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Schwarz Y, Klein P, Lev-Shalem L. Masked anemia and hematocrit elevation under sodium glucose transporter inhibitors: findings from a large real-world study. Acta Diabetol 2024; 61:99-105. [PMID: 37698758 DOI: 10.1007/s00592-023-02174-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
AIMS Sodium glucose transporter inhibitors (SGLT2i) therapy is associated with an increase in hematocrit as a class effect. There is a lack of information regarding the clinical magnitude and significance of hematocrit elevation, especially cardiovascular outcomes in patients with polycythemia and possible masking of lower hemoglobin levels as a sign of potential severe disease. METHODS A retrospective study utilizing large community healthcare provider electronic database. Hematocrit levels and variables with potential effect on hematocrit change were compared before and during SGLT2i treatment in adults with type 2 diabetes mellitus. RESULTS Study population included 9646 patients treated with Dapagliflozin or Empagliflozin between 01.2015 and 06.2019. Hematocrit levels were significantly higher after treatment initiation (2.1%), with higher median elevation among male vs female (2.3% vs. 1.8%). Anemia prevalence was significantly lower under treatment (20% vs. 31.6%). In multivariable model, gender, smoking status, SGLT2i type, pretreatment hematocrit, diabetes duration, body mass index and estimated glomerular filtration rate change significantly effected hematocrit change. CONCLUSIONS In the current study SGLT2i treatment was associated with significant hematocrit elevation, polycythemia and lower anemia prevalence. Further studies are needed to determine the clinical significance and approach to patients with pretreatment or on treatment polycythemia and the approach to patients with lower-normal hemoglobin levels under SGLT2i treatment.
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Affiliation(s)
- Yair Schwarz
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Derech Sheba 2, 5266202, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - Pinchas Klein
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Derech Sheba 2, 5266202, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
- Maccabi Health Care Services, Tel-Avia-Jaffa, 6812509, Israel
| | - Liat Lev-Shalem
- Maccabi Health Care Services, Tel-Avia-Jaffa, 6812509, Israel
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2
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Berounský K, Vacková I, Vištejnová L, Malečková A, Havránková J, Klein P, Kolinko Y, Petrenko Y, Pražák Š, Hanák F, Přidal J, Havlas V. Autologous Mesenchymal Stromal Cells Immobilized in Plasma-Based Hydrogel for the Repair of Articular Cartilage Defects in a Large Animal Model. Physiol Res 2023; 72:485-495. [PMID: 37795891 PMCID: PMC10634567 DOI: 10.33549/physiolres.935098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/02/2023] [Indexed: 01/05/2024] Open
Abstract
The treatment of cartilage defects in trauma injuries and degenerative diseases represents a challenge for orthopedists. Advanced mesenchymal stromal cell (MSC)-based therapies are currently of interest for the repair of damaged cartilage. However, an approved system for MSC delivery and maintenance in the defect is still missing. This study aimed to evaluate the effect of autologous porcine bone marrow MSCs anchored in a commercially available polyglycolic acid-hyaluronan scaffold (Chondrotissue®) using autologous blood plasma-based hydrogel in the repair of osteochondral defects in a large animal model. The osteochondral defects were induced in twenty-four minipigs with terminated skeletal growth. Eight animals were left untreated, eight were treated with Chondrotissue® and eight received Chondrotissue® loaded with MSCs. The animals were terminated 90 days after surgery. Macroscopically, the untreated defects were filled with newly formed tissue to a greater extent than in the other groups. The histological evaluations showed that the defects treated with Chondrotissue® and Chondrotissue® loaded with pBMSCs contained a higher amount of hyaline cartilage and a lower amount of connective tissue, while untreated defects contained a higher amount of connective tissue and a lower amount of hyaline cartilage. In addition, undifferentiated connective tissue was observed at the edges of defects receiving Chondrotissue® loaded with MSCs, which may indicate the extracellular matrix production by transplanted MSCs. The immunological analysis of the blood samples revealed no immune response activation by MSCs application. This study demonstrated the successful and safe immobilization of MSCs in commercially available scaffolds and defect sites for cartilage defect repair.
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Affiliation(s)
- K Berounský
- Motol University Hospital, Prague, Czech Republic.
