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Avila M, Funston JR, Hoffman MS. Robotic radical stump trachelectomy: Critical steps of a radical procedure without normal anatomical landmarks. Gynecol Oncol Rep 2024; 53:101384. [PMID: 38633672 PMCID: PMC11021824 DOI: 10.1016/j.gore.2024.101384] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
Background Cervical stump malignancies are an uncommon finding post subtotal hysterectomy. Tumors arise from a primary cervical origin with an incidence of 1-5%. Other described malignancies can include uterine origin, ovarian origin or as metastases from another primary site. A uterine primary is an extremely rare entity and can result from remnant endometrial tissue at the stump apex. Case 70yo female with a history of remote supracervical hysterectomy for benign indication who presented with postmenopausal spotting. Endocervical curettage of the endocervical stump revealed a grade 2 endometrioid endometrial adenocarcinoma. She was taken to the operating for a robotic radical stump trachelectomy and sentinel lymph node dissection. Conclusions The surgical video delineates key surgical steps of robotic radical stump trachelectomy including robotic port placement and injection of ICG dye, adhesiolysis and restoration of normal anatomy, opening of the pelvic spaces and exposure of the retroperitoneum, identification and excision of pelvic sentinel lymph nodes, bladder dissection, ureterolysis and ligation of uterine remnant, ureteric tunnel dissection and mobilization of parametrial wing, delineation of a vaginal margin, colpotomy and specimen removal, and vaginal cuff closure.
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Affiliation(s)
- Monica Avila
- Department of Gynecologic Oncology, H Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Mitchel S. Hoffman
- Department of Gynecologic Oncology, H Lee Moffitt Cancer Center, Tampa, FL, USA
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Scussel A, Marcondes-Braga F, Espinoza C, De Marchi D, Avila M, Duque A, de Paulo A, Mangini S, de Campos I, Seguro L, Gaiotto F, Bacal F. The Role of High-Sensitive Troponin in Identifying Patients with Cardiac Allograft Rejection. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1223] [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: 04/05/2023] Open
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Aronowitz D, Bougioukas L, Newman J, Avila M, Kon Z, Saikus C. Mechanical Circulatory Support and Heart Transplantation for Acute on Chronic Heart Failure in Untreated Hypothyroidism. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.630] [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: 04/05/2023] Open
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Stawiarski K, Stevens G, Kon Z, Saikus C, Avila M. Complete Heart Block as a Presentation of Antibody Medication Rejection Early Post Heart-Lung Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1231] [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: 04/05/2023] Open
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Pham MM, Avila M, Hinchcliff E, Westin SN. Clinical Application of Poly(ADP-Ribose) Polymerase (PARP) Inhibitors in Ovarian Cancer. Cancer Treat Res 2023; 186:71-89. [PMID: 37978131 DOI: 10.1007/978-3-031-30065-3_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The treatment of ovarian cancer has remained a clinical challenge despite high rates of initial response to platinum-based chemotherapy. Patients are generally diagnosed at an advanced stage with significant disease burden, which portends to worse survival outcomes. Deficiencies in the homologous recombination (HRD) DNA damage repair (DDR) pathway and mutations in the BRCA1/2 genes have been found in ovarian carcinomas. Moreover, patients with these specific molecular aberrations have demonstrated sensitivity and thus improved response to poly(ADP-ribose) polymerase inhibitor (PARPi) treatment. The results of various clinical trials exploring the use of PARPi in different populations of ovarian cancer patients have shown impressive survival and response outcomes. With expanding indications, the use of PARPi has thus changed the landscape of ovarian cancer treatment. In this chapter, we will describe the different settings of PARPi treatment-frontline maintenance therapy, maintenance therapy for patients with recurrent platinum-sensitive disease, and treatment in the recurrent setting-and discuss treatment considerations and management of toxicities, as well as offer thoughts on future directions.
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Affiliation(s)
- Melissa M Pham
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, M.D. Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA
| | - Monica Avila
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, M.D. Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA
- Department of Gynecologic Oncology, H. Lee Moffitt Center and Research Institute, Tampa, USA
| | - Emily Hinchcliff
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, M.D. Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA.
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Batman S, Rauh-Hain JA, Grinsfelder MO, Harrison R, Avila M, Cun H, How JA, Tandon N, Wang X, Hinchcliff E, Jazaeri AA, Schmeler KM. Exceptional Response to Pembrolizumab for Treatment of Metastatic Chemorefractory Endometrial Carcinoma in a Patient with Lynch Syndrome: A Case Report. Case Rep Oncol 2023; 16:273-278. [PMID: 37123608 PMCID: PMC10134052 DOI: 10.1159/000530154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/02/2023] [Indexed: 05/02/2023] Open
Abstract
Advanced endometrial cancer is associated with poor outcomes and few treatment options exist. Recently, the US Federal Drug Administration approved pembrolizumab for the treatment of endometrial cancers that are deficient in mismatch repair and have high microsatellite instability (MSI). Lynch syndrome is an autosomal dominant disease that causes MSI-high endometrial cancer. We report a case of a 46-year-old woman with Lynch syndrome and advanced endometrial cancer who experienced progressive disease after treatment with chemotherapy with carboplatin and paclitaxel. She was then treated with single-agent pembrolizumab and had an exceptional response. She was noted to have a significant decrease in the size of a large uterine mass extending into the vagina and vulva, as well as decrease in the size of lymphadenopathy. Data are limited at this time for patients with Lynch syndrome treated with single-agent pembrolizumab. Our case report seeks to add to the body of literature that suggests that this patient population may particularly benefit from this novel therapy.
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Affiliation(s)
- Samantha Batman
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J. Alejandro Rauh-Hain
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Ross Harrison
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monica Avila
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Han Cun
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey Andrew How
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nidhi Tandon
- Department of Pathology, The University of Texas Houston McGovern Medical School, Houston, TX, USA
| | - Xiaohong Wang
- Department of Pathology, The University of Texas Houston McGovern Medical School, Houston, TX, USA
| | - Emily Hinchcliff
- Department of Gynecologic Oncology, Northwestern University Feinberg School of Medicine and Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Amir Anthony Jazaeri
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kathleen M. Schmeler
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Avila M, Grinsfelder MO, Pham M, Westin SN. Targeting the PI3K Pathway in Gynecologic Malignancies. Curr Oncol Rep 2022; 24:1669-1676. [PMID: 36401704 PMCID: PMC10862662 DOI: 10.1007/s11912-022-01326-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW This review explores the PI3K pathway aberrations common in gynecologic malignancies, the relevant therapeutic targets that have been explored to date particularly given their success in endometrial cancers, and predictive biomarkers of response to therapy. RECENT FINDINGS Landmark trials have been noted involving this pathway, particularly in endometrial cancers. One phase II trial of the potent orally bioavailable mTOR inhibitor, everolimus, in combination with letrozole demonstrated an unprecedented clinical benefit rate (CBR) of 40% and high objective response rate (RR) of 32% in hormone agnostic endometrial cancers. This was followed by GOG 3007 that compared everolimus and letrozole to hormonal therapy yielding similar response rates but double progression-free survival rates. The phosphoinositide 3-kinase (PI3K) signaling pathway is implicated in tumorigenesis given its regulation over cell growth, cellular trafficking, and angiogenesis. In gynecologic malignancies, alterations in PI3K signaling are common. Therefore, developing modulators of the PI3K pathway and identifying molecular markers to predict response are of great interest for these cancer types.
