P Gelain
- Departamento de Stress Oxidativo, Universidade do Rio Grande do Sul, Rio Grande do Sul, RS, BR
| | - D F Barbeiro
- Departamento de Emergência Clínica, Universidade de São Paulo, São Paulo, SP, BR
| | - C K Grisolia
- Departamento de Genética e Morfologia, Universidade de Brasília, Brasília, DF, BR
| | - E R Parra
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
| | - V L Capelozzi
- Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR
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Koopman T, Smits MM, Louwen M, Hage M, Boot H, Imholz ALT. HER2 positivity in gastric and esophageal adenocarcinoma: clinicopathological analysis and comparison. J Cancer Res Clin Oncol 2014; 141:1343-51. [PMID: 25544671 DOI: 10.1007/s00432-014-1900-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 12/18/2014] [Indexed: 12/13/2022]
Abstract
PURPOSE Primary tumor classification of gastric or esophageal cancer has changed significantly with recent alterations of the tumor-node-metastasis (TNM) staging system. Considering these alterations, human epidermal growth factor receptor 2 (HER2) positivity rates were determined and compared in gastric and esophageal adenocarcinoma. Additionally, HER2 positivity in relation to other clinicopathological characteristics was evaluated. METHODS A total of 321 patients with histologically confirmed invasive gastric or esophageal adenocarcinoma were examined for HER2 by immunohistochemy (IHC) and chromogenic in situ hybridization (CISH). IHC 3+ or IHC 2+/CISH-positive tumors were considered HER2 positive. Clinicopathological characteristics were retrospectively retrieved from the patient records. RESULTS HER2 positivity was found in 50 of 321 patients (15.6 %). In univariate and multivariate logistic models, HER2 positivity rates were significantly higher in esophageal primary tumors (esophageal 25.0 % vs. gastric 7.4 %) and in intestinal histological tumor type (intestinal 22.6 % vs. diffuse/mixed 5.7 %). No significant differences in HER2 positivity were found between males and females, age below and above 65 years, biopsies and surgical specimens or advanced and early-stage disease. Using the 7th TNM edition, many tumors (30.5 % of all included tumors and 64.5 % of all esophageal primary tumors) previously classified as gastric cancer are now classified as esophageal cancer. CONCLUSIONS HER2 positivity occurs in 15.6 % of invasive gastroesophageal adenocarcinoma in Western patients, of which the majority is esophageal primary tumors and of the intestinal tumor type. With the introduction of the 7th TNM edition, a large number of tumors previously classified as gastric are now classified as esophageal tumors instead, with relatively high HER2 positivity rates in these esophageal primary tumors.
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Affiliation(s)
- T Koopman
- Department of Medical Oncology, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands
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8
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Polovic N, Wadén K, Binnmyr J, Hamsten C, Grönneberg R, Palmberg C, Milcic‐Matic N, Bergman T, Grönlund H, Hage M. Dog saliva - an important source of dog allergens. Allergy 2013; 68:585-92. [PMID: 23464525 PMCID: PMC3652036 DOI: 10.1111/all.12130] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Allergy to dog (Canis familiaris) is a worldwide common cause of asthma and allergic rhinitis. However, dander extract in routine diagnostics is not an optimal predictor of IgE-mediated dog allergy. Our objective was to evaluate saliva as an allergen source for improved diagnostics of allergy to dog. METHODS IgE-binding proteins in dog saliva and dander extract were analysed by immunoblot and mass spectrometry (LC-MS/MS) using pooled or individual sera from dog-allergic patients (n = 13). Sera from 59 patients IgE positive to dander and 55 patients IgE negative to dander but with symptoms to dog were analysed for IgE against saliva and dander by ELISA. Basophil stimulation with dog saliva and dander extract was measured by flow cytometry among three dog-allergic patients. Additionally, IgE-binding protein profiles of saliva from different breeds were investigated by immunoblot. RESULTS Greater number and diversity of IgE-binding proteins was found in saliva compared to dander extract and varied among dog breeds. In saliva, Can f 1, 2, 3 and 6 were identified but also four new saliva allergen candidates. The majority of the 59 dog dander-positive sera (n = 44) were IgE positive to dog saliva. Among patients IgE negative to dander, but with symptoms to dog, 20% were IgE positive to saliva. The biological activity of saliva was confirmed by basophil degranulation. CONCLUSIONS Dog saliva is an allergen source for improved diagnostics of dog allergy. The IgE-binding protein profile of saliva from different dogs varies.
