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Stafford M, Dunn RL, Gupta N, Kakarla R, Kirkpatrick D, Magparangalan D, Ngo D, Gryniewicz-Ruzicka C, Smith A, Stark M, Ye W, Yilmaz H, Woodruff J, Manibusan M, Stiber N, Viehmann A. Quality of New Domestic Hand Sanitizer Drug Product Manufacturers During COVID-19. AAPS J 2023; 26:7. [PMID: 38114792 DOI: 10.1208/s12248-023-00877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023] Open
Abstract
The FDA initiated a cross-sectional, statistically based sampling and testing study to characterize the quality of marketed alcohol-based hand sanitizer (ABHS) by evaluating the alcohol content and impurities present in ABHS products manufactured by establishments that registered with the FDA during March-April 2020. A stratified sampling design divided the population of manufacturers into independent groups based on each establishment's level of experience with FDA oversight and its geographic location. ABHS products were collected and analyzed by spatially offset Raman spectroscopy and gas chromatography with mass spectrometry (GC-MS). The GC-MS results for 310 products, from 196 newly registered domestic manufacturers, showed that 71.6% (± 5.7%) of these manufacturers had violative products. In 104 (33.5%) cases, the alcohol content did not meet label claim assay specifications but still fell within CDC efficacy ranges. Ethanol ABHS products failed more often overall (assay and impurities) (84.3%) and for impurities (84.3%), than isopropanol ABHS products (11.2% and 6.2%, respectively). Differences in test results across active ingredients were statistically significant. Ethanol ABHS products often (63.5% of cases) failed due to the presence of acetal or acetaldehyde, particularly in products with pH ≤ 6. Other impurities were also detected in several ABHS products, suggesting the use of low-grade alcohol in the manufacture of these products. Evidence was insufficient to conclude that having experience manufacturing FDA-regulated products, or lack thereof, influenced product-level violative results. This study highlights the importance of sourcing and testing active pharmaceutical ingredients to produce quality drug products.
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Affiliation(s)
- Michelle Stafford
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 10903 New Hampshire Ave, Silver Spring, Maryland, 20993, USA
| | - Rachel Linck Dunn
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Nirzari Gupta
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Raghavi Kakarla
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Douglas Kirkpatrick
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Daniel Magparangalan
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Diem Ngo
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Connie Gryniewicz-Ruzicka
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Anjanette Smith
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Matthew Stark
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Wei Ye
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Huzeyfe Yilmaz
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Jeffrey Woodruff
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 645 South Newstead Ave, Saint Louis, MO, 63110, USA
| | - Mary Manibusan
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 10903 New Hampshire Ave, Silver Spring, Maryland, 20993, USA.
| | - Neil Stiber
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 10903 New Hampshire Ave, Silver Spring, Maryland, 20993, USA
| | - Alex Viehmann
- United States Food and Drug Administration, Center of Drug Evaluation and Research/Office of Pharmaceutical Quality, 10903 New Hampshire Ave, Silver Spring, Maryland, 20993, USA
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2
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Craver R, Stark M, Moss S, Long S, Prasad P, C Roth C. WAGR, Sex Reversal, Bilateral Gonadoblastomas, and Intralobar Nephrogenic Rests: Uncertainties of Pre-Biopsy Chemotherapy in a High Risk Syndrome for Nephroblastoma. Fetal Pediatr Pathol 2023; 42:63-71. [PMID: 35199613 DOI: 10.1080/15513815.2022.2043962] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: WT1 deletions are associated with nephroblastomas, WT mutations are associated with 46, XY sex reversal. It is unclear why only a few WT1 deletions are associated with sex reversal. Case report. This 46, XY female had a 15.2 MB interstitial deletion of 11p14.1p11.2, which included WT1 and FSHB. No pathogenic abnormalities were identified in 156 other genes associated with disorders of sexual development. Bilateral gonadoblastomas were incidentally diagnosed at 17 months of age at the time of prophylactic gonadectomies. She was treated without biopsy for bilateral nephroblastomas radiologically identified at 18 months of age. Bilateral partial nephrectomies contained treated intralobular nephrogenic rests. Conclusion: It is unclear why WT1 deletions are less associated with 46, XY sex reversal than WT1 mutations. Treating suspected nephroblastomas without biopsy, even in patients with syndromes associated with bilateral nephroblastomas, may still lead to diagnostic and therapeutic uncertainties.
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Affiliation(s)
- Randall Craver
- Departments of Pathology, Children's Hospital of New Orleans and Louisiana State University Health Science Centers, New Orleans, LA, USA
| | - Matthew Stark
- Departments of Pathology, Children's Hospital of New Orleans and Louisiana State University Health Science Centers, New Orleans, LA, USA
| | - Stephanie Moss
- Departments of Pathology, Children's Hospital of New Orleans and Louisiana State University Health Science Centers, New Orleans, LA, USA
| | - Sarah Long
- Department of Radiology, Tulane University Medical School, New Orleans, LA, USA
| | - Pinki Prasad
- Hematology and Oncology Section, Department of Pediatrics, Children's Hospital of New Orleans and Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Christopher C Roth
- Department of Urology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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3
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Zeky N, Glisson K, LeBlanc C, Beyl R, Stark M. Establishing normal mucosal eosinophil counts in pediatric gastrointestinal biopsies in Lousiana. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00562-1] [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: 01/28/2023]
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4
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Condon K, Anderson M, Stark M, Dietrich ML. Case of complex cutaneous leishmaniasis in four year old female with prior residence in honduras. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00383-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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5
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Brzezinski RY, Melloul A, Berliner S, Goldiner I, Stark M, Rogowski O, Banai S, Shenhar-Tsarfaty S, Shacham Y. Early detection of inflammation-prone STEMI patients using the CRP Troponin Test (CTT). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Elevated concentrations of C-reactive protein (CRP) early after acute coronary syndrome (ACS) may reflect the magnitude of the inflammatory response to myocardial damage and are associated with worse outcome. However, the routine measurement of both CRP and cardiac troponin simultaneously in the setting of ST segment myocardial infarction (STEMI) is not used broadly. Here, we sought to identify and characterize individuals who are prone to an elevated inflammatory response following STEMI using the CRP Troponin test (CTT) and determine their short- and long-term outcome.
Material and methods
We retrospectively examined 1,186 patients with the diagnosis of acute STEMI, who had at least two successive measurements of combined CRP and cardiac troponin (up to 6 hours apart), all within the first 48 hours of admission. We used Chi-Square Automatic Interaction Detector (CHAID) tree analysis to determine which parameters, timing (baseline vs. serial measurements), and cut-offs should be used to predict mortality.
Results
Patients with high CRP concentrations (above 90th percentile, >33mg/L) had higher 30 day- and all-cause mortality rates regardless of their troponin test status (above or below 118,000 ng/L); 14.4% vs 2.7%, p<0.01. Furthermore, patients with both high CRP and high Troponin levels on their second measurement had the highest 30-day mortality rates compared to the rest of the cohort; 21.4% vs. 3.7%, p<0.01. These patients also had the highest all-cause mortality rates after a median follow up of 4.5 years compared to the rest of the cohort; 42.9% vs 12.7%, p<0.01 (Figure 1).
Conclusions
In conclusion, serial measurements of both CRP and cardiac troponin might detect patients at increased risk for short-and long-term mortality following STEMI. We suggest the future use of the combined CRP Troponin-test (CTT) as a potential early marker for inflammatory-prone patients with worse outcomes following ACS. This sub-type of patients might benefit from early anti-inflammatory therapy such as colchicine and anti-IL-1β agents.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Y Brzezinski
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - A Melloul
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - S Berliner
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - I Goldiner
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - M Stark
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - O Rogowski
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - S Banai
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - S Shenhar-Tsarfaty
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
| | - Y Shacham
- Tel Aviv University and Tel Aviv Sourasky Medical Center , Tel Aviv , Israel
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6
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Kohse EK, Siebert HK, Sasu PB, Loock K, Dohrmann T, Breitfeld P, Barclay-Steuart A, Stark M, Sehner S, Zöllner C, Petzoldt M. A model to predict difficult airway alerts after videolaryngoscopy in adults with anticipated difficult airways - the VIDIAC score. Anaesthesia 2022; 77:1089-1096. [PMID: 36006056 DOI: 10.1111/anae.15841] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2022] [Indexed: 12/31/2022]
Abstract
A model to classify the difficulty of videolaryngoscopic tracheal intubation has yet to be established. The videolaryngoscopic intubation and difficult airway classification (VIDIAC) study aimed to develop one based on variables associated with difficult videolaryngoscopic tracheal intubation. We studied 374 videolaryngoscopic tracheal intubations in 320 adults scheduled for ear, nose and throat or oral and maxillofacial surgery, for whom airway management was expected to be difficult. The primary outcome was whether an anaesthetist issued a 'difficult airway alert' after videolaryngoscopy. An alert was issued after 183 (49%) intubations. Random forest and lasso regression analysis selected six intubation-related variables associated with issuing an alert: impaired epiglottic movement; increased lifting force; direct epiglottic lifting; vocal cords clearly visible; vocal cords not visible; and enlarged arytenoids. Internal validation was performed by a 10-fold cross-validation, repeated 20 times. The mean (SD or 95%CI) area under the receiver operating characteristic curve was 0.92 (0.05) for the cross validated coefficient model and 0.92 (0.89-0.95) for a simplified unitary score (VIDIAC score with component values of -1 or 1 only). The calibration belt for the coefficient model was consistent with observed alert probabilities, from 0% to 100%, while the unitary VIDIAC score overestimated probabilities < 20% and underestimated probabilities > 70%. Discrimination of the VIDIAC score for patients more or less likely to be issued an alert was better than discrimination by the Cormack-Lehane classification, with mean (95%CI) areas under the receiver operating characteristic curve of 0.92 (0.89-0.95) vs. 0.75 (0.70-0.80), respectively, p < 0.001. Our model and score can be used to calculate the probabilities of difficult airway alerts after videolaryngoscopy.