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Affiliation(s)
- Monica Avila
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA
| | - Michaela Onstad Grinsfelder
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA
| | - Melissa Pham
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA
| | - Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1155 Herman Pressler Dr. CPB 6.3279, Houston, TX, 77030, USA.
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Ashraf-Uz-Zaman M, Ji G, Tidwell D, Yin L, Thakolwiboon S, Pan J, Junell R, Griffin Z, Shahi S, Barthels D, Sajib MS, Trippier PC, Mikelis CM, Das H, Avila M, Neugebauer V, German NA. Correction to "Evaluation of Urea-Based Inhibitors of the Dopamine Transporter Using the Experimental Autoimmune Encephalomyelitis Model of Multiple Sclerosis". ACS Chem Neurosci 2022; 13:3138. [PMID: 36264675 DOI: 10.1021/acschemneuro.2c00459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tielke J, Maas M, Castillo M, Rezwan K, Avila M. Statistical analysis of thermal conductivity experimentally measured in water-based nanofluids. Proc Math Phys Eng Sci 2021. [DOI: 10.1098/rspa.2021.0222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Nanofluids are suspensions of nanoparticles in a base heat-transfer liquid. They have been widely investigated to boost heat transfer since they were proposed in the 1990s. We present a statistical correlation analysis of experimentally measured thermal conductivity of water-based nanofluids available in the literature. The influences of particle concentration, particle size, temperature and surfactants are investigated. For specific particle materials (alumina, titania, copper oxide, copper, silica and silicon carbide), separate analyses are performed. The conductivity increases with the concentration in qualitative agreement with Maxwell’s theory of homogeneous media. The conductivity also increases with the temperature (in addition to the improvement due to the increased conductivity of water). Surprisingly, only silica nanofluids exhibit a statistically significant effect of the particle size, whereby smaller particles lead to faster heat transfer. Overall, the large scatter in the experimental data prevents a compelling, unambiguous assessment of these effects. Taken together, the results of our analysis suggest that more comprehensive experimental characterizations of nanofluids are necessary to estimate their practical potential.
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Affiliation(s)
- J. Tielke
- University of Bremen, Center of Applied Space Technology and Microgravity (ZARM), Am Fallturm, 2, 28359 Bremen, Germany
| | - M. Maas
- University of Bremen, Advanced Ceramics, Am Biologischen Garten, 2, 28359 Bremen, Germany
- MAPEX Center for Materials and Processes, University of Bremen, 28359 Bremen, Germany
| | - M. Castillo
- University of Bremen, Center of Applied Space Technology and Microgravity (ZARM), Am Fallturm, 2, 28359 Bremen, Germany
| | - K. Rezwan
- University of Bremen, Advanced Ceramics, Am Biologischen Garten, 2, 28359 Bremen, Germany
- MAPEX Center for Materials and Processes, University of Bremen, 28359 Bremen, Germany
| | - M. Avila
- University of Bremen, Center of Applied Space Technology and Microgravity (ZARM), Am Fallturm, 2, 28359 Bremen, Germany
- MAPEX Center for Materials and Processes, University of Bremen, 28359 Bremen, Germany
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Avila M, Fellman B, Crumley S, Hudgens C, Tetzlaff M, Broaddus R. CD3+ tumor-associated lymphocytes as a novel prognostic biomarker in endometrial carcinoma. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Avila M, Fellman B, Broaddus R. Mismatch repair deficiency predicts worse survival despite adjuvant treatment in stage I endometrial cancer: Opportunities for novel adjuvant therapy. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Avila M, Fellman B, Crumley S, Hudgens C, Tetzlaff M, Broaddus R. A quantification model of lymphocytic tumor infiltration in endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Kurnit KC, Avila M, Hinchcliff EM, Coleman RL, Westin SN. PARP inhibition in the ovarian cancer patient: Current approvals and future directions. Pharmacol Ther 2020; 213:107588. [PMID: 32450190 PMCID: PMC8331065 DOI: 10.1016/j.pharmthera.2020.107588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022]
Abstract
Poly (ADP-ribose) polymerase (PARP) inhibitors have transformed the therapeutic management of solid tumors, particularly ovarian cancer. Initially studied in BRCA deficient tumors, the Food and Drug Administration (FDA) indications have expanded to include other homologous recombination deficient tumors as well as biomarker-wildtype tumors. They have also gained momentum not only as a treatment strategy, but as a maintenance strategy as well. While PARP inhibitors were initially ev aluated in the recurrent setting, they have now moved to frontline therapy. This review will discuss the current FDA indications of the clinically available PARP inhibitors for treatment and maintenance therapies. We will then review the recently completed and ongoing clinical trials which may inform future clinical approvals.
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Affiliation(s)
- Katherine C Kurnit
- Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, The University of Chicago, Chicago, IL, United States
| | - Monica Avila
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Emily M Hinchcliff
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Robert L Coleman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Centeno C, Serra Mitja P, Avila M, Carcereny E, Muñoz-Mármol AM, Moran T, Castellà E, Sanz-Santos J, García-Olivè I, Ramirez Serrano JL, Rosell Gratacos A, Andreo García F. Molecular analysis in cytological samples obtained by endobronchial or oesophageal ultrasound guided needle aspiration in non-small cell lung cancer. Pulmonology 2020; 28:28-33. [PMID: 32507497 DOI: 10.1016/j.pulmoe.2020.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/04/2020] [Revised: 04/28/2020] [Accepted: 05/03/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Cytological samples obtained by endobronchial ultrasound (EBUS) are capital for diagnosis, staging and molecular profile in non-small cell lung carcinoma (NSCLC). OBJECTIVE To assess the success rate of complete, partial and individual of molecular analysis in samples obtained by EBUS-guided transbronchial needle aspiration (TBNA) and/or by oesophageal ultrasound-guided fine needle aspiration with an echobronchoscope (EUS-B-FNA) in patients with NSCLC. METHODS Prospective study including 90 patients with non-squamous NSCLC, or non-smoking squamous. Cytological samples were classified into two groups. Group 1: PEN membrane slide and/or cell blocks for the determination of mutations of EGFR, KRAS, ERBB2 and BRAF. Group 2: silane coated slides or cell blocks for rearrangements of ALK, ROS1 and MET amplification. RESULTS The success rate was 78.6% for 4 molecular alterations (EGFR, KRAS, ALK and ROS1), and 44% for 7 determinations. The individual success rate for EGFR was 97%, KRAS 96.3%, ALK 85%, ROS1 82.3%, ERBB2 71.4%, BRAF 67.7% and MET 81.1%. There were no significant differences (p=0.489) in the number of molecular analyses (1-3 vs. 4) in group 1, depending on the types of samples (cell block vs. PEN membrane slide vs. cell block and PEN membrane slide). CONCLUSIONS In patients with NSCLC, the cytological material obtained by ultrasound-guided needle aspiration is sufficient for individual and partial molecular analysis in the vast majority of cases. Membrane slides such as cell blocks are valid samples for molecular analysis.