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Affiliation(s)
- N. Polovic
- Department of Medicine Solna, Clinical Immunology and Allergy Unit Karolinska Institutet Stockholm Sweden
- Department of Biochemistry Faculty of Chemistry University of Belgrade Belgrade Serbia
| | - K. Wadén
- Department of Medicine Solna, Clinical Immunology and Allergy Unit Karolinska Institutet Stockholm Sweden
| | - J. Binnmyr
- Department of Medicine Solna, Clinical Immunology and Allergy Unit Karolinska Institutet Stockholm Sweden
| | - C. Hamsten
- Department of Medicine Solna, Clinical Immunology and Allergy Unit Karolinska Institutet Stockholm Sweden
- Center for Inflammatory Diseases Karolinska Institutet StockholmSweden
| | - R. Grönneberg
- Department of Medicine Solna, Respiratory Medicine Unit Karolinska Institutet StockholmSweden
| | - C. Palmberg
- Department of Medical Biochemistry and Biophysics Karolinska Institutet Stockholm Sweden
| | - N. Milcic‐Matic
- Department of Dermatology Faculty of Veterinary Medicine University of Belgrade Belgrade Serbia
| | - T. Bergman
- Department of Medical Biochemistry and Biophysics Karolinska Institutet Stockholm Sweden
| | - H. Grönlund
- Department of Medicine Solna, Clinical Immunology and Allergy Unit Karolinska Institutet Stockholm Sweden
- Department of Clinical Neuroscience Therapeutic Immune Design Unit Karolinska Institutet Stockholm Sweden
| | - M. Hage
- Department of Medicine Solna, Clinical Immunology and Allergy Unit Karolinska Institutet Stockholm Sweden
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Kassab A, Hage M, Jabbur SJ, Chidiac JJ. Modified technique for the exposure of the inferior alveolar nerve in rats. J Pharmacol Toxicol Methods 2013; 67:182-6. [PMID: 23337246 DOI: 10.1016/j.vascn.2013.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 01/08/2013] [Accepted: 01/09/2013] [Indexed: 11/28/2022]
Abstract
The inferior alveolar nerve (IAN), a branch of the mandibular division of the trigeminal nerve, is a major component of the neurovascular bundle along with the inferior alveolar artery and vein. In rats, when exposed using an external oral approach while remaining intact, it can serve as an important tool to study the different effects of neuromediators and assess the role of different groups of nerve fibers. This paper describes a new technique to expose this nerve giving some experimental results to support its usefulness.
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Affiliation(s)
- A Kassab
- Department of Anatomy, Cell Biology and Physiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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10
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Pires A, Pieri P, Hage M, Santos ABG, Medeiros MCR, Garcia RCT, Yonamine M, Hallak J, Saldiva PHN, Zorzetto J, Bueno HMS. Repeated inhalation of crack-cocaine affects spermatogenesis in young and adult mice. Inhal Toxicol 2012; 24:439-46. [DOI: 10.3109/08958378.2012.684450] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- A. Pires
- Reproductive Toxicology Unit, Experimental Air Pollution Laboratory, São Paulo University Medical School,
São Paulo, SP, Brazil
- National Institute for Integrated Analysis of Environmental Risk (INAIRA), Brazil
| | - P. Pieri
- Reproductive Toxicology Unit, Experimental Air Pollution Laboratory, São Paulo University Medical School,
São Paulo, SP, Brazil
- Section of Andrology, Division of Urology, São Paulo University Medical School,
São Paulo, SP, Brazil
| | - M. Hage
- Reproductive Toxicology Unit, Experimental Air Pollution Laboratory, São Paulo University Medical School,
São Paulo, SP, Brazil
| | - A. B. G. Santos
- Imunohistochemistry Laboratory, Department of Pathology, São Paulo University Medical School,
São Paulo, SP, Brazil
| | - M. C. R. Medeiros
- Imunohistochemistry Laboratory, Department of Pathology, São Paulo University Medical School,
São Paulo, SP, Brazil
| | - R. C. T. Garcia
- Department of Clinical and Toxicological Analyses, Faculty of Pharmaceutical Sciences, São Paulo University,
São Paulo, SP, Brazil
| | - M. Yonamine
- Department of Clinical and Toxicological Analyses, Faculty of Pharmaceutical Sciences, São Paulo University,
São Paulo, SP, Brazil
| | - J. Hallak
- Reproductive Toxicology Unit, Experimental Air Pollution Laboratory, São Paulo University Medical School,
São Paulo, SP, Brazil
- Section of Andrology, Division of Urology, São Paulo University Medical School,
São Paulo, SP, Brazil
| | - P. H. N. Saldiva