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Affiliation(s)
- E K Kohse
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - H K Siebert
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - P B Sasu
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - K Loock
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - T Dohrmann
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - P Breitfeld
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - A Barclay-Steuart
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - M Stark
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - S Sehner
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - C Zöllner
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - M Petzoldt
- Department of Anaesthesiology, Centre of Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Moore BT, Tsien F, Sheets G, Umrigar A, Doss J, Norman M, Stark M, Prasad P, Musso A, Hicks C, Otohinoyi D, Zabaleta J, Li L. Abstract 3658: Ototoxicity of chemotherapy and radiation agents used in pediatric cancer treatment. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Many highly effective therapies used to treat cancer have been associated with irreversible development of detrimental neurological sequelae following the survival of childhood and adolescent cancer. While cancer treatment-induced late effects vary due to patient-related risk factors, cancer survivors who received chemotherapy or radiation may develop conductive or sensorineural hearing loss (SNHL). The purpose of this project is to determine which neuroinflammation-associated genes and biological pathways are affected by pediatric cancer treatments, and which treatment protocols are associated with increased ototoxicity. We hypothesize that cancer treatment causes abnormal gene expression of neuroinflammation and deafness-associated genes. The hypothesis will be tested with two specific aims. Aim I is to perform a retrospective review of diagnostic audiograms from pediatric cancer survivors enrolled in the Treatment After Cancer and Late Effects Center at Children’s Hospital New Orleans, Louisiana (CHNOLA). Aim II is to perform Nanostring neuroinflammation gene expression analysis followed by Ingenuity Pathway Analysis (IPA) of brain autopsy specimens from deceased pediatric patients who have previously undergone cancer treatment (Pathology Department, CHNOLA). Preliminary results revealed abnormal upregulation or downregulation of key genes, some of which are related to hearing loss and cochlear neuron degeneration when compared to age-matched controls (e.g., GJA1 and CASP3). The present study may provide information regarding which cancer treatment agents are ototoxic and reveal the candidate risk genes and pathways that contribute to auditory late effects. The long term goal of this project is to identify the needs of cancer survivors who are affected by treatment-induced hearing loss and provide them and their families with access to educational materials, medical resources, and social support to increase their health-related quality of life.
Citation Format: Brittney T. Moore, Fern Tsien, Gabrielle Sheets, Ayesha Umrigar, Jordan Doss, Michael Norman, Matthew Stark, Pinki Prasad, Amanda Musso, Chindo Hicks, David Otohinoyi, Jovanny Zabaleta, Li Li. Ototoxicity of chemotherapy and radiation agents used in pediatric cancer treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3658.
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Affiliation(s)
| | - Fern Tsien
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | - Gabrielle Sheets
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | - Ayesha Umrigar
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | - Jordan Doss
- 2Children’s Hospital New Orleans, New Orleans, LA
| | - Michael Norman
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | | | - Pinki Prasad
- 3Children's Hospital New Orleans, New Orleans, LA
| | - Amanda Musso
- 3Children's Hospital New Orleans, New Orleans, LA
| | - Chindo Hicks
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | - David Otohinoyi
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | - Jovanny Zabaleta
- 4Stanley S. Scott Cancer Center, Louisiana Cancer Research Center, New Orleans, LA
| | - Li Li
- 4Stanley S. Scott Cancer Center, Louisiana Cancer Research Center, New Orleans, LA
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8
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Hollenbach AD, Stark M, Zabaleta J, Tsien F. Abstract 2355: Intratumoral translocation positive heterogeneity in pediatric alveolar rhabdomyosarcoma tumors correlates to changes in genes predicted to inhibit the immunological response. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Alveolar rhabdomyosarcoma (ARMS) is characterized by one of three translocation states: t(2;13)(q35;q14) producing PAX3-FOXO1, t(1;13)(p36;q14) producing PAX7-FOXO1, or translocation-negative. Tumors with t(2;13) are associated with greater disease severity and mortality than t(1;13) positive or translocation negative patients. We demonstrated that ARMS tumor samples contain intratumoral genetic heterogeneity with respect to the presence of t(2;13). Further, we demonstrated that this heterogeneity had an inverse correlation with tumor aggressiveness, with tumors containing higher translocation positivity having lower failure-free survival of patients. However, it is not yet known whether a correlation exists between percent t(2;13) positivity and changes in gene expression, in particular genes whose function contributes to immune invasion in the tumor microenvironment. Of fifty-five rhabdomyosarcoma patient tumor samples received from Children’s Hospital in New Orleans, nine were confirmed to contain t(2;13) ranging from 16 - 98% cells positive for the translocation. We used aged-matched normal muscle tissue derived from autopsies as a control. RNA was isolated from whole tissue samples and analyzed using the Nanostring nCounter®️ PanCancer IO 360™ Panel. This panel contains 770 genes that specifically analyze tumor immunogenicity, tumor sensitivity to immune attack, inhibitory immune mechanisms, stromal factors, inhibitory metabolism, anti-tumor immune activity, inhibitory immune signaling, immune cell population and abundance, and tumor inflammation. We found 487 genes have an average change in expression ≥ 1.5-fold relative to the control. Of these genes 31 (6.4%) have a statistically significant positive correlation and nearly 25% (114 genes) had a statistically significant negative correlation to percent intratumoral translocation positivity. A closer examination indicated that genes with a negative correlation had biological functions that target a variety of different immunological processes. These include the recognition of antigen by T cells; the activation, maturation, and differentiation of lymphocytes and myeloid cells; adhesion of immune responsive cells; promotion of the inflammatory response; and activation of the innate immune response. These results suggest that increased intratumoral t(2;13) positivity negatively impacts the immunological response thereby increasing the ability for immune evasion of the tumors with higher levels of the translocation, a result consistent with our previously published work.
Citation Format: Andrew D. Hollenbach, Matthew Stark, Jovanny Zabaleta, Fern Tsien. Intratumoral translocation positive heterogeneity in pediatric alveolar rhabdomyosarcoma tumors correlates to changes in genes predicted to inhibit the immunological response [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2355.
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Affiliation(s)
| | | | - Jovanny Zabaleta
- 1Louisiana State University Health Sciences Center, New Orleans, LA
| | - Fern Tsien
- 1Louisiana State University Health Sciences Center, New Orleans, LA
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9
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Duffy J, Cairns AE, Richards-Doran D, van 't Hooft J, Gale C, Brown M, Chappell LC, Grobman WA, Fitzpatrick R, Karumanchi SA, Khalil A, Lucas DN, Magee LA, Mol BW, Stark M, Thangaratinam S, Wilson MJ, von Dadelszen P, Williamson PR, Ziebland S, McManus RJ. A core outcome set for pre-eclampsia research: an international consensus development study. BJOG 2020; 127:1516-1526. [PMID: 32416644 DOI: 10.1111/1471-0528.16319] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To develop a core outcome set for pre-eclampsia. DESIGN Consensus development study. SETTING International. POPULATION Two hundred and eight-one healthcare professionals, 41 researchers and 110 patients, representing 56 countries, participated. METHODS Modified Delphi method and Modified Nominal Group Technique. RESULTS A long-list of 116 potential core outcomes was developed by combining the outcomes reported in 79 pre-eclampsia trials with those derived from thematic analysis of 30 in-depth interviews of women with lived experience of pre-eclampsia. Forty-seven consensus outcomes were identified from the Delphi process following which 14 maternal and eight offspring core outcomes were agreed at the consensus development meeting. Maternal core outcomes: death, eclampsia, stroke, cortical blindness, retinal detachment, pulmonary oedema, acute kidney injury, liver haematoma or rupture, abruption, postpartum haemorrhage, raised liver enzymes, low platelets, admission to intensive care required, and intubation and ventilation. Offspring core outcomes: stillbirth, gestational age at delivery, birthweight, small-for-gestational-age, neonatal mortality, seizures, admission to neonatal unit required and respiratory support. CONCLUSIONS The core outcome set for pre-eclampsia should underpin future randomised trials and systematic reviews. Such implementation should ensure that future research holds the necessary reach and relevance to inform clinical practice, enhance women's care and improve the outcomes of pregnant women and their babies. TWEETABLE ABSTRACT 281 healthcare professionals, 41 researchers and 110 women have developed #preeclampsia core outcomes @HOPEoutcomes @jamesmnduffy. [Correction added on 29 June 2020, after first online publication: the order has been corrected.].
