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Palácios R, Castagna D, Barbosa L, Souza AP, Imbiriba B, Zolin CA, Nassarden D, Duarte L, Morais FG, Franco MA, Cirino G, Kuhn P, Sodré G, Curado L, Basso J, Roberto de Paulo S, Rodrigues T. ENSO effects on the relationship between aerosols and evapotranspiration in the south of the Amazon biome. Environ Res 2024; 250:118516. [PMID: 38373551 DOI: 10.1016/j.envres.2024.118516] [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] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/08/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
The effects of the El Nino-Southern Oscillation (ENSO) events have local, regional, and global consequences for water regimes, causing floods or extreme drought events. Tropical forests are strongly affected by ENSO, and in the case of the Amazon, its territorial extension allows for a wide variation of these effects. The prolongation of drought events in the Amazon basin contributes to an increase in gas and aerosol particle emissions mainly caused by biomass burning, which in turn alter radiative fluxes and evapotranspiration rates, cyclically interfering with the hydrological regime. The ENSO effects on the interactions between aerosol particles and evapotranspiration is a critical aspect to be systematically investigated. Therefore, this study aimed to evaluate the ENSO effect on a site located on the southern portion of the Amazonian region. In addition to quantifying and testing possible differences between aerosols and evapotranspiration under different ENSO classes (El Niño, La Niña and Neutrality), this study also evaluated possible variations in evapotranspiration as a function of the aerosol load. A highly significant difference was found for air temperature, relative humidity and aerosol load between the El Niño and La Niña classes. For evapotranspiration, significant differences were found for the El Niño and La Niña classes and for El Niño and Neutrality classes. Under the Neutrality class, the aerosol load correlated significantly with evapotranspiration, explaining 20% of the phenomenon. Under the El Niño and La Niña classes, no significant linear correlation was found between aerosol load and evapotranspiration. However, the results showed that for the total data set, there is a positive and significant correlation between aerosol and evapotranspiration. It increases with a quadratic fit, i.e., the aerosol favors evapotranspiration rates up to a certain concentration threshold. The results obtained in this study can help to understand the effects of ENSO events on atmospheric conditions in the southern Amazon basin, in addition to elucidating the role of aerosols in feedback to the water cycle in the region.
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Affiliation(s)
- Rafael Palácios
- Instituto de Geociências, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil; Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil.
| | - Daniela Castagna
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - Luzinete Barbosa
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - Adilson P Souza
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - Breno Imbiriba
- Instituto de Geociências, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil
| | - Cornélio A Zolin
- Empresa Brasileira de Pesquisa Agropecuária (Embrapa), Sinop, MT, 78550-000, Brazil
| | - Danielle Nassarden
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - Leilane Duarte
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - Fernando G Morais
- Instituto de Física, Universidade de São Paulo, São Paulo, SP, 05508-090, Brazil
| | - Marco A Franco
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP, 05508-090, Brazil
| | - Glauber Cirino
- Instituto de Geociências, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil
| | - Paulo Kuhn
- Instituto de Geociências, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil
| | - Giordani Sodré
- Instituto de Geociências, Universidade Federal do Pará, Belém, PA, 66075-110, Brazil
| | - Leone Curado
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - João Basso
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | | | - Thiago Rodrigues
- Instituto de Física, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil; Instituto de Física, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, 79070-900, Brazil
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Vandanmagsar B, Yu Y, Simmler C, Dang TN, Kuhn P, Poulev A, Ribnicky DM, Pauli GF, Floyd ZE. Bioactive compounds from Artemisia dracunculus L. activate AMPK signaling in skeletal muscle. Biomed Pharmacother 2021; 143:112188. [PMID: 34563947 PMCID: PMC8516709 DOI: 10.1016/j.biopha.2021.112188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022] Open
Abstract
An extract from Artemisia dracunculus L. (termed PMI-5011) improves glucose homeostasis by enhancing insulin action and reducing ectopic lipid accumulation, while increasing fat oxidation in skeletal muscle tissue in obese insulin resistant male mice. A chalcone, DMC-2, in PMI-5011 is the major bioactive that enhances insulin signaling and activation of AKT. However, the mechanism by which PMI-5011 improves lipid metabolism is unknown. AMPK is the cellular energy and metabolic sensor and a key regulator of lipid metabolism in muscle. This study examined PMI-5011 activation of AMPK signaling using murine C2C12 muscle cell culture and skeletal muscle tissue. Findings show that PMI-5011 increases Thr172-phosphorylation of AMPK in muscle cells and skeletal muscle tissue, while hepatic AMPK activation by PMI-5011 was not observed. Increased AMPK activity by PMI-5011 affects downstream signaling of AMPK, resulting in inhibition of ACC and increased SIRT1 protein levels. Selective deletion of DMC-2 from PMI-5011 demonstrates that compounds other than DMC-2 in a "DMC-2 knock out extract" (KOE) are responsible for AMPK activation and its downstream effects. Compared to 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) and metformin, the phytochemical mixture characterizing the KOE appears to more efficiently activate AMPK in muscle cells. KOE-mediated AMPK activation was LKB-1 independent, suggesting KOE does not activate AMPK via LKB-1 stimulation. Through AMPK activation, compounds in PMI-5011 may regulate lipid metabolism in skeletal muscle. Thus, the AMPK-activating potential of the KOE adds therapeutic value to PMI-5011 and its constituents in treating insulin resistance or type 2 diabetes.
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Affiliation(s)
- B Vandanmagsar
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Y Yu
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - C Simmler
- Center for Natural Product Technologies, Pharmacognosy Institute and Department of Pharmaceutical Sciences, University of Illinois at Chicago, 833 South Wood Street, Chicago, IL 60612, USA
| | - T N Dang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - P Kuhn
- Department of Plant Biology, Rutgers University, New Brunswick, NJ 08901, USA
| | - A Poulev
- Department of Plant Biology, Rutgers University, New Brunswick, NJ 08901, USA
| | - D M Ribnicky
- Department of Plant Biology, Rutgers University, New Brunswick, NJ 08901, USA
| | - G F Pauli
- Center for Natural Product Technologies, Pharmacognosy Institute and Department of Pharmaceutical Sciences, University of Illinois at Chicago, 833 South Wood Street, Chicago, IL 60612, USA
| | - Z E Floyd
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
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Ancel PY, Breart G, Bruel H, Debillon T, D'Ercole C, Deruelle P, Dreyfus M, Foix-L'Helias L, Goffinet F, Jarreau PH, Kuhn P, Langer B. [Propositions for perinatal care at extremely low gestational ages - Working group on "Extremely low gestational ages" for SFMP, CNGOF, and SFN]. Gynecol Obstet Fertil Senol 2020; 48:850-857. [PMID: 33022445 DOI: 10.1016/j.gofs.2020.09.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES International literature suggests that active perinatal management at extremely low gestational ages improves survival without increasing the risk of impairment in survivors, compared to less active management. Although these results are limited to a small number of countries, they question current practices in France. New propositions on perinatal management of extremely preterm infants have carried out by the French Society of Perinatal Medicine, the French Society of Neonatology and the National College of French Obstetricians and Gynecologists. METHODS This group was set up in 2015 on the initiative of the professional societies and in collaboration with parents' and users' associations. The work was based on a review of the literature on the prognosis of extremely preterm children, as well as on recommendations by European societies. Based on this information, a text was produced, submitted to all members of the working group and definitively validated in April 2019. RESULTS This text offers a decision-making guideline for the management at extremely low gestational ages. Its principles are: the administration of steroids independently of management (resuscitation or comfort care); a prognostic evaluation and a collegial decision, outside the context of the emergency; a consensus on the information to be given to parents before going to inform them and gather their opinion. CONCLUSIONS These new propositions will contribute to modifying perinatal care at extremely low gestational ages in France.
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Affiliation(s)
- P-Y Ancel
- Paris, Société française de médecine périnatale, 75008 Paris, France.
| | - G Breart
- Paris, Société française de médecine périnatale, 75008 Paris, France
| | - H Bruel
- Le Havre, Société française de médecine périnatale, Société française de néonatologie, 76600 Le Havre, France
| | - T Debillon
- Grenoble, Société française de médecine périnatale, Société française de néonatologie, 38000 Grenoble, France
| | - C D'Ercole
- Marseille, Société française de médecine périnatale, Collège national des gynécologues et obstétriciens français, 13000 Marseille, France
| | - P Deruelle
- Strasbourg, Collège national des gynécologues obstétriciens français, 67000 Strasbourg, France
| | - M Dreyfus
- Caen, Société française de médecine périnatale, Collège national des gynécologues et obstétriciens français, 14000 Caen, France
| | - L Foix-L'Helias
- Paris, Société française de néonatologie, 75008 Paris, France
| | - F Goffinet
- Paris, Société française de médecine périnatale, Collège national des gynécologues et obstétriciens français, 75008 Paris, France
| | - P-H Jarreau
- Paris, Société française de néonatologie, 75008 Paris, France
| | - P Kuhn
- Strasbourg, Société française de néonatologie, 67000 Strasbourg, France
| | - B Langer
- Strasbourg, Société française de médecine périnatale, Collège national des gynécologues et obstétriciens français, 67000 Strasbourg, France
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Pladys P, Zaoui C, Girard L, Mons F, Reynaud A, Casper C, Kuhn P, Souet G, Fichtner C, Laprugne‐garcia E, Legouais S, Zores C, Thiriez G, Duboz MA, Knezovic‐Daniel N, Renesme L, Brandicourt A, Gonnaud F, Picaud JC, Julie‐Fische C, Tourneux P, Truffert P, Berne Audeoud F, Pierrat V, Caeymaex L, Granier M, Bouvard C, Evrard A, Saliba E, Allen A, Sizun J, Zana‐Taieb E, Huppi P. French neonatal society position paper stresses the importance of an early family-centred approach to discharging preterm infants from hospital. Acta Paediatr 2020; 109:1302-1309. [PMID: 31774567 DOI: 10.1111/apa.15110] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 12/01/2022]
Abstract
AIM The families of hospitalised preterm infants risk depression and post-traumatic stress and the preterm infants risk re-hospitalisation. The French neonatal society's aim was to review the literature on how the transition from hospital to home could limit these risks and to produce a position paper. METHODS A systematic literature review was performed covering 1 January 2000 to 1 January 2018, and multidisciplinary experts examined the scientific evidence. RESULTS We identified 939 English and French papers and 169 are quoted in the position paper. Most studies stressed the importance of early, personalised and progressive involvement of the family. Healthcare staff and families should assess discharge preparations jointly. This evaluation should assess the capacities of the newborn infant, with regard to its physiological maturity. It should also assess the family's ability to supply the medical, psychological and social assistance required before and after discharge. There should be a structured follow-up process that includes effective communication, various tools, interventions, networks, health and social professionals. CONCLUSION Discharge preparations may improve the transition from hospital to home and the outcomes for the parents and newborn preterm infant. This early family-centred approach should be structured, coordinated and based on individual needs and circumstances.