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Affiliation(s)
- C Centeno
- Bronchoscopy Unit, Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Department of Medicine, Universitat Autonoma de Barcelona, Spain.
| | - P Serra Mitja
- Bronchoscopy Unit, Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Department of Medicine, Universitat Autonoma de Barcelona, Spain
| | - M Avila
- Pathology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - E Carcereny
- Oncology Department, Badalona Applied Research Group in Oncology (B-ARGO), Institut Catala d' Oncologia, Barcelona, Spain
| | - A M Muñoz-Mármol
- Pathology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - T Moran
- Oncology Department, Badalona Applied Research Group in Oncology (B-ARGO), Institut Catala d' Oncologia, Barcelona, Spain
| | - E Castellà
- Pathology Department, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - J Sanz-Santos
- Bronchoscopy Unit, Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - I García-Olivè
- Bronchoscopy Unit, Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J L Ramirez Serrano
- Oncology Department, Badalona Applied Research Group in Oncology (B-ARGO), Institut Catala d' Oncologia, Barcelona, Spain
| | - A Rosell Gratacos
- Bronchoscopy Unit, Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Department of Medicine, Universitat Autonoma de Barcelona, Spain; CIBERES, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - F Andreo García
- Bronchoscopy Unit, Pulmonology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Department of Medicine, Universitat Autonoma de Barcelona, Spain; CIBERES, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
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Avila M, Wathoo C, Zeng J, Andersen C, Yuan Y, Yap TA, Rodon Ahnert J, Meric-Bernstam F. Variety of clinical trial enrollment by actionable tumor suppressor genotype. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15674 Background: In the last decade, genomics has been increasingly used for therapeutic management of cancer. In precision oncology, genes that can be directly or indirectly targeted with therapeutic agents are considered “actionable”. However, not all alterations affect gene function and alterations in tumor suppressor genes are especially challenging to interpret. The objective of this study was to determine frequency of trial enrollment in patients with “actionable” tumor suppressor alterations and determine whether this varied by genotype and tumor type. Methods: A single-institution retrospective review was performed on patients with metastatic, advanced, or recurrent solid tumors perceived to likely benefit from genomic profiling. Between 1/2015 and 1/2020, the top 5 tumor suppressor alterations CDKN2A, BRCA1/2, PTEN, ATM and NF1 were considered most common “actionable” tumor suppressor genes among patients reviewed by MD Anderson Precision Oncology Decision Support system. Once literature-based or inferred actionability of the tumor-suppressor alteration was determined, a clinical record review was performed to assess an institution-specific annotation detailing trial availability. This annotation matches somatic genomic alteration based on therapeutic significance and availability of matched investigative therapy based on available literature at the time. From here, patient demographics and trial enrollment was extracted from the electronic medical record. Results: 424 patients were categorized as having actionable alterations that had a trial available for enrollment based on genomic characteristics. Of these, 61 patients (14%) enrolled in a matched trial. Primary reasons for non-enrollment for a specific alteration were: enrollment in non-targeted therapeutic trial (39%), treatment with another stand of care therapy (32%), or enrollment in another genomically matched trial targeting another genomic alteration (14%). There was variability in enrollment by disease type approaching statistical significance (p = 0.073). CDKN2A alterations were the most common while BRCA1/2 had the highest rate of matched enrollment (39.5%). Conclusions: In this cohort of patients, the presence of an actionable tumor-suppressor alteration was associated with trial enrollment varying by genotype. Further work is needed to determine the impact of decision support on trial enrollment as well as strategies to increase actionability by building genomically-driven combination therapy trials.
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Affiliation(s)
- Monica Avila
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chetna Wathoo
- Sheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jia Zeng
- Sheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Clark Andersen
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Timothy A Yap
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Avila M, Fellman BM, Broaddus R. Tumor lymphocytic infiltration impacts recurrence in endometrioid-type endometrial carcinoma. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e15239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15239 Background: Endometrial cancers that have mismatch repair deficiency are associated with higher numbers of tumor-associated lymphocytes, but the clinical significance of this observation is unknown. Our objective was to quantify CD3+ and CD8+ tumor lymphocytes of MMR intact (MMRi) and MMRd endometrioid-type endometrial carcinomas and determine if there was an association with survival. Methods: MMRd was defined as endometrial carcinomas with loss of MLH1 expression due to MLH1 gene methylation and determined by immunohistochemistry. MMRi was defined as positive expression of MLH1, MSH2, MSH6, and PMS2. This was followed by Aperio image-based quantification was used to assess CD3+ and CD8+ lymphocyte populations in different regions of the primary endometrial carcinomas, including tumor periphery (tumor-myometrial interface), tumor center (bounded on all sides by tumor), and tumor hotspot (area with highest number of lymphocytes). Recurrence-free survival was estimated using Kaplan Meier and Cox regression. Median follow up time was 44 months. Results: 180 patients with endometrial carcinoma were analyzed of which 132 were MMRi and 48MMRd. The MMRd group had significantly higher levels of CD3+ and CD8+ lymphocytes regardless of which tumor region was assessed (Figure 1a, P < 0.001). Lymphocyte counts in both MMRd and MMRi groups had wide standard deviations such that there was some overlap in counts between the groups (Figure 1). Both MMRd and higher CD3+ counts were associated with worse recurrence-free survival. CD3+ quantification in the tumor periphery captured 21/23 recurrences (Figure 1b, HR = 8.04; 95% CI: 1.88 -34.31; p = 0.005); this included all of the MMRd cases that recurred and 7 MMRi cases with higher numbers of CD3+ lymphocytes that also recurred. Conclusions: MMRd endometrial cancers have increased numbers of CD3+ lymphocytic infiltrates within the primary tumor. Higher CD3+ infiltration is associated with greater risk of recurrence regardless of tumor location. In predicting tumor recurrence, lymphocytic counts performed better than assessment of MMR. Thus, quantification of CD3+ lymphocytes should be explored as a predictive biomarker.