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Affiliation(s)
- Jmn Duffy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Institute for Women's Health, University College London, London, UK
| | - A E Cairns
- Institute for Women's Health, University College London, London, UK
| | - D Richards-Doran
- Institute for Women's Health, University College London, London, UK
| | - J van 't Hooft
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Academic Medical Centre, Amsterdam, The Netherlands
| | - C Gale
- Academic Neonatal Medicine, Imperial College London, London, UK
| | - M Brown
- Department of Renal Medicine, St George Hospital and University of New South Wales, Kogarah, NSW, Australia
| | - L C Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - W A Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - R Fitzpatrick
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - A Khalil
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - D N Lucas
- London North West University Healthcare NHS Trust, Harrow, UK
| | - L A Magee
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Vic., Australia
| | - M Stark
- Department of Obstetrics and Gynaecology, University of Adelaide, Adelaide, SA, Australia
| | - S Thangaratinam
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, London, UK
| | - M J Wilson
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - P von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - P R Williamson
- MRC North West Hub for Trials Methodology Research, Department of Biostatistics, University of Liverpool, Liverpool, UK
| | - S Ziebland
- Institute for Women's Health, University College London, London, UK
| | - R J McManus
- Institute for Women's Health, University College London, London, UK
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10
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Khokhar H, Craver R, Stark M. Malignant Extrarenal Rhabdoid Tumor in a 5-Month-Old Male With Mediastinal and Heart/Great Vessel Involvement. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Extrarenal rhabdoid tumor is a high-grade soft-tissue predominately pediatric malignancy with a frequency of 0.15 per million children less than 15 years. It is associated with del(22) (q11.2) with SMARCB1 loss, recognized by loss of INI-1 staining. It has distinct perinuclear hyaline inclusions; however, this feature can be present in other tumors. We describe a malignant extrarenal rhabdoid tumor involving the heart and great vessels to highlight the multiple modalities required for the diagnosis of this tumor in this unusual location.
Methods
We utilized routine histology, immunohistochemistry, and electron microscopy.
Results
This 5 -month -old male presented with respiratory distress due to a mass that invaded the heart, surrounding the great vessels. The tumor was composed of sheets of polygonal large cells with light pink to clear cytoplasm, eccentric nuclei with mild anisonucleosis, peripherally marginating chromatin, prominent nucleoli, with 2 mitoses per 10 high power field. Hyaline perinuclear inclusions were inapparent. There were frequent clusters of lymphocytes and eosinophils, with 10 percent necrosis and moderately increased vascularity. The tumor was positive for vimentin, SMA, EMA, MSA, S-100, keratin, and WT1, and negative for INI-1, CD34, ALK, AFP, PLAP, CD30, myogenin, NeuN1, synaptophysin, chromogranin, and NSE. Electron microscopy demonstrated occasional cells with perinuclear collections of intermediate filaments, some with whorls. The strong positivity for vimentin, keratin, SMA, MSA, S-100, negative staining for INA-1 and CD34, and visualization of perinuclear intermediate filament whorls by electron microscopy helped make the diagnosis of extrarenal rhabdoid tumor.
Conclusion
Malignant extrarenal rhabdomyosarcomas may occur in the middle mediastinum, invade the heart, occur in the first 6 months of life, and not have the typical rhabdoid cells. Diagnoses depend on multiple modalities
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Affiliation(s)
- H Khokhar
- Pathology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, UNITED STATES
| | - R Craver
- Pathology, Children’s Hospital, New Orleans, Louisiana, UNITED STATES
| | - M Stark
- Pathology, Children’s Hospital, New Orleans, Louisiana, UNITED STATES
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11
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Gleditsch K, Peñas J, Mercer D, Umrigar A, Briscoe J, Stark M, Tsien F, Hollenbach AD. Intratumoral Translocation Positive Heterogeneity in Pediatric Alveolar Rhabdomyosarcoma Tumors Correlates to Patient Survival Prognosis. Front Cell Dev Biol 2020; 8:564136. [PMID: 33072748 PMCID: PMC7530338 DOI: 10.3389/fcell.2020.564136] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022] Open
Abstract
Alveolar rhabdomyosarcoma (ARMS) is characterized by one of three translocation states: t(2;13) (q35;q14) producing PAX3-FOXO1, t(1;13) (p36;q14) producing PAX7-FOXO1, or translocation-negative. Tumors with t(2;13) are associated with greater disease severity and mortality than t(1;13) positive or translocation negative patients. Consistent with this fact, previous work concluded that a molecular analysis of RMS translocation status is essential for the accurate determination of prognosis and diagnosis. However, despite this knowledge, most diagnoses rely on histology and in some cases utilize fluorescence in situ hybridization (FISH) probes unable to differentiate between translocation products. Along these same lines, diagnostic RT-PCR analysis, which can differentiate translocation status, is unable to determine intratumoral translocation heterogeneity, making it difficult to determine if heterogeneity exists and whether correlations exist between this heterogeneity and patient outcomes. Using newly developed FISH probes, we demonstrate that intratumoral heterogeneity exists in ARMS tumors with respect to the presence or absence of the translocation product. We found between 3 and 98% of cells within individual tumor samples contained a translocation event with a significant inverse correlation (R2 = 0.66, p = 0.001) between the extent of intratumoral translocation heterogeneity and failure-free survival of patients. Taken together, these results provide additional support for the inclusion of the molecular analysis of these tumors and expand on this idea to support determining the extent of intratumoral translocation heterogeneity in the diagnosis of ARMS to improve diagnostic and prognostic indicators for patients with these tumors.
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Affiliation(s)
- Katrina Gleditsch
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States.,Division of Pediatric Hematology/Oncology, Children's Hospital of New Orleans, New Orleans, LA, United States
| | - Jorge Peñas
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Danielle Mercer
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Ayesha Umrigar
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - James Briscoe
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Matthew Stark
- Department of Pathology, Children's Hospital of New Orleans, New Orleans, LA, United States
| | - Fern Tsien
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Andrew D Hollenbach
- Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, LA, United States
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12
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Benhidjeb T, Stark M, Schulte Am Esch J. Re: "Comparative Study Between Endoscopic Thyroid Surgery via the Oral Vestibular Approach and the Areola Approach" by Guo et al. J Laparoendosc Adv Surg Tech A 2020; 30:866-867. [PMID: 32364829 DOI: 10.1089/lap.2020.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tahar Benhidjeb
- Department of General and Visceral Surgery, Evangelisches Klinikum Bethel, Bielefeld, Germany.,The New European Surgical Academy (NESA), Berlin, Germany
| | - M Stark
- The New European Surgical Academy (NESA), Berlin, Germany
| | - Jan Schulte Am Esch
- Department of General and Visceral Surgery, Evangelisches Klinikum Bethel, Bielefeld, Germany
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13
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Benhidjeb T, Witzel K, Stark M, Schulte Am Esch J. Transoral thyroidectomy: new method with new complications' spectrum. J Endocrinol Invest 2019; 42:1509-1510. [PMID: 31452115 DOI: 10.1007/s40618-019-01101-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Affiliation(s)
- T Benhidjeb
- Department of General and Visceral Surgery, Evangelisches Klinikum Bethel, Bielefeld, Germany.
- The New European Surgical Academy (NESA), Berlin, Germany.
| | - K Witzel
- Minimal Invasiv Center, Hünfeld, Germany
| | - M Stark
- The New European Surgical Academy (NESA), Berlin, Germany
| | - J Schulte Am Esch
- Department of General and Visceral Surgery, Evangelisches Klinikum Bethel, Bielefeld, Germany
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14
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Patterson CW, Stark M, Sharma S, Mundinger GS. Regeneration and expansion of autologous full-thickness skin through a self-propagating autologous skin graft technology. Clin Case Rep 2019; 7:2449-2455. [PMID: 31893078 PMCID: PMC6935643 DOI: 10.1002/ccr3.2533] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 02/03/2023] Open
Abstract
New autologous skin regeneration technology yielded full-thickness skin as evidenced by clinical observation and skin biopsy 5 months after surgery, providing relief for debilitating split-thickness skin graft contracture in a pediatric burn case.