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Affiliation(s)
- Patrick Pladys
- CHU Rennes Inserm LTSI ‐ UMR 1099 Univ Rennes Rennes France
| | | | | | | | - Audrey Reynaud
- SOS‐Prema family association Boulogne‐Billancourt France
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5
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Lauffer D, Kuhn P, Thalmann S, Breuneval T, Laouiti M, Petra M, Tercier P, Risse G, Allal A. PO-142: Impact of adjuvant radiotherapy on biological and clinical parameters in right-sided breast cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(20)30484-9] [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]
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6
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Renesme L, Allen A, Audeoud F, Bouvard C, Brandicourt A, Casper C, Cayemaex L, Denoual H, Duboz MA, Evrard A, Fichtner C, Fischer-Fumeaux CJ, Girard L, Gonnaud F, Haumont D, Hüppi P, Knezovic N, Laprugne-Garcia E, Legouais S, Mons F, Pelofy V, Picaud JC, Pierrat V, Pladys P, Reynaud A, Souet G, Thiriez G, Tourneux P, Touzet M, Truffert P, Zaoui C, Zana-Taieb E, Zores C, Sizun J, Kuhn P. Recommendation for hygiene and topical in neonatology from the French Neonatal Society. Eur J Pediatr 2019; 178:1545-1558. [PMID: 31463766 DOI: 10.1007/s00431-019-03451-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/10/2019] [Accepted: 08/09/2019] [Indexed: 11/24/2022]
Abstract
We sought to establish guidelines for hygiene care in newborns based on a systematic review of the literature and grading of evidence using the Groupe de Réflexion et d'Evaluation de l'Environement des Nouveau-nés (GREEN) methodology. We examined 45 articles and 4 reports from safety agencies. These studies recommend a tub bath (rather than a sponge bath) for full-term infants and a swaddle bath for preterm newborns. They also recommend against daily cleansing of preterm infants. The literature emphasized that hygiene care must consider the clinical state of the newborn, including the level of awareness and behavioral responses. Hospitalized newborns treated with topical agents may also experience high exposure to potentially harmful excipients of interest. Caregivers should therefore be aware of the excipients present in the different products they use. In high-resource countries, the available data do not support the use of protective topical agents for preterm infants.Conclusions: We recommend individualization of hygiene care for newborns. There is increasing concern regarding the safety of excipients in topical agents that are used in neonatology. A multidisciplinary approach should be used to identify an approach that requires lower levels of excipients and alternative excipients. What is known: • Hygiene care is one of the most basic and widespread types of care received by healthy and sick newborns worldwide. • There is no current guideline on hygiene for preterm or hospitalized term newborn. What is new: • The French Group of Reflection and Evaluation of the environment of Newborns (GREEN) provided here guidelines based on the current body of evidence. • Caregivers should be aware of the many issues related to hygiene care of newborns including newborns' behavioral responses to hygiene care, exposition to excipients of interest, and the potential risk of protective topical agents in a preterm infant. provided here guidelines based on the current body of evidence. • Caregivers should be aware of the many issues related to hygiene care of newborns including newborns' possible behavioral responses to hygiene care, exposition to excipients of interest and the potential risk of protective topical agents in a preterm infant.
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Affiliation(s)
- Laurent Renesme
- Unité de Néonatalogie Soins Intensifs-Pédiatrie de Maternité, Centre Aliénor d'Aquitaine, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba Léon, 33000, Bordeaux, France.
| | - A Allen
- Port Royal Assitance Publique Hôpitaux de Paris, Paris, France
| | - F Audeoud
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - C Bouvard
- Association SOS Préma, Boulogne-Billancourt, France
| | - A Brandicourt
- Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
| | - C Casper
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - L Cayemaex
- Centre Hospitalier Inter-Communal de Créteil, Créteil, France
| | - H Denoual
- Centre Hospitalier du Mans, Le Mans, France
| | - M A Duboz
- Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - A Evrard
- Comité Inter-Associatif de la Naissance, Paris, France
| | - C Fichtner
- Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | | | - L Girard
- Association Co-Naître, Pertuis, France
| | - F Gonnaud
- Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - D Haumont
- Hôpital Saint-Pierre Bruxelles, Brussels, Belgium
| | - P Hüppi
- Centre Hospitalier Universitaire de Genève, Genève, Switzerland
| | - N Knezovic
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | | | | | - F Mons
- Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - V Pelofy
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - J C Picaud
- Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - V Pierrat
- Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - P Pladys
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - A Reynaud
- Association SOS Préma, Boulogne-Billancourt, France
| | - G Souet
- Agence Régionale de Santé Centre, Orleans, France
| | - G Thiriez
- Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - P Tourneux
- Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - M Touzet
- Port Royal Assitance Publique Hôpitaux de Paris, Paris, France
| | - P Truffert
- Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - C Zaoui
- Centre Hospitalier Général de Valenciennes, Valenciennes, France
| | - E Zana-Taieb
- Port Royal Assitance Publique Hôpitaux de Paris, Paris, France
| | - C Zores
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - J Sizun
- Centre Hospitalier Universitaire de Brest, Brest, France
| | - P Kuhn
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
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de Gregorio A, Nagel G, Rothenbacher D, Möller P, Rempen A, Schlicht E, Fritz S, Flock F, Felberbaum R, Friedl TWP, Thiel F, Kühn T, Kuhn P, Tzschaschel M, Janni W, Wiesmüller L, Huober J. Das BRandO Biology and Outcome (BiO)-Projekt – eine Registerstudie zum biologischen Erkrankungsprofil und klinischen Verlauf bei Mamma- und Ovarialkarzinomen (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- A de Gregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum Biberach
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Memmingen
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten
| | - TWP Friedl
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - F Thiel
- Klinik für Frauenheilkunde und Geburtshilfe, Alb-Fils Klinik Göppingen
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm
| | - M Tzschaschel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - L Wiesmüller
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
| | - J Huober
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinik Ulm
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8
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Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. Abstract OT1-11-01: The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot1-11-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Further progress in the treatment of breast cancer will likely come from contributions of molecular biology and immunologic approaches. The search for druggable molecular aberrations may enable treatment based on the molecular profile. A better identification of patients with a high risk of relapse facilitates the selection of these pts for clinical trials investigating early therapeutic molecular-based interventions.
Trial Design:
The BRandO BiO Registry is a multi-center regional registry to record clinical, epidemiological, and biological data from patients with newly diagnosed breast and ovarian cancer at the University of Ulm, Dept. of Gynecology and 19 affiliated network hospitals and practices in the Alb-Allgäu Bodensee region (outreach area of the Comprehensive Cancer Center Ulm). Longitudinal biobanking is included with collection of paraffin-embedded samples of the primary tumor as well as blood samples at first diagnosis, after 6 and 12 months and at first relapse to isolate and investigate cell-free and germline DNA. Epidemiological, life style and quality of life (QOL) questionnaires are collected at first diagnosis, after 12, 36 and 60 months. The follow up is planned for 10 years.
Eligibility criteria:
Patients with primary newly diagnosed untreated breast or ovarian cancer of ≥ 18 years are eligible; primary metastatic untreated disease is allowed. Exclusion criteria comprise severe neurological or psychiatric disorders interfering with the ability to give an informed consent, no consent for registration, storage and processing of the individual disease characteristics and bio samples, and any malignant tumor in the last 3 years (except in situ disease).
Specific aims:
To register the majority of patients with newly diagnosed breast or ovarian cancer in all BRandO-BiO participating centers of a well-defined geographical area. To assess clinical characteristics and outcome data (event-free survival, overall survival) of these patients. To evaluate the primary tumor of all patients for mutational (druggable) aberrations. Further to assess cell-free DNA in the serial blood samples at baseline, 6 and 12 months and correlate these results with clinical outcome data as well as tumor and patient characteristics to look for early markers predicting relapse. To perform a longitudinal assessment of the patients' sociodemographic factors, comorbidities, lifestyle and QOL factors by analyzing serial questionnaires collected at recruitment and at 12, 36 and 60 months.