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Affiliation(s)
- Monica Avila
- University of Texas MD Anderson Cancer Center, Houston, TX
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Lentz SE, Salyer CV, Dontsi M, Armstrong MA, Hoodfar E, Alvarado MM, Avila M, Nguyen NT, Powell CB. Comparison of two Lynch screening strategies in endometrial cancer in a California health system. Gynecol Oncol 2020; 158:158-166. [PMID: 32386910 DOI: 10.1016/j.ygyno.2020.04.692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/16/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Compare detection of Lynch syndrome in endometrial cancer between regions of a health care system with different screening strategies. METHODS A retrospective study of endometrial cancer (EC) cases from 2 regions of an integrated health care system (Kaiser Permanente Northern (KPNC) and Southern (KPSC) California). Within KPNC, immunohistochemistry tumor screening (IHC) was physician ordered and risk-based; within KPSC, IHC was universal and automated. Clinical risk factors associated with abnormal IHC and Lynch Syndrome (LS) were identified. RESULTS During the study, there were 2045 endometrial cancers: 1399 in the physician-order group and 646 in the universal testing group. In the physician-order group: among women < age 60, 34% underwent IHC; 9.6% were abnormal, and 3% were possible LS after methylation testing; among women ≥60, 11% underwent IHC, 3% were abnormal and <1% were possible LS. In the universal group, 87% of women age <60 had IHC, 19.4% were abnormal, and 6% were possible LS; Among women age ≥60, 82% underwent IHC, 26% were abnormal, and 2% were possible LS. There were no differences in LS cases between the physician-order group and the universal group in either age strata (<60: 3% vs. 3.6%, p=0.62; ≥60: <1% vs. 1%, p=0.63) Factors associated with LS were younger age (odds ratio (OR) 0.11, 95% confidence interval (CI) 0.04-0.29) and lower body mass index (BMI), (OR 0.38 95% CI 0.18-0.80). CONCLUSIONS Universal IHC screening did not result in increased LS detection in EC.
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Affiliation(s)
- Scott E Lentz
- Kaiser Permanente Southern California Gynecologic Oncology Program, United States of America
| | - Chelsea V Salyer
- Kaiser Permanente Oakland Ob/Gyn Residency Program, United States of America
| | - Makdine Dontsi
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States of America
| | - Mary Anne Armstrong
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States of America
| | - Elizabeth Hoodfar
- Kaiser Permanente Northern California Genetics Department, United States of America
| | - Monica M Alvarado
- Kaiser Permanente Southern California Regional Genetics Department, United States of America
| | - Monica Avila
- Kaiser Permanente Southern California Gynecologic Oncology Program, United States of America
| | - Nancy T Nguyen
- Kaiser Permanente Oakland Ob/Gyn Residency Program, United States of America
| | - C Bethan Powell
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States of America; Northern California Gynecologic Cancer Program, San Francisco, CA, United States of America.
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Plazas E, Casoti R, Avila M, Da Costa F, Cuca LE. Corrigendum to "Metabolomic profiling of Zanthoxylum species: Identification of anticholinesterase alkaloids candidates" [Phytochemistry 168 (2019) 112128]. Phytochemistry 2020; 172:112284. [PMID: 32014266 DOI: 10.1016/j.phytochem.2020.112284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Erika Plazas
- Universidad Nacional de Colombia, Sede Bogotá, Facultad de Ciencias, Departamento de Química, Grupo de Investigación en Química de Productos Naturales Bioactivos, Ciudad Universitaria, Av. Cr. 30 # 45-03, Bogotá, Colombia.
| | - Rosana Casoti
- AsterBioChem Research Team, University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Av. Do Café s/n, 140440-903, Ribeirão Preto, SP, Brazil
| | - Monica Avila
- Universidad Nacional de Colombia, Sede Bogotá, Facultad de Ciencias, Departamento de Química, Grupo de Investigación en Química de Productos Naturales Bioactivos, Ciudad Universitaria, Av. Cr. 30 # 45-03, Bogotá, Colombia
| | - Fernando Da Costa
- AsterBioChem Research Team, University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Av. Do Café s/n, 140440-903, Ribeirão Preto, SP, Brazil
| | - Luis Enrique Cuca
- Universidad Nacional de Colombia, Sede Bogotá, Facultad de Ciencias, Departamento de Química, Grupo de Investigación en Química de Productos Naturales Bioactivos, Ciudad Universitaria, Av. Cr. 30 # 45-03, Bogotá, Colombia
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Ayub-Ferreira SM, Avila M, Brandão S, Cruz FD, Wanderley M, Rigaud VO, Hajjar L, Kalil-Filho R, Cruz CB, Alves MS, Guimarães GV, Abduch M, Issa VS, Santos M, Bittencourt M, Bocchi EA. CARVEDILOL FOR PREVENTION OF CHEMOTHERAPY-INDUCED CARDIOTOXICITY: FINAL RESULTS OF THE PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND, PLACEBO CONTROLLED CECCY TRIAL. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31285-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Avila M, Siqueira S, Waldeck L, Ayub-Ferreira SM, Takx R, Bittencourt M, Bocchi EA. RENIN-ANGIOTENSIN SYSTEM AND BETA BLOCKERS IN PREVENTION OF ANTHRACYCLINE CARDIOTOXICITY: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31458-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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22
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23
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Iturriaga V, Bornhardt T, Avila M, Astete N, Cresp N. Quality of sleep, daytime sleepiness and used of stimulating substances in patients with orofacial musculoskeletal pain. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Avila M, Meric-Bernstam F. Next-generation sequencing for the general cancer patient. Clin Adv Hematol Oncol 2019; 17:447-454. [PMID: 31449513 PMCID: PMC6739831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Next-generation sequencing is a novel method of DNA sequencing that has become a cornerstone of precision oncology. This sequencing method detects differences in specific DNA sequences between a sample and a reference genome or matched normal DNA. In addition to single-nucleotide variants, other insertions, deletions, copy number changes, and fusions may be drivers of cancer growth, and thus represent therapeutic opportunities. As a result, genomic characterization has been increasingly used to guide treatment decisions, especially in patients with advanced disease. This review discusses the basic technologies involved in next-generation sequencing, the applications of this method, and limitations in the clinical realm.