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Affiliation(s)
- Charles W. Patterson
- Division of Plastic and Reconstructive SurgeryDepartment of SurgeryLouisiana State University Health Sciences CenterNew OrleansLouisiana
- Division of Plastic and Reconstructive SurgeryChildren’s Hospital of New OrleansNew OrleansLouisiana
| | - Matthew Stark
- Department of PathologyChildren’s Hospital of New OrleansNew OrleansLouisiana
| | - Silpa Sharma
- Division of Plastic and Reconstructive SurgeryChildren’s Hospital of New OrleansNew OrleansLouisiana
| | - Gerhard S. Mundinger
- Division of Plastic and Reconstructive SurgeryDepartment of SurgeryLouisiana State University Health Sciences CenterNew OrleansLouisiana
- Division of Plastic and Reconstructive SurgeryChildren’s Hospital of New OrleansNew OrleansLouisiana
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15
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Zaami S, Stark M, Beck R, Malvasi A, Marinelli E. Does episiotomy always equate violence in obstetrics? Routine and selective episiotomy in obstetric practice and legal questions. Eur Rev Med Pharmacol Sci 2019; 23:1847-1854. [PMID: 30915726 DOI: 10.26355/eurrev_201903_17219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The study's main goal is to figure out whether episiotomy, a widely applied invasive procedure, may constitute a determining factor of liability for practitioners according to the standards of obstetric violence. MATERIALS AND METHODS The authors have aimed to analyze laws and documentation issued on the matter by sovereign states, statements and remarks from International health organizations, in addition to scientific article available on the main search engines (PubMed, Scopus, Google Scholar) and legal databases (Lexis, Justia). RESULTS The body of research has highlighted the existence of a wide-ranging agreement as to routine episiotomy, deemed to be a scientifically unfounded procedure, and which should, therefore, be avoided. By virtue of that, routine episiotomy might easily give rise to charges and liability for doctors and midwives alike; likewise to claims may stem from a failure to perform an episiotomy when it was actually needed. CONCLUSIONS Unlike routine episiotomy, selective episiotomy is far more unlikely to cause charges of obstetric violence against operators. Unfortunately, the criteria in order to establish when a selective episiotomy is indicated are far from consistent and would require an additional effort on the part of scientific societies towards a more clearly defined and shared description.
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Affiliation(s)
- S Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, "Sapienza" University of Rome, Rome, Italy.
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Affiliation(s)
- Anne C Kane
- Department of Otorhinolaryngology, Louisiana State University Health Science Center, New Orleans
| | - Matthew Stark
- Children's Hospital of New Orleans, New Orleans, Louisiana
| | - Sohit P Kanotra
- Children's Hospital of New Orleans, New Orleans, Louisiana.,Department of Otolaryngology-Head & Neck Surgery, Louisiana State University, New Orleans
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17
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Stark M, Stuart J. Eruptive xanthoma in the setting of hypertriglyceridemia and pancreatitis. Am J Emerg Med 2018; 36:1524.e5-1524.e7. [PMID: 29716801 DOI: 10.1016/j.ajem.2018.04.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND Undifferentiated dermatologic complaints are often encountered in the emergency department. While a patient's exposures, risk factors, and comorbidities may help guide emergency department evaluation, the accurate diagnosis of dermatologic findings is critical to allowing rapid identification and treatment of disease. CASE In this vignette we discuss a case of eruptive xanthoma in a 33-year-old male with diabetic ketoacidosis and pancreatitis. DISCUSSION Dermatologic complaints pose a unique challenge to the emergency physician. Many dermatologic findings are benign; however, some may represent underlying serious disease even in young, otherwise healthy appearing patients. Eruptive xanthomas are cutaneous lesions often indicating severe hypertriglyceridemia and uncontrolled diabetes. Likely presentations and risk factors for eruptive xanthomas will be discussed as well as ED evaluation and management.
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Affiliation(s)
- Matthew Stark
- Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave., Fort Hood, TX 76544, United States.
| | - Jonathan Stuart
- Carl R. Darnall Army Medical Center, 36065 Santa Fe Ave., Fort Hood, TX 76544, United States
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18
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Giovannetti E, Zucali PA, Assaraf YG, Funel N, Gemelli M, Stark M, Thunnissen E, Hou Z, Muller IB, Struys EA, Perrino M, Jansen G, Matherly LH, Peters GJ. Role of proton-coupled folate transporter in pemetrexed resistance of mesothelioma: clinical evidence and new pharmacological tools. Ann Oncol 2017; 28:2725-2732. [PMID: 28945836 PMCID: PMC5808668 DOI: 10.1093/annonc/mdx499] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Thymidylate synthase (TS) has a predictive role in pemetrexed treatment of mesothelioma; however, additional chemoresistance mechanisms are poorly understood. Here, we explored the role of the reduced-folate carrier (RFC/SLC19A1) and proton-coupled folate transporter (PCFT/SLC46A1) in antifolate resistance in mesothelioma. PATIENTS AND METHODS PCFT, RFC and TS RNA and PCFT protein levels were determined by quantitative RT-PCR of frozen tissues and immunohistochemistry of tissue-microarrays, respectively, in two cohorts of pemetrexed-treated patients. Data were analyzed by t-test, Fisher's/log-rank test and Cox proportional models. The contribution of PCFT expression and PCFT-promoter methylation to pemetrexed activity were evaluated in mesothelioma cells and spheroids, through 5-aza-2'-deoxycytidine-mediated demethylation and siRNA-knockdown. RESULTS Pemetrexed-treated patients with low PCFT had significantly lower rates of disease control, and shorter overall survival (OS), in both the test (N = 73, 11.3 versus 20.1 months, P = 0.01) and validation (N = 51, 12.6 versus 30.3 months, P = 0.02) cohorts. Multivariate analysis confirmed PCFT-independent prognostic role. Low-PCFT protein levels were also associated with shorter OS. Patients with both low-PCFT and high-TS levels had the worst prognosis (OS, 5.5 months), whereas associations were neither found for RFC nor in pemetrexed-untreated patients. PCFT silencing reduced pemetrexed sensitivity, whereas 5-aza-2'-deoxycytidine overcame resistance. CONCLUSIONS These findings identify for the first time PCFT as a novel mesothelioma prognostic biomarker, prompting prospective trials for its validation. Moreover, preclinical data suggest that targeting PCFT-promoter methylation might eradicate pemetrexed-resistant cells characterized by low-PCFT expression.
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Affiliation(s)
- E Giovannetti
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands; Cancer Pharmacology Lab, AIRC Start-Up Unit, Department of Translational Research and The New Technologies in Medicine and Surgery, University of Pisa, Pisa
| | - P A Zucali
- Department of Oncology, University of Milan, Humanitas Clinical and Research Hospital, Rozzano (Milan), Italy
| | - Y G Assaraf
- Department of Biology, Fred Wyszkowski Cancer Research Laboratory, Technion-Institute of Technology, Haifa, Israel
| | - N Funel
- Cancer Pharmacology Lab, AIRC Start-Up Unit, Department of Translational Research and The New Technologies in Medicine and Surgery, University of Pisa, Pisa
| | - M Gemelli
- Department of Oncology, University of Milan, Humanitas Clinical and Research Hospital, Rozzano (Milan), Italy
| | - M Stark
- Department of Biology, Fred Wyszkowski Cancer Research Laboratory, Technion-Institute of Technology, Haifa, Israel
| | - E Thunnissen
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Z Hou
- Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, USA
| | - I B Muller
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam
| | - E A Struys
- Department of Clinical Chemistry, VU University Medical Center, Amsterdam
| | - M Perrino
- Department of Oncology, University of Milan, Humanitas Clinical and Research Hospital, Rozzano (Milan), Italy
| | - G Jansen
- Amsterdam Rheumatology and Immunology Center - Location VUmc, Amsterdam, The Netherlands
| | - L H Matherly
- Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, USA
| | - G J Peters
- Department of Medical Oncology, VU University Medical Center, Cancer Center Amsterdam, Amsterdam, The Netherlands.
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19
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Abstract
Chondromyxoid fibroma-like osteosarcoma (CMF-OS) is a low-grade osteosarcoma, often misdiagnosed on initial biopsy as a benign lesion, with five cases previously described. We report a 13-year-old male with an intramedullary lytic CMF-OS of the right tibial proximal metaphysis with cortical destruction and soft tissue extension. Diagnosis was based on malignant new bone formation, increased mitotic figures, lamellar bone permeation with bony destruction, and correlation with imaging studies. There were no metastasis at presentation and the tumor showed good response to standard chemotherapy with >95% necrosis.
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Affiliation(s)
- Matthew Stark
- a Department of Pathology , Children's Hospital New Orleans , New Orleans , LA , USA
| | | | | | - Dane Mackey
- d Department of Radiology , LSUHSC , New Orleans , LA , USA
| | - Ewa Wasilewska
- e Department of Radiology , Children's Hospital New Orleans , New Orleans , LA , USA
| | - Randall Craver
- a Department of Pathology , Children's Hospital New Orleans , New Orleans , LA , USA.,f Department of Pathology , LSUHSC , New Orleans , LA , USA
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20
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Abstract
Scopulariopsis species cause a broad range of disease, from superficial skin infections to often fatal disseminated disease in the immunocompromised that is refractory to standard antifungal treatment. This report describes the first case of fatal disseminated Scopulariopsis brumptii in a pediatric patient with hyper-IgM syndrome status post bone marrow transplant.