Present accrual and target accrual:
The BRandO BiO Registry started January 2016 in the Dept. of Gynecology, University of Ulm and February 2017 at the network hospitals and practices. Until June 2018, 1180 patients with primary breast or ovarian cancer have been enrolled. The current adherence to serial blood testing and serial questionnaires is good with a return rate of 90%. A sample size of 3000 patients is planned.
Contact information:
Jens Huober, University of Ulm, Dept of Gynecology, Breast Center, jens.huober@uniklinik-ulm.de
Amelie de Gregorio, University of Ulm, Dept of Gynecology, Breast Center, Amelie.de Gregorio@uniklinik-ulm.de
Citation Format: Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-11-01.
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Affiliation(s)
- J Huober
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - G Nagel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - A Rempen
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - E Schlicht
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - F Flock
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - S Fritz
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - F Thiel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - L Wiesmüller
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - R Felderbaum
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - V Heilmann
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - I Bekes
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - V Fink
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - S Albrecht
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - N De Gregorio
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - M Tzschaschel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - K Ernst
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - C Wolf
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - P Kuhn
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - T Friedl
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - W Janni
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - A De Gregorio
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
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de Gregorio A, Nagel G, Rothenbacher D, Möller P, Rempen A, Schlicht E, Fritz S, Flock F, Felberbaum R, Friedl TWP, Kuhn P, Tzschaschel M, Janni W, Wiesmüller L, Huober J. Das BRandO Biology and Outcome (BiO)-Projekt – eine Registerstudie zum biologischen Erkrankungsprofil und klinischen Verlauf bei Mamma- und Ovarialkarzinomen (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | | | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
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10
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de Gregorio A, Rempen A, Schlicht E, Fritz S, Flock F, Kühn T, Thiel F, Felberbaum R, Kuhn P, Rothenbacher D, Albrecht S, Ernst K, Schochter F, Tzschaschel M, Friedl TWP, Möller P, Janni W, Huober J, Nagel G. Erste epidemiologische Daten zum Patientenkollektiv des BRandO Biology and Outcome (BiO)-Projekts (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Deutschland
| | - F Thiel
- Klinik am Eichert, Frauenklinik, Göppingen, Göppingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - S Albrecht
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - K Ernst
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Schochter
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
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11
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Escourrou G, Renesme L, Zana E, Rideau A, Marcoux MO, Lopez E, Gascoin G, Kuhn P, Tourneux P, Guellec I, Flamant C. How to assess hemodynamic status in very preterm newborns in the first week of life? J Perinatol 2017; 37:987-993. [PMID: 28471441 DOI: 10.1038/jp.2017.57] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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] [Received: 09/16/2016] [Revised: 02/12/2017] [Accepted: 03/28/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Assessing hemodynamic status in preterm newborns is an essential task, as many studies have shown increased morbidity when hemodynamic parameters are abnormal. Although oscillometric monitoring of arterial blood pressure (BP) is widely used due to its simplicity and lack of side effects, these values are not always correlated with microcirculation and oxygen delivery. OBJECTIVES This review focuses on different tools for the assessment of hemodynamic status in preterm newborns. These include the measurement of clinical (BP, capillary refill time and urinary output (UO)) or biological parameters (lactate analysis), functional echocardiography, and near-infrared spectroscopy (NIRS). We describe the concepts and techniques involved in these tools in detail, and examine the interest and limitations of each type of assessment. CONCLUSIONS This review highlights the complementarities between the different parameters used to assess hemodynamic status in preterm newborns during the first week of life. The analysis of arterial BP measured by oscillometric monitoring must take into account other clinical data, in particular capillary refill time and UO, and biological data such as lactate levels. Echocardiography improves noninvasive hemodynamic management in newborns but requires specific training. In contrast, NIRS may be useful in monitoring the clinical course of infants at risk of, or presenting with, hypotension. It holds the potential for early and noninvasive identification of silent hypoperfusion in critically ill preterm infants. However, more data are needed to confirm the usefulness of this promising tool in significantly changing the outcome of these infants.
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Affiliation(s)
- G Escourrou
- Department of Neonatal Medicine, CH Montreuil, Montreuil, France
| | - L Renesme
- Department of Neonatal Medicine, CHU Bordeaux, France
| | - E Zana
- Department of Neonatal Medicine, Port Royal Maternity, Paris, France
| | - A Rideau
- Department of Neonatal Medicine, CHU Paris, France
| | - M O Marcoux
- Paediatric Intensive Care Unit, CHU Toulouse, France
| | - E Lopez
- Department of Neonatal Medicine, CHU Tours, France
| | - G Gascoin
- Department of Neonatal Medicine, CHU Angers, France
| | - P Kuhn
- Department of Neonatal Medicine, CHU Strasbourg, France
| | - P Tourneux
- Department of Neonatal Medicine, CHU Amiens, France
| | - I Guellec
- Department of Neonatal Medicine, CHU Paris, France
| | - C Flamant
- Department of Neonatal Medicine, CHU Nantes, Service de Réanimation néonatale, Nantes, France
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Abstract
Evaluation of circulating tumor cells (CTCs) has demonstrated clinical validity as a prognostic tool based on enumeration, but since the introduction of this tool to the clinic in 2004, further clinical utility and widespread adoption have been limited. However, immense efforts have been undertaken to further the understanding of the mechanisms behind the biology and kinetics of these rare cells, and progress continues toward better applicability in the clinic. This review describes recent advances within the field, with a particular focus on understanding the biological significance of CTCs, and summarizes emerging methods for identifying, isolating, and interrogating the cells that may provide technical advantages allowing for the discovery of more specific clinical applications. Included is an atlas of high-definition images of CTCs from various cancer types, including uncommon CTCs captured only by broadly inclusive nonenrichment techniques.
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Affiliation(s)
- J-A Thiele
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University in Prague, 323 00 Pilsen, Czech Republic
| | - K Bethel
- Scripps Clinic Medical Group, Scripps Clinic, La Jolla, California 92121
| | - M Králíčková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University in Prague, 301 00 Pilsen, Czech Republic
| | - P Kuhn
- Bridge Institute, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California 90089; .,Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California 90089
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Dive C, Shishido SN, Kuhn P. Cancer Moonshot Connecting International Liquid Biopsy Efforts Through Academic Partnership. Clin Pharmacol Ther 2017; 101:622-624. [PMID: 28182274 PMCID: PMC7679176 DOI: 10.1002/cpt.657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/07/2017] [Accepted: 02/07/2017] [Indexed: 01/10/2023]
Abstract
The Kuhn Laboratory at the University of Southern California and the Dive Laboratory at the Cancer Research UK's Manchester Institute are teaming up to apply new cancer cell detection technology to identify patients who will progress after initial treatment. Researchers will take a simple blood sample to identify early those patients whose cancer has returned, while analyzing circulating tumor cells (CTCs) in great detail, providing new clues on the most effective therapy for the patient's cancer.
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Affiliation(s)
- C Dive
- Clinical and Experimental Pharmacology Group, Cancer Research UK Manchester Institute, University of Manchester, Manchester, UK
| | - SN Shishido
- Bridge Institute, University of Southern California, Dornsife College of Letters, Arts and Sciences, Los Angeles, California, USA
| | - P Kuhn
- Bridge Institute, University of Southern California, Dornsife College of Letters, Arts and Sciences, Los Angeles, California, USA
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Grossman RL, Abel B, Angiuoli S, Barrett JC, Bassett D, Bramlett K, Blumenthal GM, Carlsson A, Cortese R, DiGiovanna J, Davis-Dusenbery B, Dittamore R, Eberhard DA, Febbo P, Fitzsimons M, Flamig Z, Godsey J, Goswami J, Gruen A, Ortuño F, Han J, Hayes D, Hicks J, Holloway D, Hovelson D, Johnson J, Juhl H, Kalamegham R, Kamal R, Kang Q, Kelloff GJ, Klozenbuecher M, Kolatkar A, Kuhn P, Langone K, Leary R, Loverso P, Manmathan H, Martin AM, Martini J, Miller D, Mitchell M, Morgan T, Mulpuri R, Nguyen T, Otto G, Pathak A, Peters E, Philip R, Posadas E, Reese D, Reese MG, Robinson D, Dei Rossi A, Sakul H, Schageman J, Singh S, Scher HI, Schmitt K, Silvestro A, Simmons J, Simmons T, Sislow J, Talasaz A, Tang P, Tewari M, Tomlins S, Toukhy H, Tseng HR, Tuck M, Tzou A, Vinson J, Wang Y, Wells W, Welsh A, Wilbanks J, Wolf J, Young L, Lee J, Leiman LC. Collaborating to Compete: Blood Profiling Atlas in Cancer (BloodPAC) Consortium. Clin Pharmacol Ther 2017; 101:589-592. [PMID: 28187516 PMCID: PMC5525192 DOI: 10.1002/cpt.666] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 01/02/2023]
Abstract
The cancer community understands the value of blood profiling measurements in assessing and monitoring cancer. We describe an effort among academic, government, biotechnology, diagnostic, and pharmaceutical companies called the Blood Profiling Atlas in Cancer (BloodPAC) Project. BloodPAC will aggregate, make freely available, and harmonize for further analyses, raw datasets, relevant associated clinical data (e.g., clinical diagnosis, treatment history, and outcomes), and sample preparation and handling protocols to accelerate the development of blood profiling assays.