- Reproductive Toxicology Unit, Experimental Air Pollution Laboratory, São Paulo University Medical School,
São Paulo, SP, Brazil
- National Institute for Integrated Analysis of Environmental Risk (INAIRA), Brazil
| | - J.C. Zorzetto
- Medical and Health School of the University of Marilia,
Marilia, SP, Brazil
| | - H. M. S. Bueno
- Reproductive Toxicology Unit, Experimental Air Pollution Laboratory, São Paulo University Medical School,
São Paulo, SP, Brazil
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Ferreira SC, Toledo AC, Hage M, Santos ABG, Medeiros MCR, Martins MA, Carvalho CRF, Dolhnikoff M, Vieira RP. Creatine activates airway epithelium in asthma. Int J Sports Med 2010; 31:906-12. [PMID: 21072743 DOI: 10.1055/s-0030-1267160] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Airway epithelium plays important roles in the pathophysiology of asthma. Creatine supplementation (Cr) was shown to increase asthma features in a murine model of allergic asthma; however, the role of the airway epithelium in this inflammatory response is not known. BALB/c mice were divided into control, creatine supplementation, ovalbumin-sensitized (OVA) and OVA plus creatine supplementation groups. OVA sensitization occurred on days 0, 14, 28 and 42, and ovalbumin challenge from days 21-53. Cr was also given on days 21-53. Total and differential cells counts in BALF were evaluated. Quantitative epithelial expression of interleukin (IL)-4, IL-5, IL-13, CCL11, CCL5, CCL2, iNOS, VCAM-1, ICAM-1, NF-κB, VEGF, TGF-β, IGF-1, EGFR, TIMP-1, TIMP-2, MMP-9, MMP-12 and arginase II were performed. Cr increased the number of total cells and eosinophils in BALF, the epithelial content of goblet cells and the epithelial expression of IL-5, CCL2, iNOS, ICAM-1, NF-κB, TGF-β, TIMP-1 and MMP-9 when compared to the control group (p<0.05). Creatine supplementation also exacerbated goblet cell proliferation, and IL-5 and iNOS expression by epithelial cells compared to the OVA group (p<0.01). Creatine up-regulates the pro-inflammatory cascade and remodelling process in this asthma model by modulating the expression of inflammatory mediators by epithelial cells.
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Affiliation(s)
- S C Ferreira
- University of Sao Paulo, Pathology (LIM 05), Sao Paulo, Brazil
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12
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Hage M, Siersema PD, van Dekken H, Steyerberg EW, Dees J, Kuipers EJ. Oesophageal cancer incidence and mortality in patients with long-segment Barrett's oesophagus after a mean follow-up of 12.7 years. Scand J Gastroenterol 2004; 39:1175-9. [PMID: 15742992 DOI: 10.1080/00365520410003524] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Data on cancer risk in patients with long-segment Barrett's oesophagus (BO) from older studies are often difficult to interpret, since the definition of BO has evolved from an endoscopical to a histological diagnosis. In this work the diagnoses in the Rotterdam BO cohort on current standards was redefined to obtain more accurate data on cancer risk in patients who had not undergone standard endoscopic surveillance. In addition, it was determined which patient factors present at index endoscopy were associated with neoplastic progression in BO. METHODS The Rotterdam BO cohort comprises all patients with > or =3 cm BO, diagnosed at endoscopy between 1973 and 1984. In the present study, only patients with intestinal metaplasia were included (n = 105). Follow-up data were obtained by questionnaires and/or interviews with patients or treating physicians. A Kaplan-Meier analysis was used to estimate 20-year risks. RESULTS The mean length of the BO was 7.1 cm (range: 3-15 cm). Cancer in BO developed in 6/105 (6%) patients, and high-grade dysplasia (HGD) in 5/105 (5%) patients during 1329 patient-years of follow-up, which equals one cancer case per 221 patient-years and one HGD case per 266 patient-years. After a mean follow-up of 12.7 years, 72 (69%) patients had died; only 4 of them died of oesophageal cancer or its treatment. A longer length of BO was associated with an increased risk of progression to HGD or cancer (P < 0.02). Six of 24 patients who ever had low-grade dysplasia progressed to HGD or cancer 2-16 years after a diagnosis of BO. CONCLUSIONS The annual risk of developing HGD or adenocarcinoma in patients with long-segment BO is 0.83%. Death due to adenocarcinoma is, however, uncommon, even in a cohort of patients with long-segment BO.