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Affiliation(s)
- Louise Helander
- a Louisiana State University Health Sciences Center, Pathology, LSUHSC School of Medicine Medical Education Building , New Orleans , Louisiana , USA
| | - Matthew Stark
- b Children's Hospital of New Orleans , Department of Pathology , New Orleans , Louisiana , USA
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Bharucha T, Traianou A, Keniger M, Chisholm G, Lewis G, Roland J, Stark M, Brown C. Corrigendum to “Volunteering to improve health worldwide. Current trends in Out of Programme Experience/Training in the UK 2014” [J. Epidemiol. Glob. Health 5 (2015) 295–296]. J Epidemiol Glob Health 2016; 6:123. [PMID: 27155025 PMCID: PMC7320440 DOI: 10.1016/j.jegh.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Hiebel C, Kromm T, Stark M, Behl C. Cannabinoid receptor 1 modulates the autophagic flux in a non-canonic fashion. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1557958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Mynbaev OA, Malvasi A, Melerzanov AV, Stark M, Tinelli A. Abdominopelvic drainage during laparoscopic myomectomy: left-over hook or still relevant? Eur J Obstet Gynecol Reprod Biol 2015; 191:138-9. [PMID: 26076983 DOI: 10.1016/j.ejogrb.2015.05.002] [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] [Received: 04/15/2015] [Accepted: 05/15/2015] [Indexed: 11/25/2022]
Affiliation(s)
- O A Mynbaev
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; Department of Obstetrics, Gynaecology and Reproductive Medicine, Peoples' Friendship University of Russia, Moscow, Russia; The New European Surgical Academy, Berlin, Germany.
| | - A Malvasi
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy, Berlin, Germany; Department of Obstetrics and Gynaecology, Santa Maria Hospital, Bari, Italy
| | - A V Melerzanov
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy, Berlin, Germany
| | - M Stark
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy, Berlin, Germany
| | - A Tinelli
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The New European Surgical Academy, Berlin, Germany; Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Vito Fazzi Hospital, Lecce, Italy
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24
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Belci D, Di Renzo GC, Stark M, Đurić J, Zoričić D, Belci M, Peteh LL. Morbidity and chronic pain following different techniques of caesarean section: A comparative study. J OBSTET GYNAECOL 2014; 35:442-6. [DOI: 10.3109/01443615.2014.968114] [Citation(s) in RCA: 10] [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] [Indexed: 11/13/2022]
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25
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Dippel EJ, Makam P, Kovach RC, George JC, Patlola RR, Metzger DC, Mena CI, Soukas P, Colon-Hernadez P, Stark M, Walker C. TCT-531 EXCITE ISR: A Prospective, Randomized Controlled Trial of Excimer Laser Atherectomy vs Balloon Angioplasty for the Treatment of Femoropopliteal In-Stent Restenosis. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Mynbaev OA, Eliseeva MY, Tinelli A, Malvasi A, Kosmas IP, Medvediev MV, Babenko TI, Mazitova MI, Kalzhanov ZR, Stark M. A personalized adhesion prevention strategy: E. Arslan, T. Talih, B. Oz, B. Halaclar, K. Caglayan, M. Sipahi, Comparison of lovastatin and hyaluronic acid/carboxymethyl cellulose on experimental created peritoneal adhesion model in rats, Int. J. Surg. 12 (2) (2014) 120-124. Int J Surg 2014; 12:901-5. [PMID: 25072704 DOI: 10.1016/j.ijsu.2014.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/02/2014] [Accepted: 03/14/2014] [Indexed: 11/26/2022]
Affiliation(s)
- O A Mynbaev
- The International Translational Medicine & Biomodeling Research Team, Department of Applied Mathematics, Moscow Institute of Physics & Technology (State University), Dolgoprudny, Moscow Region, Russia; The Department of Obstetrics, Gynecology & Reproductive Medicine, Peoples' Friendship, University of Russia, Moscow, Russia; Laboratory of Pilot Projects, Moscow State University of Medicine & Dentistry, Moscow, Russia; The New European Surgical Academy, Berlin, Germany.
| | - M Yu Eliseeva
- The Department of Obstetrics, Gynecology & Reproductive Medicine, Peoples' Friendship, University of Russia, Moscow, Russia
| | - A Tinelli
- Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Vito Fazzi Hospital, Piazza Muratore, Lecce, Italy
| | - A Malvasi
- Department of Obstetrics and Gynecology, Santa Maria Hospital, Bari, Italy
| | - I P Kosmas
- Xatzikosta General Hospital, Ioannina, Ioannina, Greece
| | - M V Medvediev
- State Establishment "Dnepropetrovsk Medical Academy of Health Ministry of Ukraine", Dnepropetrovsk, Ukraine
| | - T I Babenko
- Stavropol State Medical Academy, Stavropol, Russia
| | | | - Zh R Kalzhanov
- School of Health and Human Sciences, University of Essex, UK
| | - M Stark
- The New European Surgical Academy, Berlin, Germany
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Mynbaev OA, Eliseeva MY, Tinelli A, Malvasi A, Massaro F, Simakov SS, Stark M. Re. 'Abdominal hypertension and decompression: the effect on peritoneal metabolism in an experimental porcine study'. Eur J Vasc Endovasc Surg 2014; 48:229-30. [PMID: 24931381 DOI: 10.1016/j.ejvs.2014.03.044] [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] [Received: 03/25/2014] [Accepted: 03/28/2014] [Indexed: 12/01/2022]
Affiliation(s)
- O A Mynbaev
- International Translational Medicine and Biomodeling Research Group, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), 9 Institutsky per, Dolgoprudny, Moscow 141700, Russia; Department of Obstetrics, Gynecology and Reproductive Medicine, Peoples' Friendship University of Russia, Moscow, Russia; Laboratory of Pilot Projects, Moscow State University of Medicine and Dentistry, Moscow, Russia; The New European Surgical Academy, Berlin, Germany.
| | - M Yu Eliseeva
- Department of Obstetrics, Gynecology and Reproductive Medicine, Peoples' Friendship University of Russia, Moscow, Russia
| | - A Tinelli
- Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Vito Fazzi Hospital, Lecce, Italy
| | - A Malvasi
- Department of Obstetrics and Gynecology, Santa Maria Hospital, Bari, Italy
| | - F Massaro
- Anesthesia and Intensive Care Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy
| | - S S Simakov
- International Translational Medicine and Biomodeling Research Group, Department of Applied Mathematics, Moscow Institute of Physics and Technology (State University), 9 Institutsky per, Dolgoprudny, Moscow 141700, Russia
| | - M Stark
- The New European Surgical Academy, Berlin, Germany
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28
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Zboray R, Mor I, Dangendorf V, Stark M, Tittelmeier K, Cortesi M, Adams R. High-frame rate imaging of two-phase flow in a thin rectangular channel using fast neutrons. Appl Radiat Isot 2014; 90:122-31. [PMID: 24709611 DOI: 10.1016/j.apradiso.2014.03.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/06/2014] [Accepted: 03/16/2014] [Indexed: 11/19/2022]
Abstract
We have demonstrated the feasibility of performing high-frame-rate, fast neutron radiography of air-water two-phase flows in a thin channel with rectangular cross section. The experiments have been carried out at the accelerator facility of the Physikalisch-Technische Bundesanstalt. A polychromatic, high-intensity fast neutron beam with average energy of 6 MeV was produced by 11.5 MeV deuterons hitting a thick Be target. Image sequences down to 10 ms exposure times were obtained using a fast-neutron imaging detector developed in the context of fast-neutron resonance imaging. Different two-phase flow regimes such as bubbly slug and churn flows have been examined. Two phase flow parameters like the volumetric gas fraction, bubble size and mean bubble velocities have been measured. The first results are promising, improvements for future experiments are also discussed.
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Affiliation(s)
- R Zboray
- Paul Scherrer Institute, PSI Villigen, CH-5232, Switzerland.
| | - I Mor
- Soreq NRC, Yavne 81800, Israel
| | - V Dangendorf
- Physikalisch-Technische Bundesanstalt (PTB), 38116 Braunschweig, Germany
| | - M Stark
- Paul Scherrer Institute, PSI Villigen, CH-5232, Switzerland
| | - K Tittelmeier
- Physikalisch-Technische Bundesanstalt (PTB), 38116 Braunschweig, Germany
| | - M Cortesi
- Paul Scherrer Institute, PSI Villigen, CH-5232, Switzerland; Swiss Federal Institute of Technology Zurich, Sonnegstrasse 3, CH-8092 Zurich, Switzerland
| | - R Adams
- Swiss Federal Institute of Technology Zurich, Sonnegstrasse 3, CH-8092 Zurich, Switzerland
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29
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Wright CB, Dong C, Stark M, Silverberg S, Rundek T, Elkind MSV, Sacco RL, Mendez A, Wolf M. Plasma FGF23 and the risk of stroke: the Northern Manhattan Study (NOMAS). Neurology 2014; 82:1700-6. [PMID: 24706015 DOI: 10.1212/wnl.0000000000000410] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To examine fibroblast growth factor 23 (FGF23) as a risk factor for incident stroke in a racially/ethnically diverse population-based urban cohort. METHODS Stroke-free Northern Manhattan Study participants with FGF23 measurements (n = 2,525) were followed for a mean of 12 (±5) years to detect incident strokes. We used Cox proportional hazards models to estimate the association of baseline FGF23 with incident total, ischemic, and hemorrhagic stroke. RESULTS Median FGF23 was 57 relative units (RU)/mL (interquartile range = 44-81 RU/mL). Each unit increase of natural log-transformed FGF23 conferred a 40% greater overall stroke risk after adjusting for estimated glomerular filtration rate and sociodemographic and vascular risk factors (hazard ratio = 1.4, 95% confidence interval 1.1-1.6, p = 0.004). Penalized spline analysis revealed a linear association with overall stroke risk at ≥90 RU/mL FGF23, compared with <90 RU/mL (hazard ratio = 1.5, 95% confidence interval = 1.2-2.1, p = 0.004). Greater FGF23 conferred a doubling of intracerebral hemorrhage (ICH) risk but no significant increased risk of ischemic stroke. The associations of elevated FGF23 levels with greater risks of overall stroke and ICH events were independent of phosphate and parathyroid hormone levels and were similar among participants without chronic kidney disease. CONCLUSIONS Elevated FGF23 was a risk factor for overall stroke and ICH events, in particular in a racially and ethnically diverse urban community, independent of chronic kidney disease.