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Affiliation(s)
- R L Grossman
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - B Abel
- Genomic Health, Redwood City, California, USA
| | - S Angiuoli
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | | | | | - K Bramlett
- Thermo Fisher Scientific, Austin, Texas, USA
| | - G M Blumenthal
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Springs, Maryland, USA
| | - A Carlsson
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - R Cortese
- Seven Bridges, Cambridge, Massachusetts, USA
| | | | | | - R Dittamore
- Epic Research and Diagnostics, San Diego, California, USA
| | | | - P Febbo
- Genomic Health, Redwood City, California, USA
| | - M Fitzsimons
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - Z Flamig
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Godsey
- Thermo Fisher Scientific, Waltham, Massachusetts, USA
| | - J Goswami
- Thermo Fisher Scientific, Carlsbad, California, USA
| | - A Gruen
- Seven Bridges, Cambridge, Massachusetts, USA
| | - F Ortuño
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Han
- Genomic Health, Redwood City, California, USA
| | - D Hayes
- University of Michigan, Ann Arbor, Michigan, USA
| | - J Hicks
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - D Holloway
- Seven Bridges, Cambridge, Massachusetts, USA
| | - D Hovelson
- University of Michigan, Ann Arbor, Michigan, USA
| | - J Johnson
- AstraZeneca, Waltham, Massachusetts, USA
| | - H Juhl
- Indivumed GmbH, Hamburg, Germany
| | - R Kalamegham
- Genentech, Washington, District of Columbia, USA
| | - R Kamal
- Omicia, Oakland, California, USA
| | - Q Kang
- University of Michigan, Ann Arbor, Michigan, USA
| | - G J Kelloff
- Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
| | | | - A Kolatkar
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - P Kuhn
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - K Langone
- Genomic Health, Redwood City, California, USA
| | - R Leary
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - P Loverso
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - H Manmathan
- Seven Bridges, Cambridge, Massachusetts, USA
| | - A-M Martin
- Novartis Pharmaceuticals, East Hanover, New Jersey, USA
| | | | - D Miller
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - M Mitchell
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - T Morgan
- University of Michigan, Ann Arbor, Michigan, USA
| | - R Mulpuri
- Provista Diagnostics Inc., New York, New York, USA
| | - T Nguyen
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - G Otto
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - A Pathak
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - E Peters
- Genentech, South San Francisco, California, USA
| | - R Philip
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - E Posadas
- CytoLumina, Inc., Los Angeles, California, USA.,Cedar-Sinai Medical Center, Los Angeles, California, USA
| | - D Reese
- Provista Diagnostics Inc., New York, New York, USA
| | | | - D Robinson
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - A Dei Rossi
- Genomic Health, Redwood City, California, USA
| | - H Sakul
- Pfizer, San Diego, California, USA
| | - J Schageman
- Thermo Fisher Scientific, Austin, Texas, USA
| | - S Singh
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - H I Scher
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - K Schmitt
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - A Silvestro
- Novartis Institute for Biomedical Research, Cambridge, Massachusetts, USA
| | - J Simmons
- Personal Genome Diagnostics, Baltimore, Maryland, USA
| | - T Simmons
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - J Sislow
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - A Talasaz
- Guardant Health, Inc., Redwood City, California, USA
| | - P Tang
- Center for Data Intensive Science, University of Chicago, Chicago, Illinois, USA
| | - M Tewari
- University of Michigan, Ann Arbor, Michigan, USA
| | - S Tomlins
- University of Michigan, Ann Arbor, Michigan, USA
| | - H Toukhy
- Guardant Health, Inc., Redwood City, California, USA
| | - H R Tseng
- CytoLumina, Inc., Los Angeles, California, USA.,Crump Institute for Molecular Imaging, University of California, Los Angeles, California, USA
| | - M Tuck
- University of Michigan, Ann Arbor, Michigan, USA
| | - A Tzou
- Center for Device and Radiological Health, Food and Drug Administration, Silver Springs, Maryland, USA
| | - J Vinson
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Y Wang
- Epic Research and Diagnostics, San Diego, California, USA
| | - W Wells
- Open Commons Consortium, Chicago, Illinois, USA
| | - A Welsh
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - J Wilbanks
- Sage Bionetworks, Seattle, Washington, USA
| | - J Wolf
- Provista Diagnostics Inc., New York, New York, USA
| | - L Young
- Foundation Medicine, Cambridge, Massachusetts, USA
| | - Jsh Lee
- Office of the Director, National Cancer Institute, Bethesda, Maryland, USA
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15
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Cojean N, Strub C, Kuhn P, Calvel L. [Neonatal palliative care at home: Contribution of the regional pediatric palliative care team]. Arch Pediatr 2016; 24:160-168. [PMID: 28007511 DOI: 10.1016/j.arcped.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 11/09/2016] [Accepted: 11/16/2016] [Indexed: 10/20/2022]
Abstract
The "patients' rights and end-of-life care" act, known as the Leonetti law, has allowed implementation of palliative care in neonatology as an alternative to unreasonable therapeutic interventions. A palliative care project can be offered to newborns suffering from intractable diseases. It must be focused on the newborn's quality of life and comfort and on family support. Palliative care for newborns can be provided in the delivery room, in the neonatal unit, and also at home. Going home is possible but requires medical support. Here we describe the potential benefits of the intervention of a regional team of pediatric palliative care for newborns, both in the hospital and at home. Two clinical situations of palliative care at home started in the neonatal period and the neonatal unit are presented. They are completed by a retrospective national survey focusing on the type of support to newborns in palliative care in 2014, which was conducted in 22 French regional pediatric palliative care teams. It shows that 26 newborns benefited from this support at home in 2014. Sixteen infants were born after a pregnancy with a palliative care birth plan and ten entered palliative care after a decision to limit life-sustaining treatments. Twelve of them returned home before the 20th day of life. Sixteen infants died, six of them at home. The regional pediatric palliative care team first receives in-hospital interventions: providing support for ethical reflection in the development of the infant's life project, meeting with the child and its family, helping organize the care pathway to return home. When the child is at home, the regional pediatric palliative care team can support the caregiver involved, provide home visits to continue the clinical monitoring of the infant, and accompany the family. The follow-up of the bereavement and the analysis of the practices with caregivers are also part of its tasks.
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Affiliation(s)
- N Cojean
- Équipe ressource alsacienne de soins palliatifs pédiatriques, CHU de Strasbourg, 67000 Strasbourg, France.
| | - C Strub
- Équipe ressource alsacienne de soins palliatifs pédiatriques, CHU de Strasbourg, 67000 Strasbourg, France
| | - P Kuhn
- Service de médecine et de réanimation néonatale, CHU de Strasbourg, 67000 Strasbourg, France
| | - L Calvel
- Équipe d'accompagnement, de soins de confort et de soins palliatifs, CHU de Strasbourg, 67000 Strasbourg, France
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16
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17
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Casper C, Caeymaex L, Dicky O, Akrich M, Reynaud A, Bouvard C, Evrard A, Kuhn P. [Parental perception of their involvement in the care of their children in French neonatal units]. Arch Pediatr 2016; 23:974-82. [PMID: 27496640 DOI: 10.1016/j.arcped.2016.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 06/10/2016] [Accepted: 06/22/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The experience of becoming the parent of a sick or premature newborn can be particularly distressing for parents. They often encounter challenges to the development of their parenting roles. Perception of the hospital stay has never been analyzed on a large scale. OBJECTIVE To analyze parents' perception of their involvement in the care of their newborn. METHODS An internet-based survey started in France in February 2014 on the basis of a validated questionnaire composed of 222 neonatal care-related items. A quantitative and qualitative analysis was performed on the items dealing with parents' involvement until August 2014. RESULTS The survey was completed by 1500 parents, 98 % of whom were mothers. The infants had a mean GA of 32 weeks and a mean birth weight of 1600g. Parents rated their first care of their infant with mixed emotions (joy, stress, etc.). Parents were willing to practice new skills through guided participation, even for more complex care. Skin-to-skin care was only proposed after 7 days for 20 % of the parents; 10 % of the parents did not feel secure during this practice. The need for privacy and professional guidance was essential for meaningful skin-to-skin contact. DISCUSSION Parents' perception of participating actively in their infant's care was positive and they felt guided by the nursing team. Most of them would have been more active with guidance. Skin-to-skin care was appreciated and desired, but could become stressful if the conditions were not optimal.