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Affiliation(s)
- Monica Avila
- The University of Texas MD Anderson Cancer Center, Houston, Texas
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25
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26
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Avila M, Alvarado M, Axtell A, Goff J, Funston J, Lentz S. Universal immunohistochemistry testing in endometrial cancer tumors maximizes Lynch Syndrome identification among affected individuals. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.187] [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: 10/26/2022]
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27
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Salyer C, Lentz S, Dontsi M, Armstrong M, Butt A, Hoodfar E, Alvarado M, Landers E, Avila M, Nguyen N, Powell CB. Comparison of effectiveness of two strategies to identify Lynch Syndrome in women with endometrial cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.186] [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: 10/26/2022]
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Salyer C, Lentz S, Dontsi M, Armstrong M, Hoodfar E, Alvarado M, Landers E, Avila M, Nguyen N, Powell B. Lynch syndrome in women with endometrial cancer: Comparison of universal and age-based strategies in a California healthcare system. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.479] [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: 10/26/2022]
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29
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Avila M, Crumley S, Fellman B, Broaddus R. Identification of a subset of microsatellite-stable endometrial carcinoma with high PD-L1 expression and tumor-associated lymphocytes: A potential strategy for immune checkpoint blockade. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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30
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Avila M, Fellman B, Broaddus R. MSI-high due to MLH1 methylation is associated with worse recurrence-free and overall survival in endometrioid-type endometrial cancer: Implications for adjuvant therapy. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Serra P, Sanz-Santos J, Castellà E, Cirauqui B, Andreo F, Llatjós M, Avila M, Margelí M, Serrano L, Centeno C, Quiroga V, Torky M, Ruiz-Manzano J. Identification of oestrogen, progesterone receptor and human epidermal growth factor receptor 2 expression in mediastinal metastases of breast cancer obtained by endobronchial ultrasound-guided transbronchial needle aspiration. Cytopathology 2017; 29:35-40. [PMID: 29119620 DOI: 10.1111/cyt.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND In breast cancer patients, the expression statuses of oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are crucial in the choice of treatment. Receptor expression in metastatic lesions can differ from the primary tumour. The aim of our study was to analyse the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to obtain samples allowing the identification of ER, PR and HER2 expression in patients with mediastinal metastases of breast cancer. PATIENTS AND METHODS The clinical files of all patients with a final diagnosis of breast cancer mediastinal metastases diagnosed by EBUS-TBNA in our institution were retrospectively analysed. The ability of EBUS-TBNA to obtain samples that allowed hormone receptor and HER2 expression analysis was calculated. RESULTS Twenty-four patients were included. ER, PR and HER2 assessments could be performed in 22, 20 and 22 patients, respectively. In 20 of the 24 patients it was possible to investigate all three types of receptor expression. In the remaining four cases, where ER, PR or HER2 expression tests could not be performed, it was due to a lack of tissue. In cases with adequate results for EBUS-TBNA and the primary tumour agreement was greater for ER (16/19) and HER2 (12/14) than PR (8/17). Based on receptor status, there was a change in the choice of treatment for five patients. CONCLUSION In patients with breast cancer mediastinal metastases, ER, PR and HER2 expression can be assessed in samples obtained by EBUS-TBNA whenever a sufficient tissue sample is collected.
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Affiliation(s)
- P Serra
- Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain.,Department of Medicine, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra (Barcelona), Spain
| | - J Sanz-Santos
- Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain.,Department of Pulmonology, Hospital Mútua de Terrassa, Terrassa (Barcelona), Spain
| | - E Castellà
- Department of Pathology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - B Cirauqui
- Catalan Institute of Oncology, Badalona (Barcelona), Spain
| | - F Andreo
- Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - M Llatjós
- Department of Pathology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - M Avila
- Department of Pathology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - M Margelí
- Catalan Institute of Oncology, Badalona (Barcelona), Spain
| | - L Serrano
- Department of Pathology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - C Centeno
- Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - V Quiroga
- Catalan Institute of Oncology, Badalona (Barcelona), Spain
| | - M Torky
- Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
| | - J Ruiz-Manzano
- Department of Pulmonology, Hospital Germans Trias i Pujol, Badalona (Barcelona), Spain
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Avila M, Lentz S, Axtell A. Does Pre-Operative Vaginal Metronidazole Decrease the Risk of Pelvic Infections following Robotic Radical Hysterectomy? Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- F. Ceccherelli
- Istituto di Anestesiologia e Rianimazione, Università di Padova
| | - F. Ambrosio
- Istituto di Anestesiologia e Rianimazione, Università di Padova
| | - M. Avila
- Istituto di Anestesiologia e Rianimazione, Università di Padova
| | - G. Duse
- Istituto di Anestesiologia e Rianimazione, Università di Padova
| | - A. Munari
- Istituto di Anestesiologia e Rianimazione, Università di Padova
| | - G.P. Giron
- Istituto di Anestesiologia e Rianimazione, Università di Padova
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35
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Narberhaus B, Avila M, Orriols J, Saura J. Unilateral ptosis as the initial sign of multiple myeloma. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2014.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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36
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Thevenon J, Duplomb L, Phadke S, Eguether T, Saunier A, Avila M, Carmignac V, Bruel AL, St-Onge J, Duffourd Y, Pazour GJ, Franco B, Attie-Bitach T, Masurel-Paulet A, Rivière JB, Cormier-Daire V, Philippe C, Faivre L, Thauvin-Robinet C. Autosomal recessive IFT57 hypomorphic mutation cause ciliary transport defect in unclassified oral-facial-digital syndrome with short stature and brachymesophalangia. Clin Genet 2016; 90:509-517. [PMID: 27060890 DOI: 10.1111/cge.12785] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 01/04/2016] [Revised: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
The 13 subtypes of oral-facial-digital syndrome (OFDS) belong to the heterogeneous group of ciliopathies. Disease-causing genes encode for centrosomal proteins, components of the transition zone or proteins implicated in ciliary signaling. A unique consanguineous family presenting with an unclassified OFDS with skeletal dysplasia and brachymesophalangia was explored. Homozygosity mapping and exome sequencing led to the identification of a homozygous mutation in IFT57, which encodes a protein implicated in ciliary transport. The mutation caused splicing anomalies with reduced expression of the wild-type transcript and protein. Both anterograde ciliary transport and sonic hedgehog signaling were significantly decreased in subjects' fibroblasts compared with controls. Sanger sequencing of IFT57 in 13 OFDS subjects and 12 subjects with Ellis-Van Creveld syndrome was negative. This report identifies the implication of IFT57 in human pathology and highlights the first description of a ciliary transport defect in OFDS, extending the genetic heterogeneity of this subgroup of ciliopathies.