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Affiliation(s)
- Clinton B Wright
- From the Evelyn F. McKnight Brain Institute (C.B.W., C.D., T.R., R.L.S.) and Departments of Neurology (C.B.W., C.D., M.S., T.R., R.L.S.), Public Health Sciences (C.B.W., R.L.S.), Human Genomics (R.L.S.), and Medicine (A.M., M.W.), Leonard M. Miller School of Medicine, and the Neuroscience Program (C.B.W., R.L.S.), University of Miami, FL; and Departments of Neurology (M.S.V.E.) and Medicine (S.S.), College of Physicians and Surgeons, and Department of Epidemiology (M.S.V.E.), Mailman School of Public Health, Columbia University, New York
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Raz S, Sheban D, Gonen N, Stark M, Berman B, Assaraf YG. Severe hypoxia induces complete antifolate resistance in carcinoma cells due to cell cycle arrest. Cell Death Dis 2014; 5:e1067. [PMID: 24556682 PMCID: PMC3944254 DOI: 10.1038/cddis.2014.39] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 01/14/2014] [Indexed: 02/08/2023]
Abstract
Antifolates have a crucial role in the treatment of various cancers by inhibiting key enzymes in purine and thymidylate biosynthesis. However, the frequent emergence of inherent and acquired antifolate resistance in solid tumors calls for the development of novel therapeutic strategies to overcome this chemoresistance. The core of solid tumors is highly hypoxic due to poor blood circulation, and this hypoxia is considered to be a major contributor to drug resistance. However, the cytotoxic activity of antifolates under hypoxia is poorly characterized. Here we show that under severe hypoxia, gene expression of ubiquitously expressed key enzymes and transporters in folate metabolism and nucleoside homeostasis is downregulated. We further demonstrate that carcinoma cells become completely refractory, even at sub-millimolar concentrations, to all hydrophilic and lipophilic antifolates tested. Moreover, tumor cells retained sensitivity to the proteasome inhibitor bortezomib and the topoisomerase II inhibitor doxorubicin, which are independent of cell cycle. We provide evidence that this antifolate resistance, associated with repression of folate metabolism, is a result of the inability of antifolates to induce DNA damage under hypoxia, and is attributable to a hypoxia-induced cell cycle arrest, rather than a general anti-apoptotic mechanism. Our findings suggest that solid tumors harboring a hypoxic core of cell cycle-arrested cells may display antifolate resistance while retaining sensitivity to the chemotherapeutics bortezomib and doxorubicin. This study bears important implications for the molecular basis underlying antifolate resistance under hypoxia and its rational overcoming in solid tumors.
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Affiliation(s)
- S Raz
- Department of Biology, The Fred Wyszkowski Cancer Research Laboratory, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - D Sheban
- Department of Biology, The Fred Wyszkowski Cancer Research Laboratory, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - N Gonen
- Department of Biology, The Fred Wyszkowski Cancer Research Laboratory, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - M Stark
- Department of Biology, The Fred Wyszkowski Cancer Research Laboratory, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - B Berman
- Department of Biology, The Fred Wyszkowski Cancer Research Laboratory, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - Y G Assaraf
- Department of Biology, The Fred Wyszkowski Cancer Research Laboratory, Technion-Israel Institute of Technology, Haifa 3200003, Israel
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Stark M, Ditze S, Lepper M, Zhang L, Schlott H, Buchner F, Röckert M, Chen M, Lytken O, Steinrück HP, Marbach H. Massive conformational changes during thermally induced self-metalation of 2H-tetrakis-(3,5-di-tert-butyl)-phenylporphyrin on Cu(111). Chem Commun (Camb) 2014; 50:10225-8. [DOI: 10.1039/c4cc03708a] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
2HTTBPP on Cu(111) behaves almost like a loaded spring which is held by the strong attractive interactions of the iminic nitrogens with the Cu substrate and is released upon metalation.
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Affiliation(s)
- M. Stark
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - S. Ditze
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - M. Lepper
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - L. Zhang
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - H. Schlott
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - F. Buchner
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - M. Röckert
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - M. Chen
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - O. Lytken
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - H.-P. Steinrück
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
| | - H. Marbach
- Lehrstuhl für Physikalische Chemie II
- Egerlandstrasse 3 and Interdisciplinary Center for Molecular Materials (ICMM)
- Universität Erlangen-Nürnberg
- D-91058 Erlangen, Germany
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Mynbaev OA, Eliseeva MY, Tinelli A, Malvasi A, Kosmas IP, Medvediev MV, Kalzhanov ZR, Stark M. An inexact study design produced misleading conclusions: to perform operative procedures in an optimized local atmosphere: CAn it reduce post-operative adhesion formation? de Vries A, Mårvik R, Kuhry E. [Int J Surg 11 (2013) 1118-1122]. Int J Surg 2013; 12:190-1. [PMID: 24316018 DOI: 10.1016/j.ijsu.2013.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/15/2013] [Indexed: 11/24/2022]
Affiliation(s)
- O A Mynbaev
- Moscow Institute of Physics & Technology (State University), Dolgoprudny, Moscow, Russia; Moscow State University of Medicine & Dentistry, Delegatskaya Str 20/1, Moscow 127374, Russia; The Department of Obstetrics, Gynecology & Reproductive Medicine, Peoples' Friendship University of Russia, Miklukho-Maklay, 21 Build 3, 117198 Moscow, Russia; The New European Surgical Academy, Berlin, Germany.
| | - M Yu Eliseeva
- The Department of Obstetrics, Gynecology & Reproductive Medicine, Peoples' Friendship University of Russia, Miklukho-Maklay, 21 Build 3, 117198 Moscow, Russia
| | - A Tinelli
- Department of Obstetrics and Gynaecology, Division of Experimental Endoscopic Surgery, Imaging, Minimally Invasive Therapy and Technology, Vito Fazzi Hospital, Piazza Muratore, 73100 Lecce, Italy
| | - A Malvasi
- Obstetrics and Gynecology Department, Santa Maria Hospital, Bari, Italy
| | - I P Kosmas
- Xatzikosta General Hospital, Ioannina, 45110 Ioannina, Greece
| | - M V Medvediev
- Dnepropetrovsk State Medical University, Dnepropetrovsk, Ukraine
| | - Zh R Kalzhanov
- School of Health and Human Sciences, University of Essex, UK
| | - M Stark
- The New European Surgical Academy, Berlin, Germany
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Abstract
Necrotizing enterocolitis is the most common gastrointestinal emergency in neonates. The etiology is considered multifactorial. Risk factors include prematurity, enteral feeding, hypoxia, and bacterial colonization. The etiologic role of viruses is unclear. We present a case of necrotizing enterocolitis associated with cytomegalovirus and Proteobacteria in a 48-day-old, ex-premature infant and discuss the effects of potential viral-bacterial interactions on host susceptibility to this disease.
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Affiliation(s)
- Lynn Tran
- Pediatrix Medical Group of Louisiana, Baton Rouge General Hospital Medical Center, Baton Rouge, Louisiana 70118, USA
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Stark M, Lukaszuk J, Prawitz A, Salacinski A. Protein timing and its effects on muscular hypertrophy and strength in individuals engaged in weight-training. J Int Soc Sports Nutr 2012; 9:54. [PMID: 23241341 PMCID: PMC3529694 DOI: 10.1186/1550-2783-9-54] [Citation(s) in RCA: 34] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 12/10/2012] [Indexed: 11/10/2022] Open
Abstract
The purpose of this review was to determine whether past research provides conclusive evidence about the effects of type and timing of ingestion of specific sources of protein by those engaged in resistance weight training. Two essential, nutrition-related, tenets need to be followed by weightlifters to maximize muscle hypertrophy: the consumption of 1.2-2.0 g protein.kg -1 of body weight, and ≥44-50 kcal.kg-1 of body weight. Researchers have tested the effects of timing of protein supplement ingestion on various physical changes in weightlifters. In general, protein supplementation pre- and post-workout increases physical performance, training session recovery, lean body mass, muscle hypertrophy, and strength. Specific gains, differ however based on protein type and amounts. Studies on timing of consumption of milk have indicated that fat-free milk post-workout was effective in promoting increases in lean body mass, strength, muscle hypertrophy and decreases in body fat. The leucine content of a protein source has an impact on protein synthesis, and affects muscle hypertrophy. Consumption of 3-4 g of leucine is needed to promote maximum protein synthesis. An ideal supplement following resistance exercise should contain whey protein that provides at least 3 g of leucine per serving. A combination of a fast-acting carbohydrate source such as maltodextrin or glucose should be consumed with the protein source, as leucine cannot modulate protein synthesis as effectively without the presence of insulin. Such a supplement post-workout would be most effective in increasing muscle protein synthesis, resulting in greater muscle hypertrophy and strength. In contrast, the consumption of essential amino acids and dextrose appears to be most effective at evoking protein synthesis prior to rather than following resistance exercise. To further enhance muscle hypertrophy and strength, a resistance weight- training program of at least 10-12 weeks with compound movements for both upper and lower body exercises should be followed.