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Affiliation(s)
- C Casper
- Unité de néonatologie, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
| | - L Caeymaex
- Service de médecine néonatale, centre hospitalier intercommunal de Créteil, 97010 Créteil, France
| | - O Dicky
- Unité de néonatologie, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France
| | - M Akrich
- Collectif inter-associatif autour de la naissance (CIANE), 75014 Paris, France
| | - A Reynaud
- Association SOS Préma, 32, rue du Chemin-vert, 92100 Boulogne-Billancourt, France
| | - C Bouvard
- Association SOS Préma, 32, rue du Chemin-vert, 92100 Boulogne-Billancourt, France
| | - A Evrard
- Collectif inter-associatif autour de la naissance (CIANE), 75014 Paris, France
| | - P Kuhn
- Service de réanimation néonatale, hôpital Hautepierre, CHU de Strasbourg, 67098 Strasbourg, France
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18
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Zurita A, Carlsson A, Luttgen M, Bethel K, Logothetis C, Hicks J, Kuhn P. High-Definition Single Cell Analysis (Hd-Sca) of Prostate Cancer (Pca) Cells in Matched Bone Marrow and Blood from Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu336.25] [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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19
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Astruc D, Zores C, Dillenseger L, Scheib C, Kuhn P. [Practical management of neonatal sepsis risk in term or near-term infants]. Arch Pediatr 2014; 21:1041-8. [PMID: 25129319 DOI: 10.1016/j.arcped.2014.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 05/27/2014] [Accepted: 06/19/2014] [Indexed: 11/30/2022]
Abstract
Incidence of neonatal early-onset sepsis has dramatically declined in France from 0.65 to 0.23‰ live births in 10 years since national guidelines to detect and treat intrapartum women with group B streptococcus colonization have been adopted. However, neonatal early-onset sepsis continues to be a common healthcare burden. Group B streptococcus (GBS) remains the leading cause of bacterial infection in term or near-term infants. As a result of prevention strategies, approximately 30% of pregnant women and more than 2% of newborns are treated with systemic antibiotics. Concerns have been expressed about the safety of wide use of antibiotics such as antibiotic resistance, emergence of Escherichia coli infections, and long-term side effects due to gut microbiota modifications. New recommendations from the Centers of Disease Control in the United States and from European countries aim at improving GBS detection methods, updating algorithms for GBS intrapartum chemoprophylaxis in pregnant women, defining high-risk newborns more efficiently, and limiting biological evaluation in low-risk newborns.
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Affiliation(s)
- D Astruc
- Service de néonatologie et réanimation néonatale, hôpital Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - C Zores
- Service de néonatologie et réanimation néonatale, hôpital Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - L Dillenseger
- Service de néonatologie et réanimation néonatale, hôpital Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - C Scheib
- Service de néonatologie et réanimation néonatale, hôpital Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Kuhn
- Service de néonatologie et réanimation néonatale, hôpital Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
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20
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Comen E, Mason J, Nieva J, Newton P, Kuhn P, Norton L, Venkatappa N, Jochelson M. SU-E-J-115: Using Markov Chain Modeling to Elucidate Patterns in Breast Cancer Metastasis Over Time and Space. Med Phys 2014. [DOI: 10.1118/1.4888167] [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: 11/07/2022] Open
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21
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Lorizio W, Luttgen M, Marks J, Wilderman E, Bethel K, Kuhn P, Hwang S. Abstract P4-03-05: Characterization of circulating tumor cells identified by high definition assay in patients with benign and malignant breast disease. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-03-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Identification of circulating tumor cells (CTC) has the potential for minimally invasive diagnosis and assessment of therapy response. Current CTC assay techniques rely on immunomagnetic bead isolation for CTC enrichment. However, these methods result in low cell yield, limiting the potential use in early stage where CTCs are thought to be less abundant. The high definition (HD)-CTC assay is a novel non-enrichment assay providing unique opportunities to identify single circulating epithelial cells (CepiCs) in patients before or at diagnosis. This study's goal is to determine feasibility and performance of the HD-CTC method for isolating CepiCs in women presenting for diagnostic breast biopsy. Methods: Women undergoing image-guided biopsy for BIRADS 4 and 5 mammographic abnormalities were selected from April 2012 onward at the Duke Breast Clinic. After obtaining informed consent, sample collection and shipping procedures were performed following specific standard operating procedures. Diagnosis was kept blinded during assay analysis. Quantitative measurements were used at the single-cell level to identify and enumerate CepiCs. We morphologically characterized specific high content screening variables including cytokeratin (CK) intensity and epithelial cell adhesion molecule (EpCAM) staining. Measurements included cellular size, shape, and staining pattern. For each draw, 4 monochrome images per frame from 4 stained slides were used for CK/EpCAM evaluation. Results: To date 34 women have been enrolled. Fourteen samples (41%) were drawn before biopsy and 20 (59%) after. Out of the 20, 2 (10%) were non-evaluable and a total of 18 (90%) have HD-CTC assay derived data available. The average diagnosis age was 54; 70% were Caucasian. Six (33%) out of 18 had benign disease (fibrocystic, fibroadenoma and apocrine), 10 (55%) had invasive (ductal or lobular), and 2 (12%) had atypical ductal hyperplasia and ductal carcinoma in situ. Five (83%) benign cases and 4 (40%) invasive had detectable CepiCs (Fisher exact test = 0.43). We found a borderline significant trend between the number of CepiCs and the nodes involved (P for trend = 0.06). No association found with ER, PR or ERBB2 status. The mean number of CepiCs/mL in invasive cases was 45.25 +/-96.65 (range 0 to 270.6) compared to 17.47 CepiCs/mL +/-27.8 (range 0 to 72.3) in benign. Additionally, all the CK(+) morphologically distinct cells were EpCAM(-). There is no significant difference between benign and malignant cases when analyzing draws after biopsy. Conclusion: HD-CTC technology is feasible for detection of CepiCs in early stage breast cancer, and in some cases, results in retrieval of a large number of them. Additional technology refinements including determination of appropriate thresholds are needed to improve discrimination of cancer patients from non-cancer, and follow up will help determine whether HD-CTC assay derived enumeration and characterization of CepiCs are associated with prognosis. These early results are promising and ongoing studies at Duke with TSRI will further evaluate the role of CepiCs in early stage breast cancer along with the isolation and analysis of DNA from single-CepiCs. New data will be available by time of presentation.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-03-05.
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Affiliation(s)
- W Lorizio
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
| | - M Luttgen
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
| | - J Marks
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
| | - E Wilderman
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
| | - K Bethel
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
| | - P Kuhn
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
| | - S Hwang
- Duke University Medical Center, Durham, NC; The Scripps Research Institute, La Jolla, CA
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22
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Lin S, Gao H, Wei C, Marrinucci D, Nelson D, Liao Z, Komaki R, Hauch S, Kuhn P, Reuben J. Circulating Tumor Cells With Markers of Epithelial-Mesenchymal Transition Are Associated With Distant Metastatic Failures in Lung Cancer Patients Treated With Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.289] [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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23
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Kelley RK, Nimeiri HS, Munster PN, Vergo MT, Huang Y, Li CM, Hwang J, Mulcahy MF, Yeh BM, Kuhn P, Luttgen MS, Grabowsky JA, Stucky-Marshall L, Korn WM, Ko AH, Bergsland EK, Benson AB, Venook AP. Temsirolimus combined with sorafenib in hepatocellular carcinoma: a phase I dose-finding trial with pharmacokinetic and biomarker correlates. Ann Oncol 2013; 24:1900-1907. [PMID: 23519998 PMCID: PMC3690907 DOI: 10.1093/annonc/mdt109] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [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: 12/14/2012] [Revised: 02/01/2013] [Accepted: 02/05/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Based upon preclinical evidence for improved antitumor activity in combination, this phase I study investigated the maximum-tolerated dose (MTD), safety, activity, pharmacokinetics (PK), and biomarkers of the mammalian target of rapamycin inhibitor, temsirolimus, combined with sorafenib in hepatocellular carcinoma (HCC). PATIENTS AND METHODS Patients with incurable HCC and Child Pugh score ≤B7 were treated with sorafenib plus temsirolimus by 3 + 3 design. The dose-limiting toxicity (DLT) interval was 28 days. The response was assessed every two cycles. PK of temsirolimus was measured in a cohort at MTD. RESULTS Twenty-five patients were enrolled. The MTD was temsirolimus 10 mg weekly plus sorafenib 200 mg twice daily. Among 18 patients at MTD, DLT included grade 3 hand-foot skin reaction (HFSR) and grade 3 thrombocytopenia. Grade 3 or 4 related adverse events at MTD included hypophosphatemia (33%), infection (22%), thrombocytopenia (17%), HFSR (11%), and fatigue (11%). With sorafenib, temsirolimus clearance was more rapid (P < 0.05). Two patients (8%) had a confirmed partial response (PR); 15 (60%) had stable disease (SD). Alpha-fetoprotein (AFP) declined ≥50% in 60% assessable patients. CONCLUSION The MTD of sorafenib plus temsirolimus in HCC was lower than in other tumor types. HCC-specific phase I studies are necessary. The observed efficacy warrants further study.
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Affiliation(s)
- R K Kelley
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco.