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Affiliation(s)
- J Thevenon
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France.,Centre de Référence maladies rares "Anomalies du Développement et syndrome malformatifs" de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France
| | - L Duplomb
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - S Phadke
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - T Eguether
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - A Saunier
- Laboratoire de Génétique Médicale, CHU - Hopitaux de Brabois, Vandoeuvre les Nancy cedex, France
| | - M Avila
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - V Carmignac
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - A-L Bruel
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - J St-Onge
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France.,Laboratoire de Génétique Moléculaire, PTB, CHU Dijon, Dijon, France
| | - Y Duffourd
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France
| | - G J Pazour
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - B Franco
- Telethon Institute of Genetics and Medicine, Naples, Italy.,Medical Genetics, Department of Medical Translational Sciences, University of Napoli Federico II, Naples, Italy.,Department of Medical Translational Sciences, Division of Pediatrics, Federico II University of Naples, Naples, Italy
| | - T Attie-Bitach
- Service de Génétique, Hôpital Necker-Enfants Malades, APHP, Institut Imagine, INSERM UMR1163, University Sorbonne-Paris-Cité, Paris, France
| | - A Masurel-Paulet
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Centre de Référence maladies rares "Anomalies du Développement et syndrome malformatifs" de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France
| | - J-B Rivière
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France.,Laboratoire de Génétique Moléculaire, PTB, CHU Dijon, Dijon, France
| | - V Cormier-Daire
- Service de Génétique, Hôpital Necker-Enfants Malades, APHP, Institut Imagine, INSERM UMR1163, University Sorbonne-Paris-Cité, Paris, France
| | - C Philippe
- Laboratoire de Génétique Médicale, CHU - Hopitaux de Brabois, Vandoeuvre les Nancy cedex, France
| | - L Faivre
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France.,Centre de Référence maladies rares "Anomalies du Développement et syndrome malformatifs" de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France
| | - C Thauvin-Robinet
- FHU-TRANSLAD, Université de Bourgogne/CHU Dijon, Dijon, France.,Equipe EA4271 GAD, Université de Bourgogne, Dijon, France.,Centre de Référence maladies rares "Anomalies du Développement et syndrome malformatifs" de l'Est et Centre de Génétique, Hôpital d'Enfants, CHU, Dijon, France
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Domènech B, Romero V, Vázquez MI, Avila M, Benavente J, Muñoz M, Macanás J. Chemical and electrochemical characterization of Nafion containing silver nanoparticles in a stripe-like distribution. RSC Adv 2016. [DOI: 10.1039/c5ra22838g] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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
Study of the effect of Ag-NPs stripes in Nafion: evaluation of chemical, electrochemical and mechanical properties.
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Affiliation(s)
- B. Domènech
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC)
- Campus UAB s/n
- Bellaterra 08193
- Spain
| | - V. Romero
- Universidad de Málaga
- Departamento de Física Aplicada I
- Facultad de Ciencias
- Campus de Teatinos
- Málaga 29071
| | - M. I. Vázquez
- Universidad de Málaga
- Departamento de Física Aplicada I
- Facultad de Ciencias
- Campus de Teatinos
- Málaga 29071
| | - M. Avila
- ALBA Synchrotron Light Source
- Barcelona
- Spain
| | - J. Benavente
- Universidad de Málaga
- Departamento de Física Aplicada I
- Facultad de Ciencias
- Campus de Teatinos
- Málaga 29071
| | - M. Muñoz
- Universitat Autònoma de Barcelona
- Departament de Química
- Facultat de Ciències
- Campus UAB s/n
- Bellaterra 08193
| | - J. Macanás
- Universitat Politècnica de Catalunya
- Departament d'Enginyeria Química
- Escola d'Enginyeria de Terrassa
- Terrassa 08222
- Spain
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Avila M, Dyment DA, Sagen JV, St-Onge J, Moog U, Chung BHY, Mo S, Mansour S, Albanese A, Garcia S, Martin DO, Lopez AA, Claudi T, König R, White SM, Sawyer SL, Bernstein JA, Slattery L, Jobling RK, Yoon G, Curry CJ, Merrer ML, Luyer BL, Héron D, Mathieu-Dramard M, Bitoun P, Odent S, Amiel J, Kuentz P, Thevenon J, Laville M, Reznik Y, Fagour C, Nunes ML, Delesalle D, Manouvrier S, Lascols O, Huet F, Binquet C, Faivre L, Rivière JB, Vigouroux C, Njølstad PR, Innes AM, Thauvin-Robinet C. Clinical reappraisal of SHORT syndrome with PIK3R1 mutations: toward recommendation for molecular testing and management. Clin Genet 2015; 89:501-506. [PMID: 26497935 DOI: 10.1111/cge.12688] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 08/03/2015] [Revised: 10/10/2015] [Accepted: 10/16/2015] [Indexed: 12/01/2022]
Abstract
SHORT syndrome has historically been defined by its acronym: short stature (S), hyperextensibility of joints and/or inguinal hernia (H), ocular depression (O), Rieger abnormality (R) and teething delay (T). More recently several research groups have identified PIK3R1 mutations as responsible for SHORT syndrome. Knowledge of the molecular etiology of SHORT syndrome has permitted a reassessment of the clinical phenotype. The detailed phenotypes of 32 individuals with SHORT syndrome and PIK3R1 mutation, including eight newly ascertained individuals, were studied to fully define the syndrome and the indications for PIK3R1 testing. The major features described in the SHORT acronym were not universally seen and only half (52%) had four or more of the classic features. The commonly observed clinical features of SHORT syndrome seen in the cohort included intrauterine growth restriction (IUGR) <10th percentile, postnatal growth restriction, lipoatrophy and the characteristic facial gestalt. Anterior chamber defects and insulin resistance or diabetes were also observed but were not as prevalent. The less specific, or minor features of SHORT syndrome include teething delay, thin wrinkled skin, speech delay, sensorineural deafness, hyperextensibility of joints and inguinal hernia. Given the high risk of diabetes mellitus, regular monitoring of glucose metabolism is warranted. An echocardiogram, ophthalmological and hearing assessments are also recommended.