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Affiliation(s)
- Matthew Stark
- School of Family, Consumer, and Nutrition Sciences, Northern Illinois University, DeKalb, IL, USA.
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MacGregor S, Brown KM, Stark M, Gartside M, Woods S, Bonazzi V, Aoude L, Dutton-Regester K, Tyagi S, Liu J, Duffy DL, Palmer J, Cust A, Schmid H, Symmons J, Holland E, Agha-Hamilton C, Holohan K, Youngkin D, Gillanders E, Jenkins MA, Kelly J, Whiteman DC, Kefford R, Giles G, Armstrong B, Aitken J, Hopper J, Montgomery G, Schmidt C, Trent JM, Martin NG, Mann GJ, Hayward NK. From GWAS to genome sequencing: complementary approaches to identify melanoma predisposition genes. Hered Cancer Clin Pract 2012. [PMCID: PMC3327126 DOI: 10.1186/1897-4287-10-s2-a46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Tinelli A, Hurst BS, Hudelist G, Tsin DA, Stark M, Mettler L, Guido M, Malvasi A. Laparoscopic myomectomy focusing on the myoma pseudocapsule: technical and outcome reports. Hum Reprod 2012; 27:427-435. [DOI: 10.1093/humrep/der369] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Zizza A, Tinelli A, Malvasi A, Barbone E, Stark M, De Donno A, Guido M. Caesarean section in the world: a new ecological approach. J Prev Med Hyg 2011; 52:161-173. [PMID: 22442920] [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: 05/31/2023]
Abstract
INTRODUCTION This study aimed to estimate the most recent caesarean section rates in the world and examine the association between these rates and old and new indicators of health care. METHODS Authors analyzed the Caesarean Section (CS) rates, also in geo-economic and economic groups, and correlated them to maternal and neonatal mortality, to births attended by skilled health personnel and to births among adolescents. Analysis of covariance and piecewise regressions were used for the statistical analysis. RESULTS In 47.2% of the countries, the CS rate exceeded 15%. Countries of Latin America and the Caribbean along with Europe, North America and Oceania had the highest values. The analysis showed an inverse association between CS rates and Maternal Mortality (MMR) and Neonatal Mortality (NMR) for all geographical areas except for Europe. The greatest association was observed in lower-middle-income countries. In developing countries only 50% of cases, occur in medical facilities and only half of these are seen by medical, nursing and obstetrical staff. Age of the mother appears to influence the outcome and choice of delivery type. Countries where an high ABR rate is present have low CS use. CONCLUSIONS To best evaluate the consequences of the increasing rate of CS, it would be useful to identify the most sensitive outcome indicators.
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Affiliation(s)
- A Zizza
- Institute of Clinical Physiology, IFC-CNR, National Council of Research, Lecce, Italy.
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Malvasi A, Tinelli A, Gustapane S, Mazzone E, Cavallotti C, Stark M, Bettocchi S. Surgical technique to avoid bladder flap formation during cesarean section. G Chir 2011; 32:498-503. [PMID: 22217381] [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: 05/31/2023]
Abstract
Cesarean section (CS) is now the most common major surgical procedure performed on women worldwide. A CS can be performed by either suturing or not suturing of the visceral peritoneum. Creation of the bladder flap is an integral step of the standard cesarean section. The bladder flap is made by superficially incising and dissecting the peritoneal lining to separate the urinary bladder from the lower uterine segment. It's still debated whether the formation of bladder flap is advantageous or not. If the uterine incision is made slightly above the vesicouterine peritoneal fold, the loose connective tissue between the uterus and the urinary bladder allows spontaneous descent of the bladder. Evidence on the role of the bladder flap in cesarean section is very limited. At present, it remains to be established whether there is any advantage in dissecting the bladder from the lower uterine segment during cesarean section.
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Steinrück HP, Libuda J, Wasserscheid P, Cremer T, Kolbeck C, Laurin M, Maier F, Sobota M, Schulz PS, Stark M. Surface science and model catalysis with ionic liquid-modified materials. Adv Mater 2011; 23:2571-2587. [PMID: 21520462 DOI: 10.1002/adma.201100211] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Indexed: 05/30/2023]
Abstract
Materials making use of thin ionic liquid (IL) films as support-modifying functional layer open up a variety of new possibilities in heterogeneous catalysis, which range from the tailoring of gas-surface interactions to the immobilization of molecularly defined reactive sites. The present report reviews recent progress towards an understanding of "supported ionic liquid phase (SILP)" and "solid catalysts with ionic liquid layer (SCILL)" materials at the microscopic level, using a surface science and model catalysis type of approach. Thin film IL systems can be prepared not only ex-situ, but also in-situ under ultrahigh vacuum (UHV) conditions using atomically well-defined surfaces as substrates, for example by physical vapor deposition (PVD). Due to their low vapor pressure, these systems can be studied in UHV using the full spectrum of surface science techniques. We discuss general strategies and considerations of this approach and exemplify the information available from complementary methods, specifically photoelectron spectroscopy and surface vibrational spectroscopy.
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Affiliation(s)
- H-P Steinrück
- Lehrstuhl für Physikalische Chemie 2 and Erlangen Catalysis, Resource Center, Friedrich-Alexander-Universität Erlangen-Nürnberg, Egerlandstr. 3, 91058 Erlangen, Germany.
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Malvasi A, Tinelli A, Brizzi A, Guido M, Laterza F, De Nunzio G, Bochicchio M, Ghi T, Stark M, Benhamou D, Di Renzo GC. Intrapartum sonography head transverse and asynclitic diagnosis with and without epidural analgesia initiated early during the first stage of labor. Eur Rev Med Pharmacol Sci 2011; 15:518-523. [PMID: 21744746] [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: 05/31/2023]
Abstract
PURPOSE To investigate if early epidural analgesia can influence fetal head engagement into the pelvis and if it can increase the rate of transverse and asynclitic position during labour. MATERIALS AND METHODS 195 women with combined spinal-epidural analgesia (CSE) or without neuraxial analgesia were studied. CSE was performed using a mixture of ropivacaine 0.02% with 0.3 microg/ml of sufentanil administered in the spinal space. Maintenance of analgesia was managed with intermittent epidural administration of 10-15 ml of ropivacaine (0.07%-0.10%) mixed with 0.5 microg/ml of sufentanil, based on the stage of labour and the degree of pain. 2D transabdominal ultrasound (US) was used. Serial transabdominal US examinations were performed at 45-90 min intervals to detect transverse and asynclitic positions, using the following signs: squint sign, sunset thalamus and cerebellum signs that best details the fetal head station. After delivery, the complete set of clinical and US data obtained by each examination were recorded and compared in women with and without labour analgesia. Data were examined by independent reviewers. RESULTS There was no difference in obstetric outcome between women in whom CSE had been used and those who did not request analgesia during labour (p > 0.05). CONCLUSIONS Epidural analgesia initiated early during labour and using low doses does not increase the rate of dystocic labors. Transverse fetal head positioning with anterior or posterior asynclitism does not seem to be promoted by drug or technique-related mechanisms, but rather should be the consequence of cephalopelvic disproportion.
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Affiliation(s)
- A Malvasi
- Department of Obstetrics and Gynaecology, Santa Maria Hospital, Bari, Italy.
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Wohlmayr M, Stark M, Pernkopf F. A Probabilistic Interaction Model for Multipitch Tracking With Factorial Hidden Markov Models. ACTA ACUST UNITED AC 2011. [DOI: 10.1109/tasl.2010.2064309] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Cremer T, Stark M, Deyko A, Steinrück HP, Maier F. Liquid/solid interface of ultrathin ionic liquid films: [C1C1Im][Tf2N] and [C8C1Im][Tf2N] on Au(111). Langmuir 2011; 27:3662-71. [PMID: 21361299 DOI: 10.1021/la105007c] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Ultrathin films of two imidazolium-based ionic liquids (IL), [C(1)C(1)Im][Tf(2)N] (= 1,3-dimethylimidazolium bis(trifluoromethyl)imide) and [C(8)C(1)Im][Tf(2)N] (= 1-methyl-3-octylimidazolium bis(trifluoromethyl)imide) were prepared on a Au(111) single-crystal surface by physical vapor deposition in ultrahigh vacuum. The adsorption behavior, orientation, and growth were monitored via angle-resolved X-ray photoelectron spectroscopy (ARXPS). Coverage-dependent chemical shifts of the IL-derived core levels indicate that for both ILs the first layer is formed from anions and cations directly in contact with the Au surface in a checkerboard arrangement and that for [C(8)C(1)Im][Tf(2)N] a reorientation of the alkyl chain with increasing coverage is found. For both ILs, geometry models of the first adsorption layer are proposed. For higher coverages, both ILs grow in a layer-by-layer fashion up to thicknesses of at least 9 nm (>10 ML). Moreover, beam damage effects are discussed, which are mainly related to the decomposition of [Tf(2)N](-) anions directly adsorbed at the gold surface.