| | - H S Nimeiri
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago
| | - P N Munster
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
| | - M T Vergo
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago
| | - Y Huang
- Drug Studies Unit, Department of Bioengineering & Therapeutic Sciences
| | - C-M Li
- Drug Studies Unit, Department of Bioengineering & Therapeutic Sciences
| | - J Hwang
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
| | - M F Mulcahy
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago
| | - B M Yeh
- Department of Radiology, UCSF, San Francisco
| | - P Kuhn
- Department of Cell Biology, The Scripps Research Institute, La Jolla, USA
| | - M S Luttgen
- Department of Cell Biology, The Scripps Research Institute, La Jolla, USA
| | - J A Grabowsky
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
| | - L Stucky-Marshall
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago
| | - W M Korn
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
| | - A H Ko
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
| | - E K Bergsland
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
| | - A B Benson
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago
| | - A P Venook
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco
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24
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Eyer K, Stratz S, Kuhn P, Küster SK, Dittrich PS. Implementing Enzyme-Linked Immunosorbent Assays on a Microfluidic Chip To Quantify Intracellular Molecules in Single Cells. Anal Chem 2013; 85:3280-7. [DOI: 10.1021/ac303628j] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- K. Eyer
- Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli-Str. 10,
CH-8093 Zurich, Switzerland
| | - S. Stratz
- Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli-Str. 10,
CH-8093 Zurich, Switzerland
| | - P. Kuhn
- Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli-Str. 10,
CH-8093 Zurich, Switzerland
| | - S. K. Küster
- Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli-Str. 10,
CH-8093 Zurich, Switzerland
| | - P. S. Dittrich
- Department of Chemistry and Applied Biosciences, ETH Zurich, Wolfgang-Pauli-Str. 10,
CH-8093 Zurich, Switzerland
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25
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Robinson T, Kuhn P, Eyer K, Dittrich PS. Microfluidic trapping of giant unilamellar vesicles to study transport through a membrane pore. Biomicrofluidics 2013; 7:44105. [PMID: 24404039 PMCID: PMC3739824 DOI: 10.1063/1.4816712] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 07/10/2013] [Indexed: 05/05/2023]
Abstract
We present a microfluidic platform able to trap single GUVs in parallel. GUVs are used as model membranes across many fields of biophysics including lipid rafts, membrane fusion, and nanotubes. While their creation is relatively facile, handling and addressing single vesicles remains challenging. The PDMS microchip used herein contains 60 chambers, each with posts able to passively capture single GUVs without compromising their integrity. The design allows for circular valves to be lowered from the channel ceiling to isolate the vesicles from rest of the channel network. GUVs containing calcein were trapped and by rapidly opening the valves, the membrane pore protein α-hemolysin (αHL) was introduced to the membrane. Confocal microscopy revealed the kinetics of the small molecule efflux for different protein concentrations. This microfluidic approach greatly improves the number of experiments possible and can be applied to a wide range of biophysical applications.
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Affiliation(s)
- T Robinson
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich 8093, Switzerland
| | - P Kuhn
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich 8093, Switzerland
| | - K Eyer
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich 8093, Switzerland
| | - P S Dittrich
- Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich 8093, Switzerland
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Lee AM, Berny-Lang MA, Liao S, Kanso E, Kuhn P, McCarty OJT, Newton PK. A low-dimensional deformation model for cancer cells in flow. Phys Fluids (1994) 2012; 24:81903. [PMID: 23024578 PMCID: PMC3443115 DOI: 10.1063/1.4748811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 07/30/2012] [Indexed: 06/01/2023]
Abstract
A low-dimensional parametric deformation model of a cancer cell under shear flow is developed. The model is built around an experiment in which MDA-MB-231 adherent cells are subjected to flow with increasing shear. The cell surface deformation is imaged using differential interference contrast microscopy imaging techniques until the cell releases into the flow. We post-process the time sequence of images using an active shape model from which we obtain the principal components of deformation. These principal components are then used to obtain the parameters in an empirical constitutive equation determining the cell deformations as a function of the fluid normal and shear forces imparted. The cell surface is modeled as a 2D Gaussian interface which can be deformed with three active parameters: H (height), σ(x) (x-width), and σ(y) (y-width). Fluid forces are calculated on the cell surface by discretizing the surface with regularized Stokeslets, and the flow is driven by a stochastically fluctuating pressure gradient. The Stokeslet strengths are obtained so that viscous boundary conditions are enforced on the surface of the cell and the surrounding plate. We show that the low-dimensional model is able to capture the principal deformations of the cell reasonably well and argue that active shape models can be exploited further as a useful tool to bridge the gap between experiments, models, and numerical simulations in this biological setting.
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Affiliation(s)
- A M Lee
- Department of Aerospace & Mechanical Engineering and Department of Mathematics, University of Southern California, Los Angeles, California 90089-1191, USA
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Kuhn P, Zores C, Astruc D, Dufour A, Casper C. [Sensory system development and the physical environment of infants born very preterm]. Arch Pediatr 2011; 18 Suppl 2:S92-102. [PMID: 21763981 DOI: 10.1016/s0929-693x(11)71097-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The sensory systems develop in several sequences, with a process specific to each system and with a transnatal continuum. This development is based partly on interactions between the fetus and the newborn and their physical and human environments. These interactions are key drivers of the child development. The adaptation of the newborn's environment is crucial for his survival, his well-being and his development, especially if he is born prematurely. The physical environment of the hospital where immature infants are immersed differs greatly from the uterine environment from which they were extracted prematurely. There are discrepancies between their sensory expectations originating in the antenatal period and the atypical stimuli that newborns encounter in their postnatal nosocomial environment. These assertions are valid for all sensory modalities. Many studies have proven that very preterm infants are highly sensitive to this environment which can affect their physiological and behavioural well being. Moreover, it can alter their perception of important human sensory signals, particularly the ones coming from their mother. The long term impacts of this environment are more difficult to identify due to the multi-sensory nature of these stimuli and the multifactorial origin of the neurological disorders that these children may develop. However, the adaptation of their physical environment is one of the corner stones of specific developmental care programs, like the NIDCAP program that has been shown to be successful to improve their short and medium term outcomes. The architectural design, technical equipment and used health-care products, and the strategies and organizations of care are the main determinants of the physical environment of these children. Recommendations for the hospital environment, integrating a newborn's developmental perspective, have been made available. They should be applied more widely and should be completed. Technological equipment advances are also expected to allow better compliance to them. All these evolutions are completely in accordance with the concept of humane neonatal care.
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Affiliation(s)
- P Kuhn
- Service de Médecine et Réanimation Néonatale, Hôpital de Hautepierre, CHU Strasbourg, 28 Avenue Molière 67098 Strasbourg cedex, France.
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Scheibner K, Kuhn P, Surbek D, Raio L. [Complex umbilical cord vein pulsations in cases with twin-twin transfusion syndrome: prognostic implications]. Ultraschall Med 2011; 32 Suppl 2:E157-E161. [PMID: 21877316 DOI: 10.1055/s-0031-1273469] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE Umbilical vein pulsations (UV-P) are due to various etiologies. The aim of the present study was to investigate the incidence and type of UV-P in monochorionic twins with twin-twin transfusion syndrome (TTTS). MATERIALS AND METHODS TTTS cases diagnosed between 1999 and 2009 were examined retrospectively. The UV flow pattern taken from a free floating loop of the umbilical cord was classified as "non-pulsatile" (NP), "monophasic" (MP) and "complex" (CP). Only Doppler flow analyses prior to intervention were examined. RESULTS Of 106 cases seen during the study period, 56 cases met the inclusion criteria. Of those, 62.5% were classified as stage III TTTS, and fetoscopic laser therapy was performed in 45 cases. NP flow patterns were more likely found in the donor twin (80.4 vs. 28.6%; p < 0.0001), while the incidence of MP (50 vs. 17.9%; p < 0.0006) and CP flow patterns (21.4 vs. 1.7%; p < 0.01) was higher in the recipient twin. Moreover, the perinatal mortality was highest in cases with CP (CP: 76.9 vs. MP 42.1 vs. NP: 26.2%; p < 0.01) as well as the rate of cases with double death. CONCLUSION CP patterns are more frequently found in the recipient twin and are associated with a considerably high mortality rate. Studying the umbilical vein flow pattern in TTTS may provide additional information for counseling and prognosis similar to that obtained by expensive fetal echocardiography.
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Affiliation(s)
- K Scheibner
- Department of Obstetrics and Gynaecology, University of Bern, Inselspital Switzerland, Bern, Schweiz.
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Abola EE, Cherezov V, Kuhn P, Stevens R. GPCR Network – understanding human GPCR biology. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311081359] [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: 11/10/2022] Open
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30
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Wendell M, Bazhenova L, Morgan A, Boisot S, Marinucci D, Luttgen M, Nieva JJ, Kuhn P, Bethel K. Circulating tumor cells (CTC) in mesothelioma and its cytomorphological and immunohistochemical correlation with the primary tumor specimens. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21170] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
Several pain scales are available for newborns, but the assessment of pain in these preverbal beings, who are in continuing neurological development, remains challenging for healthcare teams. Although neonates at the end of life are particularly vulnerable to pain and discomfort, no assessment tool has been validated in this specific population. The difficulties for assessing pain in this context are copies of those potentially encountered in other situations. Questions arise about the limits of the available scales, about possible alterations of responses to a noxious stimulus in particular contexts (extreme immaturity, brain lesions), about possibly painful situations in palliative care, about the nature of scales to choose. Data show a perception of pain at a cortical level by extremely immature infants and the ability for neonates with significant neurological injury to express pain behaviours. For some potentially painful situations (dyspnoea, gasps, hunger) neonatal data are virtually nonexistent. Fundamental scientific data and clinical data from adults and children can give some answers. One will choose scales for which the staff is trained, easily usable (preference for behavioural scales), validated for all gestational ages, reliable in the event of neurological impairment or sedation. An assessment of prolonged pain (EDIN scale or COMFORT Behaviour scale) combined with measures of acute pain (DAN or NFCS scales) is recommended. These scales should be better validated for populations of newborns and situations that are specific to palliative care. A better assessment of the parental perception and of their distress about the discomfort or pain of their child is warranted.
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Affiliation(s)
- P Kuhn
- Médecine et Réanimation Néonatale, Service de Pédiatrie 2, Pôle Médico-Chirurgical Pédiatrique, CHU, Hôpital de Hautepierre, 28, avenue Molière, 67098 Strasbourg cedex, France.