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Affiliation(s)
- M Hage
- Depts of Gastroenterology and Hepatology, Pathology and Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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13
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Hage M, Siersema PD, van Dekken H, Steyerberg EW, Haringsma J, van de Vrie W, Grool TE, van Veen RLP, Sterenborg HJCM, Kuipers EJ. 5-aminolevulinic acid photodynamic therapy versus argon plasma coagulation for ablation of Barrett's oesophagus: a randomised trial. Gut 2004; 53:785-90. [PMID: 15138203 PMCID: PMC1774080 DOI: 10.1136/gut.2003.028860] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2003] [Indexed: 12/19/2022]
Abstract
BACKGROUND Photochemical and thermal methods are used for ablating Barrett's oesophagus (BO). The aim of this study was to compare 5-aminolevulinic acid induced photodynamic therapy (ALA-PDT) with argon plasma coagulation (APC) with respect to complete reversal of BO. METHODS Patients with BO (32 no dysplasia and eight low grade dysplasia) were randomised to one of three treatments: (a) ALA-PDT as a single dose of 100 J/cm(2) at four hours (PDT100; n = 13); (b) ALA-PDT as a fractionated dose of 20 and 100 J/cm(2) at one and four hours, respectively (PDT20+100; n = 13); or (c) APC at a power setting of 65 W in two sessions (APC; n = 14). If complete elimination of BO was not achieved by the designated treatment, the remaining BO was treated by a maximum of two sessions of APC. RESULTS Mean endoscopic reduction of BO at six weeks was 51% (range 20-100%) in the PDT100 group, 86% (range 0-100%) in the PDT20+100 group, and 93% (range 40-100%) in the APC group (PDT100 v PDT20+100, p<0.005; PDT100 v APC, p<0.005; and PDT20+100 v APC, NS) with histologically complete ablation in 1/13 (8%) patients in the PDT100 group, 4/12 (33%) in the PDT20+100 group, and 5/14 (36%) in the APC group (NS). Remaining BO was additionally treated with APC in 23/40 (58%) patients. Histological examination at 12 months revealed complete ablation in 9/11 (82%) patients in the PDT100 group, in 9/10 (90%) patients in the PDT20+100 group, and in 8/12 (67%) patients in the APC group (NS). At 12 months, no dysplasia was detected. Side effects (that is, pain (p<0.01), and nausea and vomiting (p<0.05)) and elevated liver transaminases (p<0.01) were more common after PDT than APC therapy. One patient died three days after treatment with PDT, presumably from cardiac arrhythmia. CONCLUSION APC alone or ALA-PDT in combination with APC can lead to complete reversal of Barrett's epithelium in at least two thirds of patients when administered in multiple treatment sessions. As the goal of treatment should be complete reversal of Barrett's epithelium, we do not recommend these techniques for the prophylactic ablation of BO.