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Affiliation(s)
- T Cremer
- Lehrstuhl für Physikalische Chemie II and Erlangen Catalysis Resource Center, Friedrich-Alexander-Universität, Erlangen-Nürnberg Egerlandstrasse 3, 91058 Erlangen, Germany
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Stauffer JA, Shaddix KK, Achem SR, Stark M, Adelson A, Metzger PP, Landmann RG. Intra-operative use of super-selective or highly selective angiography with methylene blue injection to localize arterial-venous malformation. Colorectal Dis 2011; 13:e65-6. [PMID: 20236147 DOI: 10.1111/j.1463-1318.2010.02257.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- J A Stauffer
- Department of Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA
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Abstract
A case of myofibrosarcoma of breast is reported. A female patient aged 81 years presented with a mammary mass lesion. Histologically, the tumor consisted of neoplastic spindle cells arranged in fascicles and with variably cellularity and hyalinization. Immunohistochemical studies showed expression of vimentin, smooth-muscle actin, and Bcl-2, but not desmin, S-100, C-kit, or CD34. Proliferative index identified by Ki67 was approximately 30%. Electron microscopy revealed variable amount of rough endoplasmic reticulum, myofilaments, fibronexus junctions, and fibronectin fibrils. The histological, immunohistochemical, and ultrastructural features of this tumor were consistent with myofibrosarcoma. This case will be one of the very few cases of ultrastructurally confirmed mammary myofibrosarcoma reported in the literature and contributes to the recognition of this rare mammary malignant neoplasm. The literature on mammary myofibrosarcoma and its differential diagnosis is also reviewed.
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Affiliation(s)
- Matthew Stark
- Department of Pathology, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA 70112, USA
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Demenais F, Mohamdi H, Chaudru V, Goldstein AM, Newton Bishop JA, Bishop DT, Kanetsky PA, Hayward NK, Gillanders E, Elder DE, Avril MF, Azizi E, van Belle P, Bergman W, Bianchi-Scarrà G, Bressac-de Paillerets B, Calista D, Carrera C, Hansson J, Harland M, Hogg D, Höiom V, Holland EA, Ingvar C, Landi MT, Lang JM, Mackie RM, Mann GJ, Ming ME, Njauw CJ, Olsson H, Palmer J, Pastorino L, Puig S, Randerson-Moor J, Stark M, Tsao H, Tucker MA, van der Velden P, Yang XR, Gruis N. Association of MC1R variants and host phenotypes with melanoma risk in CDKN2A mutation carriers: a GenoMEL study. J Natl Cancer Inst 2010; 102:1568-83. [PMID: 20876876 PMCID: PMC2957428 DOI: 10.1093/jnci/djq363] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Carrying the cyclin-dependent kinase inhibitor 2A (CDKN2A) germline mutations is associated with a high risk for melanoma. Penetrance of CDKN2A mutations is modified by pigmentation characteristics, nevus phenotypes, and some variants of the melanocortin-1 receptor gene (MC1R), which is known to have a role in the pigmentation process. However, investigation of the associations of both MC1R variants and host phenotypes with melanoma risk has been limited. Methods We included 815 CDKN2A mutation carriers (473 affected, and 342 unaffected, with melanoma) from 186 families from 15 centers in Europe, North America, and Australia who participated in the Melanoma Genetics Consortium. In this family-based study, we assessed the associations of the four most frequent MC1R variants (V60L, V92M, R151C, and R160W) and the number of variants (1, ≥2 variants), alone or jointly with the host phenotypes (hair color, propensity to sunburn, and number of nevi), with melanoma risk in CDKN2A mutation carriers. These associations were estimated and tested using generalized estimating equations. All statistical tests were two-sided. Results Carrying any one of the four most frequent MC1R variants (V60L, V92M, R151C, R160W) in CDKN2A mutation carriers was associated with a statistically significantly increased risk for melanoma across all continents (1.24 × 10−6 ≤ P ≤ .0007). A consistent pattern of increase in melanoma risk was also associated with increase in number of MC1R variants. The risk of melanoma associated with at least two MC1R variants was 2.6-fold higher than the risk associated with only one variant (odds ratio = 5.83 [95% confidence interval = 3.60 to 9.46] vs 2.25 [95% confidence interval = 1.44 to 3.52]; Ptrend = 1.86 × 10−8). The joint analysis of MC1R variants and host phenotypes showed statistically significant associations of melanoma risk, together with MC1R variants (.0001 ≤ P ≤ .04), hair color (.006 ≤ P ≤ .06), and number of nevi (6.9 × 10−6 ≤ P ≤ .02). Conclusion Results show that MC1R variants, hair color, and number of nevi were jointly associated with melanoma risk in CDKN2A mutation carriers. This joint association may have important consequences for risk assessments in familial settings.
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Affiliation(s)
- F Demenais
- INSERM U946, Fondation Jean-Dausset-CEPH , 27 rue Juliette Dodu, 75010 Paris, France.
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Malvasi A, Tinelli A, Brizzi A, Guido M, Martino V, Casciaro S, Celleno D, Frigo MG, Stark M, Benhamou D. Intrapartum sonography for occiput posterior detection in early low dose combined spinal epidural analgesia by sufentanil and ropivacaine. Eur Rev Med Pharmacol Sci 2010; 14:799-806. [PMID: 21061841] [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: 05/30/2023]
Abstract
AIM To evaluate the incidence of occiput posterior position in labour with and without combined spinal epidural analgesia (CSE) by low dose of sufentanyl and ropivacaine. MATERIAL AND METHODS This study focused on 132 women subdivided in two groups, patients in spontaneous and in labour analgesia, administered by a low dose CSE by sufentanyl and ropivacaine; all women were evaluated by digital examinations and ultrasound till delivery. All data were collected and analyzed by an independent reviewer. RESULTS In the second stage, 79 were persistent occiput posterior position (POPP) fetuses and 36 were translated from anterior to posterior position (TAPP) fetuses. Specifically, in spontaneous labour on 25 women in anterior position, there were 17 TAPP and in CSE analgesia on 28 women in anterior, there were 19 in TAPP, without significant differences. The number of asynclitisms was higher in the POPP group (84%) respect to the TAPP group (75%), so as the rate of caesarean section (67% versus 52.7%). CONCLUSIONS The labour with low dose of ropivacaine and sufentanyl does not increase the occiput posterior position during fetal descent, leading to a POPP. Finally, since in the occiput anterior presentation labour analgesia significantly lengthens time to delivery, in the occiput posterior position this is significantly increased, with a prolonged second stage of labour and reduced time of descent of fetal head in obstetric pelvis.
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Affiliation(s)
- A Malvasi
- Department of Obstetrics and Gynaecology, "Santa Maria" Hospital, Bari, Italy.
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Malvasi A, Tinelli A, Stark M, Pontrelli G, Brizzi A, Wetzl RG, Benhamou D. Low-dose sequential combined spinal-epidural anaesthesia in elective Stark caesarean section: a preliminary cohort study. Eur Rev Med Pharmacol Sci 2010; 14:215-221. [PMID: 20391961] [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: 05/29/2023]
Abstract
AIM To compare combined spinal-epidural anaesthesia (CSE) VS spinal anaesthesia (SA) in caesarean section (CS) performed by Stark method. MATERIAL AND METHODS 200 women were prospectively studied before undergoing to a Stark CS in two groups: 95 patients were assigned to a local anaesthesia by SA (first group) and 105 women to CSE anaesthesia (second group). After a pre-load of 500 ml of plasma expander in both groups, SA was performed at the L1-L2 interspace with an injection of 5 ml of levobupivacaine 0.15%, with a 5 mcg of Sufentanil. The CSE was performed by a spinal-epidural injection at the L1-L2 interspace, primarily by 4 ml of levobupivacaine 0.125% and 5 mcg of Sufentanil, then by 3-7 mL of xilocaine carbonate 0.5% plus 1 mcg/ml of Sufentanil. Successively a CS by Stark method was performed in both groups. The recorded anaesthesiologic side effects in two groups were: motor block, intraoperative discomfort, vomiting, bradycardia and hypotension. Statistical evaluation was by Z-Test referred to the comparison of 2 portions with great, independent samples. RESULTS In the group with CSE anaesthesia, the prevalence of side effects was less than in the group treated with SA, where the prevalence of the motor block and intraoperative discomfort were greater and statistically significant (p<0.001); so as the vomiting and bradycardia were all in a major percentage in SA group, but only significant for hypotension (p<0.001). CONCLUSIONS These preliminary data show that the association between CS and CSE anaesthesia in elective CS by Stark method allow to have less intra and post-operative side effects; further studies need to provide specific details on the anaesthetic and surgical techniques, to tailor and optimize both in each patient to select for surgery.
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Affiliation(s)
- A Malvasi
- Department of Obstetrics and Gynaecology, "Santa Maria" Hospital, Bari, Italy.
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Stark M. I316 The ten step vaginal hysterectomy. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60316-7] [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: 10/20/2022]
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