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Kuhn P, Primio RD, Horsfield B. Bulk composition and phase behaviour of petroleum sourced by the Bakken Formation of the Williston Basin. ACTA ACUST UNITED AC 2011. [DOI: 10.1144/0071065] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractThe Bakken Formation is currently regarded primarily as a self-contained, unconventional petroleum system. While previously viewed as a source for oil occurring in overlying formations, it is now predicted that resources of more than 3.5 billion barrels of oil are trapped intraformationally. New insights into the formation's open v. closed nature are presented here using the physical properties of natural petroleum, source rock characteristics and the numerical modelling of phase behaviour. In the mature western part of the basin petroleum accumulations have been postulated to be continuous in nature, characterized by very short migration distances of indigenous hydrocarbons. This necessitates that the composition and therefore physical properties of the generated hydrocarbons must be controlled by the maturity of the source rock in the immediate vicinity. This assumption is not supported by the clustering of higher gas–oil ratios and lighter oil gravities along the locations of the anticlines in the basin. We have used open and closed system pyrolysis techniques to predict the bulk composition of the petroleum generated at different transformation stages, both cumulatively and instantaneously. Based on these predictions the Bakken would contain dominantly undersaturated fluids throughout the basin. Differences in predicted GORs of cumulative and instantaneous models support the conclusion that the reported hydrocarbon compositions cannot completely be explained by a tight self-contained petroleum system. The observed variability of in-place hydrocarbon compositions is readily explained by lateral migration of petroleum in the main middle Bakken carrier, and vertical leakage of emplaced hydrocarbons from the fractured reservoir at anticline locations. This has resulted in the loss of the early generated petroleum, and led to a present-day dominance of late generation products. These results reveal that the Bakken Formation is a partly open petroleum system, at least along the major anticlines of the Williston Basin.
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Schram ED, Kolatkar A, Yoshioka C, Scuderi R, Lazar D, Malchiodi M, Luttgen M, Yang X, Bethel K, Kuhn P. Comparative morphometric analysis of breast-circulating tumor cells and their corresponding solid tumor cytology: A case study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bétrémieux P, Gold F, Parat S, Caeymaex L, Danan C, De Dreuzy P, Vernier D, Viallard ML, Kuhn P. Réflexions et propositions autour des soins palliatifs en période néonatale : 1re partie considérations générales. Arch Pediatr 2010; 17:409-12. [DOI: 10.1016/j.arcped.2010.01.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 10/29/2009] [Accepted: 01/04/2010] [Indexed: 10/19/2022]
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Moriette G, Rameix S, Azria E, Fournié A, Andrini P, Caeymaex L, Dageville C, Gold F, Kuhn P, Storme L, Siméoni U. [Very premature births: Dilemmas and management. Second part: Ethical aspects and recommendations]. Arch Pediatr 2010; 17:527-39. [PMID: 20223643 DOI: 10.1016/j.arcped.2009.09.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Accepted: 09/15/2009] [Indexed: 11/25/2022]
Abstract
In the first part of this work, the outcome following very premature birth was assessed. This enabled a gray zone to be defined, with inherent major prognostic uncertainty. In France today, the gray zone corresponds to deliveries occurring at 24 and 25 weeks of postmenstrual age. The management of births occurring below and above the gray zone was described. Withholding intensive care at birth for babies born below or within the gray zone does not mean withholding care but rather providing palliative care to prevent pain and suffering during the time period preceding death. Given the high level of uncertainty, making good decisions within the gray zone is problematic. Decisions should be based on the infant's best interests. Decisions should be reached with the parents, who are entitled to receive clear and comprehensive information. Possible decisions to withhold intensive care should be made following the procedures described in the French law of April 2005. Guidelines, based on gestational age and the other prognostic elements, are proposed to the parents before birth. They are applied in an individualized fashion, in order to take into account the individual features of each case. At 25 weeks, resuscitation and/or full intensive care are usually proposed, unless unfavorable factors, such as severe growth restriction, are associated. A senior neonatologist will attend the delivery and will make decisions based on both the baby's condition at birth and the parents' wishes. At 24 weeks, in the absence of unfavorable associated factors, the parents' wishes should be followed in deciding between initiating full intensive care or palliative care. Below 24 weeks, palliative care is the only option to be offered in France at the present time.
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Affiliation(s)
- G Moriette
- Service de médecine néonatale de Port-Royal, 123, boulevard de Port-Royal, 75 014 Paris, France.
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Moriette G, Rameix S, Azria E, Fournié A, Andrini P, Caeymaex L, Dageville C, Gold F, Kuhn P, Storme L, Siméoni U. [Very premature births: Dilemmas and management. Part 1. Outcome of infants born before 28 weeks of postmenstrual age, and definition of a gray zone]. Arch Pediatr 2010; 17:518-26. [PMID: 20223644 DOI: 10.1016/j.arcped.2009.09.025] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Accepted: 09/14/2009] [Indexed: 11/19/2022]
Abstract
With very preterm deliveries, the decision to institute intensive care, or, alternatively, to start palliative care and let the baby die, is extremely difficult, and involves complex ethical issues. The introduction of intensive care may result in long-term survival of many infants without severe disabilities, but it may also result in the survival of severely disabled infants. Conversely, the decision to withhold resuscitation and/or intensive care at birth, which is an option at the margin of viability, implies allowing babies to die, although some of them would have developed normally if they had received resuscitation and/or intensive care. Withholding intensive care at birth does not mean withholding care but rather providing palliative care to prevent pain and suffering during the time period preceding death. The likelihood of survival without significant disabilities decreases as gestational age at birth decreases. In addition to gestational age, other factors greatly influence the prognosis. Indeed, for a given gestational age, higher birth weight, singleton birth, female sex, exposure to prenatal corticosteroids, and birth in a tertiary center are favorable factors. Considering gestational age, there is a gray zone that corresponds to major prognostic uncertainty and therefore to a major problem in making a "good" decision. In France today, the gray zone corresponds to deliveries at 24 and 25 weeks of postmenstrual age. In general, babies born above the gray zone (26 weeks of postmenstrual age and later) should receive resuscitation and/or full intensive care. Below 24 weeks, palliative care is the only option offered in France at the present time. Decisions within the gray zone will be addressed in the 2nd part of this work.
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MESH Headings
- Adrenal Cortex Hormones/administration & dosage
- Birth Weight
- Brain Damage, Chronic/etiology
- Brain Damage, Chronic/mortality
- Child
- Child, Preschool
- Developmental Disabilities/etiology
- Developmental Disabilities/mortality
- Ethics Committees
- Ethics, Medical
- Fetal Viability
- Follow-Up Studies
- France
- Gestational Age
- Humans
- Infant
- Infant, Extremely Low Birth Weight
- Infant, Newborn
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/therapy
- Intensive Care, Neonatal/ethics
- Palliative Care/ethics
- Prognosis
- Resuscitation/ethics
- Risk Factors
- Sex Factors
- Survival Rate
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Affiliation(s)
- G Moriette
- Service de médecine néonatale de Port-Royal, 123, boulevard de Port-Royal, 75014 Paris, France.
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Palkovits R, Baltes C, Antonietti M, Kuhn P, Thomas A, Schüth F. Direkte Niedrigtemperatur-Oxidation von Methan zu Methanol an festen Katalysatoren. CHEM-ING-TECH 2009. [DOI: 10.1002/cite.200950177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Didier C, Astruc D, Kuhn P. L-02 Épidémiologie des infections néonatales tardives (INT) et antibiothérapie péripartum (AP) : une étude observationnelle en population. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74446-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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39
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Luttgen MS, Marrinucci D, Lazar D, Malchiodi M, Clark P, Huynh E, Bethel K, Bazhenova L, Nieva J, Kuhn P. Circulating tumor cells monitored over time in lung cancer patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.11025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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
11025 Background: Circulating tumor cell (CTC) detection and enumeration is a valuable tool for monitoring cancer patient status and outcome. While many current techniques employ immunomagnetic-enrichment based protocols focused on the importance of a particular CTC number as the indicator of patient status or outcome, we employ a cytometric, enrichment free approach using an immunofluorescent protocol to monitor CTC counts in patients with non-small cell lung cancer (NSCLC) over the course of treatment. Methods: Eligible patients had progressive stage IV NSCLC. The histological subtypes in the 42 cases for which the data was available included adenocarcinoma (22/42), squamous cell carcinoma (6/42), large cell undifferentiated carcinoma (3/42), and non-small cell lung carcinoma not further described, poorly differentiated, or with a mixed pattern (11/42). Blood samples were collected 3 wks, 3 mo, 6 mo, 9 mo, and 1 yr after the initial sample. CTCs were identified via immunofluorescence and cytometric analysis. Patient response to therapy was determined by RECIST every 3 months between time 0 and time 12 mo. Results: 80 of 109 patient samples have CTCs (73%) and all of the 52 patients tested have CTCs. 13 of 52 patients have CTC data for time 0 and 3 wks. Only 4 of these patients (30.8%) show a correlation linking CTC count change between time 0 and 3 wks and clinical assessment. 13 patients have CTC data for time 0 and 3 mo, 10 of whom show a correlation linking CTC count change between time 0 and 3 mo and clinical assessment. 7 of the 8 patients (87.5%) showing stable or partial response at 3 mo show a decrease in CTC count between time 0 and 3 mo. Five of the 6 patients (83.3%) clinically showing progressive disease at the 3 mo time point show an increase in CTC count between time 0 and 3 mo. The patients that do not show a correlation linking CTC count change between time 0 and 3 mo and clinical assessment at 3 mo show a correlation at the 6 mo time point. Conclusions: CTCs can be effectively enumerated in metastatic NSCLC patients, with the majority demonstrating CTCs in the setting of progressive disease. The change in CTC count at 3 mo, but not at 3 wks, correlates with radiographic response to chemotherapy. Further follow-up will determine the predictive value of CTC enumeration on survival. No significant financial relationships to disclose.