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Affiliation(s)
- M Avila
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - D A Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J V Sagen
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway.,KJ Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J St-Onge
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,CHU Dijon, Laboratoire de Génétique Moléculaire, Dijon, France
| | - U Moog
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - B H Y Chung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - S Mo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - S Mansour
- SW Thames Regional Genetics Service, St. George's Hospital Medical School, London, SW17 0RE, UK
| | - A Albanese
- Paediatric Endocrine Unit, St George's Hospital, London, UK
| | - S Garcia
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain.,Instituto de Salud Carlos III, Unit 753, Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - D O Martin
- Department of Ophthalmology, Hospital Central de la Cruz Roja San Jose y Santa Adela, Madrid, Spain
| | - A A Lopez
- Puerta de Hierro, University Hospital, Madrid, Spain
| | - T Claudi
- Department of Medicine, Bodø, Norway
| | - R König
- Department of Human Genetics, University of Frankfurt, Frankfurt, Germany
| | - S M White
- Victorian Clinical genetics Services, Murdoch Childrens Research institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - S L Sawyer
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J A Bernstein
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - L Slattery
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - R K Jobling
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - G Yoon
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - C J Curry
- Genetic Medicine/, University of California, San Francisco, CA, USA
| | - M L Merrer
- Département de Génétique, Hôpital Necker Enfants Malades, Paris, France
| | - B L Luyer
- Service de Pédiatrie, CH Le Havre, Le Havre, France
| | - D Héron
- Département de Génétique et Centre de Référence "Déficiences intellectuelles de causes rares", Paris, France
| | | | - P Bitoun
- Service de Pédiatrie, Bondy, France
| | - S Odent
- Service de Génétique clinique, Rennes, France.,UMR CNRS 6290 IGDR, Universitė Rennes, Rennes, France
| | - J Amiel
- Département de Génétique, Hôpital Necker Enfants Malades, Paris, France
| | - P Kuentz
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France
| | - J Thevenon
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
| | - M Laville
- Département d'Endocrinologie, Diabétologie et Nutrition, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.,Institut National de la Santé et de la Recherche Médicale Unité 1060, Centre Européen pour la nutrition et la Santé, Centre de Recherche en Nutrition Humaine Rhône-Alpes, Université Claude Bernard Lyon, Pierre-Bénite, France
| | - Y Reznik
- Service d'Endocrinologie, Centre Hospitalier Universitaire Côte-de-Nacre, Caen, France
| | - C Fagour
- Département d'Endocrinologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - M-L Nunes
- Département d'Endocrinologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - D Delesalle
- Service de pédiatrie, CH de Valencienne, Valencienne, France
| | - S Manouvrier
- Centre de Référence CLAD NdF - Service de génétique clinique Guy Fontaine, CHRU de Lille - Hôpital Jeanne de Flandre, Lille, France
| | - O Lascols
- INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France.,UPMC Univ Paris 06, Paris, France.,ICAN, Institute of Cardiometabolism And Nutrition, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.,AP-HP, Hôpital Saint-Antoine, Laboratoire Commun de Biologie et Génétique Moléculaires, Paris, France
| | - F Huet
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - C Binquet
- Centre d'Investigation Clinique-Epidémiologique Clinique/essais cliniques du CHU de Dijon, Dijon, France
| | - L Faivre
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
| | - J-B Rivière
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,CHU Dijon, Laboratoire de Génétique Moléculaire, Dijon, France
| | - C Vigouroux
- INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France.,UPMC Univ Paris 06, Paris, France.,ICAN, Institute of Cardiometabolism And Nutrition, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.,AP-HP, Hôpital Saint-Antoine, Laboratoire Commun de Biologie et Génétique Moléculaires, Paris, France
| | - P R Njølstad
- Department of Pediatrics, Haukeland, University Hospital, Bergen, Norway
| | - A M Innes
- Department of Medical Genetics, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, Canada
| | - C Thauvin-Robinet
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
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La Cognata M, Spitaleri C, Trippella O, Kiss G, Rogachev G, Mukhamedzhanov A, Avila M, Guardo G, Koshchiy E, Kuchera A, Lamia L, Puglia S, Romano S, Santiago D, Spartà R. Measurement of sub threshold resonance contributions to fusion reactions: the case of the 13C( α, n) 16O astrophysical neutron source. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20158600023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ayala LG, Abreu M, Avila M, Bergamini BC, Neto AC, Zin WA, Neto AG, Carvalho AR. 0548. Effects of sedation and muscle paralysis on inflammation during mechanical ventilation. Intensive Care Med Exp 2014. [PMCID: PMC4798140 DOI: 10.1186/2197-425x-2-s1-p32] [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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Velasco F, Avila M, Concha L, Avendaño A, Garcia G. Changements métaboliques induits par la stimulation électrique des fibres prélemniscales dans le traitement de la maladie de Parkinson. Neurochirurgie 2014. [DOI: 10.1016/j.neuchi.2014.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Burks T, Avila M, Akhtar F, Göthelid M, Lansåker P, Toprak M, Muhammed M, Uheida A. Studies on the adsorption of chromium(VI) onto 3-Mercaptopropionic acid coated superparamagnetic iron oxide nanoparticles. J Colloid Interface Sci 2014; 425:36-43. [DOI: 10.1016/j.jcis.2014.03.025] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 03/02/2014] [Accepted: 03/10/2014] [Indexed: 11/16/2022]
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La Cognata M, Spitaleri C, Trippella O, Kiss G, Rogachev G, Mukhamedzhanov A, Avila M, Guardo G, Koshchiy E, Kuchera A, Lamia L, Puglia S, Romano S, Santiago D, Spartà R. Measurement of the 13C( α, n) 16O reaction at astrophysical energies using the Trojan Horse Method. Focus on the -3 keV sub-threshold resonance. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20146607010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Serrano-Villar S, Moreno S, Fuentes-Ferrer M, Sánchez-Marcos C, Avila M, Sainz T, de Villar NGP, Fernández-Cruz A, Estrada V. The CD4:CD8 ratio is associated with markers of age-associated disease in virally suppressed HIV-infected patients with immunological recovery. HIV Med 2013; 15:40-9. [PMID: 24007533 DOI: 10.1111/hiv.12081] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [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: 07/24/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Inversion of the CD4:CD8 ratio (< 1) has been identified as a hallmark of inmmunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and markers of age-associated disease in treated HIV-infected patients with good immunovirological response. METHODS A cross-sectional analysis was conducted in 132 HIV-infected adults on antiretroviral therapy (ART), with plasma HIV RNA < 50 HIV-1 RNA copies/mL for at least 1 year, CD4 count > 350 cells/μL and age < 65 years. We analysed the associations between the CD4:CD8 ratio and subclinical atherosclerosis [assessed using carotid intima-media thickness (IMT)], arterial stiffness [assessed using the augmentation index (AIx)], the estimated glomerular filtration rate (eGFR), muscle wasting and sarcopenia [assessed using appendicular lean mass/height(2) (ALM) measured by dual-energy X-ray absorptiometry (DEXA)]. RESULTS CD4:CD8 ratio inversion was associated with higher IMT, lower eGFR and lower ALM (all values P < 0.05), but not with AIx. In multivariate analyses adjusted for age, sex, hypertriglyceridaemia, tobacco use and cumulative ART exposure, inversion of the CD4:CD8 ratio was independently associated with higher IMT [odds ratio (OR) 2.9; 95% confidence interval (CI) 1.2-7.1], arterial stiffness (OR 4.8; 95% CI 1.0-23.5) and lower eGFR (OR 5.2; 95% CI 1.0-64.4), but not sarcopenia (OR 0.7; 95% CI 0.2-2.7). These associations persisted when models were applied to subjects with nadir CD4 counts > 200 cells/μL and those with CD4 counts > 500 cells/μL. CONCLUSIONS The CD4:CD8 ratio in treated HIV-infected subjects with good immunovirological response is independently associated with markers of age-associated disease. Hence, it might be a clinically useful predictor of non-AIDS-defining conditions.