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Affiliation(s)
- M Hage
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre Rotterdam, The Netherlands
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14
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Covington DL, Hage M, Hall T, Mathis M. Preterm delivery and the severity of violence during pregnancy. J Reprod Med 2001; 46:1031-9. [PMID: 11789082] [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: 02/23/2023]
Abstract
OBJECTIVE To determine the severity and consequences of physical violence during pregnancy among participants in a health department prenatal care coordination program. STUDY DESIGN The prospective cohort study included all program participants from 1994 to 1996. Care coordinators screened participants for physical violence during pregnancy using a validated, systematic assessment protocol three times during prenatal care. The protocol was linked with prenatal records, delivery records and infant records to document complications and infant outcomes. Multiple logistic regression was used to assess the relationship between severe physical violence during pregnancy and pregnancy outcome while controlling for confounding factors. RESULTS Among the 550 participants, 13.5% reported violence during pregnancy; it included 6.7% severe violence (hitting, kicking, injury with a weapon and abdominal injury) and 6.7% moderate violence (threats, slapping, shoving and sexual abuse). Severe physical prenatal violence was significantly associated with spontaneous preterm labor, preterm delivery, very preterm delivery, very low birth weight, preterm/low birth weight, mean birth weight, mean newborn hospital charges, five-minute Apgar < 7, neonatal intensive care unit admission, and fetal or neonatal death. Body site injured, timing of violence and number of violent incidents were significant factors associated with violence during pregnancy and preterm delivery. CONCLUSION Because severe physical violence during pregnancy was a significant problem in this population, intervention programs are needed to reduce prenatal violence and its consequences.
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Affiliation(s)
- D L Covington
- Coastal Area Health Education Center, New Hanover Regional Medical Center, Wilmington, North Carolina, USA.
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Goodwin L, Prather J, Schlitz K, Iannacchione MA, Hage M, Hammond WE, Grzymala-Busse J. Data mining issues for improved birth outcomes. Biomed Sci Instrum 1998; 34:291-6. [PMID: 9603055] [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: 02/07/2023]
Abstract
Issues obstructing progress in data mining for improved health outcomes include data quality problems, data redundancy, data inconsistency, repeated measures, temporal (time-contextual) measures, and data volume. Related issues involve theoretical and technical problems involving uncertainty management, missing data and missing values, and matching appropriate data mining techniques to patient data sets. Results of data mining research in progress are reported for Duke University's perinatal database that contains nearly a decade of clinical patient data, 71,753 database (patient) records and 4-5000 variables per patient.
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Affiliation(s)
- L Goodwin
- Duke University Durham, NC 27710, USA.
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Molina R, Jo J, Filella X, Zanon G, Pahisa J, Muñoz M, Farrus B, Latre ML, Gimenez N, Hage M, Estape J, Ballesta AM. C-erbB-2 oncoprotein in the sera and tissue of patients with breast cancer. Utility in prognosis. Anticancer Res 1996; 16:2295-300. [PMID: 8694559] [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: 02/01/2023]
Abstract
C-erbB-2 serum levels were studied in the sera of 50 healthy subjects, 56 patients with benign breast diseases and 412 patients with breast cancer. Using 15 U/ml as the cut-off, no healthy subjects, patients with benign disease and only 2.4% of patients with no-evidence of disease had serum levels higher than this cut-off point. Abnormal c-erbB-2 levels were found in 9.2% of the patients with locoregional breast carcinoma and in 45.4% of those with advanced disease. C-erbB-2 serum levels in patients with locoregional breast cancer were not related to tumor size or nodal involvement. By contrast, significantly higher c-erbB-2 serum levels were found in ER- or PgR- tumors than in those ER+ or PgR+ tumors, in both locoregional or metastatic tumors. The correlation between serum and tissue levels of C-erbB-2 was studied in the tumors of 161 patients. Significantly higher c-erbB-2 serum levels were found in patients with overexpression in tissue by immunohistochemistry, in both locoregional and advanced disease (p = 0.0001). In patients with C-erbB-2 overexpression in tissue, c-erbB-2 serum levels were related to tumor size and nodes, with higher values in tumors greater than 5 cm or in those with more than 3 nodes involved. When the prognostic value of this oncoprotein was evaluated, patients with abnormally high presurgical c-erbB-2 had a worse prognosis than those patients with normal values, in both node-negative and node-positive patients. Serum concentrations in patients with advanced disease, were related to the site of recurrence with significantly higher values in patients with metastases (mainly in those with liver metastases) than in those with locoregional recurrence. In summary, c-erbB-2 serum level seem to be a useful tumor marker in the prognosis of patients with breast cancer.