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Affiliation(s)
- M. S. Luttgen
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - D. Marrinucci
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - D. Lazar
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - M. Malchiodi
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - P. Clark
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - E. Huynh
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - K. Bethel
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - L. Bazhenova
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - J. Nieva
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
| | - P. Kuhn
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; University of California, San Diego, La Jolla, CA; Billings Clinic, Billings, MT
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Koenig-Zores C, Pervillé A, Didier C, Langlet C, Scheib-Brolly C, Kuhn P, Mansour Z, Astruc D. SFP-P109 – Néonatalogie – Thrombose artérielle iliaque néonatale spontannée associée à une mutation homozygote MTHFR. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72239-5] [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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41
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Marrinucci D, Bethel K, Fisher JM, Lazar D, Kuhn P, Nieva J. Bronchioloalveolar lung CTCs retain cytomorphologic features of primary tumor type. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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42
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Bethel K, Scuderi R, Marrinucci D, Fisher JM, Lazarus N, Lazar D, Kuhn P. Morphologic assessment of peripheral blood smears in patients with circulating tumor cells (CTCs). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Dageville C, Rameix S, Andrini P, Betrémieux P, Jarreau PH, Kuhn P, Oriot D. Fin de vie en médecine néonatale à la lumière de la loi. ACTA ACUST UNITED AC 2008; 36:571-81. [DOI: 10.1016/j.gyobfe.2008.04.003] [Citation(s) in RCA: 5] [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: 10/22/2022]
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Azria E, Bétrémieux P, Caeymaex L, Debillon T, Fournié A, Huillery ML, Kuhn P, Lequien P, Altavilla A, Mahieu-Caputo D. L’information dans le contexte du soin périnatal : aspects éthiques. ACTA ACUST UNITED AC 2008; 36:476-83. [DOI: 10.1016/j.gyobfe.2008.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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45
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Azria E, Bétrémieux P, Caeymaex L, Debillon T, Fournié A, Huillery ML, Kuhn P, Lequien P, Altavilla A, Mathieu-Caputo D. L'information dans le contexte du soin périnatal: aspects éthiques. Arch Pediatr 2007; 14:1231-9. [PMID: 17826967 DOI: 10.1016/j.arcped.2007.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Accepted: 07/09/2007] [Indexed: 10/22/2022]
Abstract
Besides the undeniable need to respect parental autonomy, providing information is a legal and moral obligation, to be informed a basic right. The act of informing should be considered as an exchange and necessarily begins by listening to the other. According to the jurisprudence of the Court of Cassation that draws on Article 35 of the Deontological Code, information has to be clear (implying an educational effort, availability and to check that the information has been well understood), appropriate (adapted to each situation and person) and honest (which supposes a moral contract between parents and physicians). Loyalty implies a consideration of the uncertainty underlying medical practice, and of the limitations in arriving at a prognosis. Indeed, caution needs to be exercised in conveying information, taking into account the risk of its becoming self-fulfilling, which could modify the way in which parents take care of their child. The information given has to be coherent, both within the spatial dimension (coherence of information between the different maternity services in the perinatal network) and the temporal dimension (coherence of information between pre- and postnatal stages). It must be acknowledged that information is essentially subjective. There is a fundamental difference between coherence and uniformity, and as regards information, uniformity is neither possible nor desirable. In each situation, priority must be given to oral information delivered in an appropriate material context. The principle of establishing, in the medical file, a written trace of the information given at various stages is one way to guarantee its coherence.
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Dageville C, Rameix S, Andrini P, Betrémieux P, Jarreau PH, Kuhn P, Oriot D. Fin de vie en médecine néonatale à la lumière de la loi. Arch Pediatr 2007; 14:1219-30. [PMID: 17728119 DOI: 10.1016/j.arcped.2007.07.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2007] [Accepted: 07/09/2007] [Indexed: 12/01/2022]
Abstract
Two recent laws have significantly reformed the French Public Health Code: the law of March 4th 2002, related to the patient's rights and the quality of the health care system and the law of April 22nd 2005, related to the patient's rights and the end of life. These changes have prompted health care professionals involved in perinatal and neonatal medicine to update their considerations on the ethical aspects of the end of life in neonatal medicine. Therefore, the authors examined the clauses of the law related to the patient's rights and to the end of life, confronting them with the distinctive features of neonatal medicine. In this paper, the medical practices, which are either prohibited or authorized in the course of end of life are considered: prohibition of euthanasia, authorization for alleviating pain at the risk of shortening life, authorization for restricting, withholding or withdrawing treatments. Next, the justifications provided by the legislation to authorize these practices are analysed: prohibition of unreasonable obstinacy and respect for individual wishes. Then, the conditions required by the law to determine and to implement these acts are discussed: consultation with the healthcare staff and justified advice from a consulting physician, consideration of parental opinion, registration of the decision and its justifications into the patient's medical file, protection of the dying patient's dignity and preservation of his life quality by providing palliative care. Lastly, we report the terms of the ethical dilemma which may occur in the area of neonatal medicine in spite of genuine and persevering efforts in order to conciliate legal requirement and ethical responsibility.
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Marrinucci D, Bethel K, Lazarus N, Leach M, Kroener J, Bruce R, Kuhn P, Nieva J. Detecting circulating tumor cells in metastatic breast cancer patients using fiber-optic array scanning technology. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1022] [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
1022 Background: Circulating tumor cell (CTC) detection and enumeration has been shown to be a valuable tool for determining prognosis in metastatic breast cancer patients. CTCs are rare, existing in the circulation at estimated concentrations of 1 in 1 - 10 million normal blood cells. To date, the most widely used technique to detect CTCs has used immunomagnetic enrichment based protocols. In this validation study, we sought to determine if an enrichment free approach using an immunofluorescent cell attachment protocol along with fiber-optic array scanning technology (FAST) could achieve similar results. Methods: We have developed and validated a scanning instrument using FAST that can be used in conjunction with an immunofluorescence staining protocol to efficiently detect CTCs. The protocol uses a pan anti-cytokeratin antibody cocktail directed against 9 cytokeratins along with a DAPI nuclear counterstain. FAST defines cell positions, so relocation and retrospective analysis of CTCs is possible. Using this system, we assayed 50 blood specimens obtained from metastatic breast cancer patients. Pathologic review of CTCs was performed identifying CTCs as cytokeratin positive and DAPI positive. Survival analyses were determined using Kaplan-Meier analyses. Results: 31 women with metastatic breast cancer were enrolled in the study and provided 50 peripheral blood specimens. The median CTC count for patients with progressive disease was 8.5, while the median CTC count for patients with stable or responding disease was 1. At a median follow-up of 1 year, 11 patients had died. Patients with =5 CTCs had a median survival of 212 days, while the median survival for patients with 0–4 CTCs had not been reached after 1 year (p=0.0012). Patients with progressive disease had significantly higher CTC counts (p<0.0001) than those who were stable or responding to therapy. Conclusions: This study confirms the previously reported efficacy of CTC enumeration in determining the prognosis of metastatic breast cancer patients and establishes the potential utility of the FAST cytometer as a method for CTC enumeration. No significant financial relationships to disclose.
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Affiliation(s)
- D. Marrinucci
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - K. Bethel
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - N. Lazarus
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - M. Leach
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - J. Kroener
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - R. Bruce
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - P. Kuhn
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
| | - J. Nieva
- The Scripps Research Institute, La Jolla, CA; Scripps Clinic, La Jolla, CA; Palo Alto Research Center, Palo Alto, CA
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Curry DN, Krivacic RT, Hsieh HB, Ladanyi A, Bergsrud DE, Ho MY, Chen LB, Kuhn P, Bruce RH. High-speed detection of occult tumor cells in peripheral blood. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:1267-70. [PMID: 17271920 DOI: 10.1109/iembs.2004.1403401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although detection of tumor cells in peripheral blood using imitiunocytochemistry and optical scanning is a promising method for screening and monitoring cancer, it poses a major technical challenge due to the extremely low tumor cell concentration in blood. The preferred detection method - digital microscopy - is far too slow for analysis of the large numbers of cells required for statistical validity. We describe here a novel prescan instrument that rapidly identifies a small number of candidates for subsequent examination by digital microscopy to determine if they are genuine tumor cells. The prescan is 500 times faster than digital microscopy and yet has a similar sensitivity. The high prescan speed is accomplished by trading resolution for field of view. The resolution of the prescan is determined by the laser spot size of about 10 microns. While this resolution is much coarser than the submicron resolution of microscopes, it is still sufficient for detecting fluorescent cells because it matches the size of a typical cell. The wide field of view and high scan rate are enabled by a novel application of fiber optics.
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Kuhn P, Matt D, Toupet L, Louati A. Crystal structure of 25,27-dibenzyIoxy-26-benzoyloxy-28-hydroxycalix[ 4]arene, C49H40O5. Z KRIST-NEW CRYST ST 2006. [DOI: 10.1524/ncrs.2006.221.14.31] [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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Kuhn P, Matt D, Ricard L, Louati A. Crystal structure of 5-acetyl-25,27-dipropyloxy-26,28-acetyloxycalix[ 4]arene ethyl acetate hemisolvate, C40H42O7 · ½ C4H8O2, partial cone. Z KRIST-NEW CRYST ST 2006. [DOI: 10.1524/ncrs.2006.221.14.551] [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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