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Affiliation(s)
- S Serrano-Villar
- Infectious Diseases Department, University Hospital Ramón y Cajal, Madrid, Spain; Health Research Institute Ramón y Cajal (IRYCIS), Madrid, Spain
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45
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Avila M, Hof B. Nature of laminar-turbulence intermittency in shear flows. Phys Rev E Stat Nonlin Soft Matter Phys 2013; 87:063012. [PMID: 23848777 DOI: 10.1103/physreve.87.063012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 04/20/2013] [Indexed: 06/02/2023]
Abstract
In pipe, channel, and boundary layer flows turbulence first occurs intermittently in space and time: at moderate Reynolds numbers domains of disordered turbulent motion are separated by quiescent laminar regions. Based on direct numerical simulations of pipe flow we argue here that the spatial intermittency has its origin in a nearest neighbor interaction between turbulent regions. We further show that in this regime turbulent flows are intrinsically intermittent with a well-defined equilibrium turbulent fraction but without ever assuming a steady pattern. This transition scenario is analogous to that found in simple models such as coupled map lattices. The scaling observed implies that laminar intermissions of the turbulent flow will persist to arbitrarily large Reynolds numbers.
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Affiliation(s)
- M Avila
- Institute of Fluid Mechanics, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany
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46
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Avila M, Mellibovsky F, Roland N, Hof B. Streamwise-localized solutions at the onset of turbulence in pipe flow. Phys Rev Lett 2013; 110:224502. [PMID: 23767729 DOI: 10.1103/physrevlett.110.224502] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Indexed: 06/02/2023]
Abstract
Although the equations governing fluid flow are well known, there are no analytical expressions that describe the complexity of turbulent motion. A recent proposition is that in analogy to low dimensional chaotic systems, turbulence is organized around unstable solutions of the governing equations which provide the building blocks of the disordered dynamics. We report the discovery of periodic solutions which just like intermittent turbulence are spatially localized and show that turbulent transients arise from one such solution branch.
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Affiliation(s)
- M Avila
- Institute of Fluid Mechanics, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91058 Erlangen, Germany.
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De Guglielmo Z, Avila M, Veitía D, Fernández A, Venegas C, Correnti de Plata M. [HPV detection in the mouth and cervix of patients with histological diagnosis suggestive of genital infection]. An Sist Sanit Navar 2013; 35:445-54. [PMID: 23296225 DOI: 10.23938/assn.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This work evaluated HPV infection in the oral cavity (using oroscopy and exfoliative oral cytology) and its relation to genital infection in women with cytological diagnosis suggestive of HPV infection. The sample consisted of 60 patients who underwent oroscopy, cytology and viral determination in mouth and cervix by PCR using generic primers MY09/MY11 and MPCR. HPV DNA was detected in oral and genital mucosa in 48.33% and 73.3% of patients, respectively, yielding a concordance of 44.2% (k=0.44, moderate agreement). The most common viral types were low risk, especially type 6, found in 86.2% of oral samples and 65.9% of cervical specimens, alone or in combination with other types of low (11) or high oncogenic risk (16, 18, 33), with a concordance of 10.45% (k = 0.1, insignificant agreement). However, in relation to type 6, there was a concordance of 75.86% (k=0.7, high agreement). The cytology of the oral cavity had a sensitivity of 3.5% and a specificity of 93.6%. For oroscopy, sensitivity was 27.6% and specificity was 74.2%. The results indicate that HPV infection in the oral cavity of patients with genital infection could be frequent. The low concordance between HPV types suggests that HPV infection in the mouth and cervix has a different biological behavior.
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Affiliation(s)
- Z De Guglielmo
- Instituto de Oncología y Hematología, Ciudad Universitaria Los Chaguaramos, Caracas, Venezuela.
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La Cognata M, Spitaleri C, Trippella O, Kiss GG, Rogachev GV, Mukhamedzhanov AM, Avila M, Guardo GL, Koshchiy E, Kuchera A, Lamia L, Puglia SMR, Romano S, Santiago D, Spartà R. Measurement of the -3 keV resonance in the reaction 13C(α,n)16O of importance in the s-process. Phys Rev Lett 2012; 109:232701. [PMID: 23368189 DOI: 10.1103/physrevlett.109.232701] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 08/10/2012] [Indexed: 06/01/2023]
Abstract
The (13)C(α,n)(16)O reaction is the neutron source for the main component of the s-process, responsible for the production of most nuclei in the mass range 90</~A</~204. It is active inside the helium-burning shell in asymptotic giant branch stars, at temperatures </~10(8) K, corresponding to an energy interval where the (13)C(α,n)(16)O is effective from 140 to 230 keV. In this region, the astrophysical S(E)-factor is dominated by the -3 keV subthreshold resonance due to the 6.356 MeV level in (17)O, giving rise to a steep increase of the S(E)-factor. Notwithstanding that it plays a crucial role in astrophysics, no direct measurements exist inside the s-process energy window. The magnitude of its contribution is still controversial as extrapolations, e.g., through the R matrix and indirect techniques, such as the asymptotic normalization coefficient (ANC), yield inconsistent results. The discrepancy amounts to a factor of 3 or more right at astrophysical energies. Therefore, we have applied the Trojan horse method to the (13)C((6)Li,n(16)O)d quasifree reaction to achieve an experimental estimate of such contribution. For the first time, the ANC for the 6.356 MeV level has been deduced through the Trojan horse method as well as the n-partial width, allowing to attain an unprecedented accuracy in the (13)C(α,n)(16)O study. Though a larger ANC for the 6.356 MeV level is measured, our experimental S(E)-factor agrees with the most recent extrapolation in the literature in the 140-230 keV energy interval, the accuracy being greatly enhanced thanks to this innovative approach.
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Affiliation(s)
- M La Cognata
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali del Sud, 95123 Catania, Italy.
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Abstract
Recent numerical studies suggest that in pipe and related shear flows, the region of phase space separating laminar from turbulent motion is organized by a chaotic attractor, called an edge state, which mediates the transition process. We here confirm the existence of the edge state in laboratory experiments. We observe that it governs the dynamics during the decay of turbulence underlining its potential relevance for turbulence control. In addition we unveil two unstable traveling wave solutions underlying the experimental flow fields. This observation corroborates earlier suggestions that unstable solutions organize turbulence and its stability border.
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Affiliation(s)
- A de Lozar
- Max Planck Institute for Dynamics and Self-Organization, 37073 Göttingen, Germany.
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