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Affiliation(s)
- R Molina
- Department of Gynecology, Hospital Clinic, Medical School, Barcelona, Spain
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Grumach AS, Jerônimo SE, Hage M, Carneiro-Sampaio MM. Nutritional factors in milk from Brazilian mothers delivering small for gestational age neonates. Rev Saude Publica 1993; 27:455-62. [PMID: 7997816 DOI: 10.1590/s0034-89101993000600008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The composition of breast milk from brazilian mothers delivering low birthweight infants and its adequacy as a source of nutrients for this group has not yet been fully elucidated. A total of 209 milk samples from 66 women were analysed. The mothers were divided into three groups: G1, mothers delivering term babies of low birthweight (TSGA, n = 16); G2, mothers delivering preterm babies of appropriate birthweight (PTAGA, n = 20); G3, mothers delivering term babies of appropriate birthweight (TAGA, n = 30). The following factors were analysed: osmolarity, total proteins and protein fractions, creamatocrit, sodium, potassium, calcium and magnesium. Milk samples were collected 48 h and 7, 15, 30 and 60 days after delivery. The groups did not differ significantly in terms of osmolarity, total proteins and fractions, creamatocrit, calcium, magnesium or potassium throughout the study period. Sodium levels were higher in all samples from mothers of TSGA infants and in samples from mothers of PTAGA infants on the 7th, 15th and 30th days than in milk from the TAGA group. The authors consider the needs of the low birthweight and TAGA infants and that these high sodium levels may be necessary for growth of low birthweight infants.
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Affiliation(s)
- A S Grumach
- Department of Pediatrics, School of Medicine, University of S. Paulo, Brazil
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Kane TT, el-Kady AA, Saleh S, Hage M, Stanback J, Potter L. Maternal mortality in Giza, Egypt: magnitude, causes, and prevention. Stud Fam Plann 1992; 23:45-57. [PMID: 1557794] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article presents results from a population-based study of the magnitude and causes of maternal mortality in the Giza governorate of Egypt in 1985-86. Deaths to women in the reproductive ages were identified through the death registration system. Family members of the deceased were interviewed using the "verbal autopsy" approach. Immediate and underlying causes of death were then assessed by a medical panel. This methodology allows for the classification of multiple causes of death and is appropriate when registration of adult deaths is nearly complete, but reporting on cause of death on death certificates is poor. Of all reproductive-age deaths, 19 percent were maternal deaths. The maternal mortality ratio for Giza is estimated to be, at minimum, 126 maternal deaths per 100,000 live births. The maternal mortality rate is estimated to be, at minimum, 22 maternal deaths per 100,000 women aged 15-49, over 100 times the rate in Sweden. An average of 2.3 causes per maternal death were reported; the most common causes were postpartum hemorrhage (31 percent of cases) and hypertensive diseases of pregnancy, such as toxemia and eclampsia (28 percent of cases). Women experiencing hemorrhage, hypertensive diseases of pregnancy, or other serious complications must have easy access to hospital and maternity centers equipped for handling these conditions. Since most deliveries occur at home, many with the help of traditional birth attendants, TBAs will need training in early diagnosis, treatment, and/or effective referral of problem pregnancies.
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Affiliation(s)
- T T Kane
- Department of Population Dynamics, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205
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Abstract
The acuity card procedure was used to assess the visual acuity of 510 neurologically normal and abnormal infants and children. Acuity estimates were obtained for 93 per cent of 842 binocular and 279 monocular tests. The observed development of binocular acuity of normal fullterm and preterm infants agreed well with previous reports using the traditional forced-choice preferential looking technique. Monocular tests seemed to support earlier suggestions that grating acuity may be relatively insensitive to strabismic amblyopia. Infants at risk of later neurological deficits but developing normally had only a slight delay in development of acuity, but there was a high incidence of acuity deficits (54 per cent) among those with severe neurological defects. The great majority of a group of multiply handicapped children had low acuity for age. Repeat tests showed a high degree of test-retest consistency. The acuity card procedure was a successful and useful method for assessing the acuity of infants and children who cannot be tested with standard ophthalmological methods.
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Affiliation(s)
- G Mohn
- Department of Physiology I, Erasmus University Rotterdam, The Netherlands
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