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3
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Klein P, Alsleibi S, Cohen O, Ilany J, Hemi R, Barhod E, Vered I, Winder O, Avior G, Tripto-Shklonik L. Parathyroid fine-needle aspiration with parathyroid hormone washout as a preoperative localisation of parathyroid adenoma-A retrospective study. Clin Endocrinol (Oxf) 2023. [PMID: 37287384 DOI: 10.1111/cen.14939] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The use of parathyroid lesion aspiration in preoperative adenoma localisation is controversial. Concerns have been raised regarding both immediate safety (hematoma, infection, alterations on a subsequent histologic preparate) and long-term safety (seeding). We aimed to evaluate the short- and long-term safety, and the efficacy, of parathyroid fine-needle aspiration with parathyroid hormone washout as a localisation modality of parathyroid adenoma in patients with primary hyperparathyroidism. DESIGN A retrospective study. PATIENTS The sample comprised 29 patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy at a tertiary referral centre, following localisation with parathyroid hormone washout. MEASUREMENTS We reviewed all parathyroid hormone washout procedures performed during 2011-2021. Clinical, biochemical, and imaging information; and cytology, surgery, and pathology reports were extracted from electronic medical records. RESULTS Parathyroid hormone levels from the needle wash were 2.1-112.5 times the upper limit of the serum norm. Other than mild neck discomfort, no immediate procedure complications were documented. Fibrotic changes and necrosis were reported in two patients, with no effect on the final pathologic diagnosis or surgery course. No long-term complications (seeding, or parathyromatosis) were found. A total of 26 (90%) patients who were operated following a positive parathyroid hormone washout result were normocalcemic at the end of a mean 38.1-month follow-up period. CONCLUSIONS Parathyroid fine-needle aspiration with parathyroid hormone washout was accurate. Immediate, surgical, or delayed complications were not demonstrated in our series. This approach might be considered for selected patients.
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Affiliation(s)
- Pinchas Klein
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shibli Alsleibi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
| | - Ohad Cohen
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Ilany
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rina Hemi
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ehud Barhod
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Iris Vered
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ophir Winder
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
| | - Galit Avior
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Liana Tripto-Shklonik
- Division of Endocrinology, Diabetes, and Metabolism, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Peltz-Sinvani N, Raz HM, Klein P, Ish-Shalom S, Vered I, Tripto-Shkolnik L. Pregnancy- and lactation-induced osteoporosis: a social-media-based survey. BMC Pregnancy Childbirth 2023; 23:311. [PMID: 37131133 PMCID: PMC10152747 DOI: 10.1186/s12884-023-05639-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/24/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Pregnancy- and lactation-induced osteoporosis (PLO) presenting as spinal fractures is rare, and the spectrum of clinical presentation, risk factors and pathophysiology are incompletely understood. The aim of this study was to delineate clinical parameters, risk factors and osteoporosis-related quality of life (QOL) of women with PLO. METHODS Participants of a social-media (WhatsApp) PLO group and mothers of a parents' WhatsApp group (control group) were offered to fill a questionnaire, including an osteoporosis-related QOL section. The groups were compared using the independent Students t test for numerical variables, and the Chi-square test or Fisher's exact test for categorical variables. RESULTS Twenty-seven women with PLO and 43 in the control group (aged 36.2 ± 4.7 and 38.8 ± 4.3 years, respectively, p = 0.04) participated. Among women with PLO, more than 5 vertebrae were involved in 13 (48%), 4 vertebrae in 6 (22%), and 3 or fewer vertebrae in 8 (30%). Among the 24 women with relevant data, 21 (88%) had nontraumatic fractures; 3 (13%) women had fractures during pregnancy, and the remaining during the early postpartum period. Diagnosis was delayed for over 16 weeks for 11 (41%) women; 16 (67%) received teriparatide. Significantly lower proportions of women in the PLO group engaged in physical activity over 2 hours/week, before and during pregnancy (37 vs. 67%, p < 0.015 and 11 vs. 44%, p < 0.003, respectively). A lower proportion of the PLO than the control group reported calcium supplementation during pregnancy (7% vs. 30%, p = 0.03) and a higher proportion reported treatment with low-molecular-weight-heparin during pregnancy (p = 0.03). Eighteen (67%) of the PLO group expressed fear of fractures and 15 (56%) fear of falls, compared to none and 2%, respectively, of the control group (p < 0.00001 for both). CONCLUSIONS Most of the women with PLO who responded to our survey reported spinal fractures involving multiple vertebrae, delayed diagnosis, and treatment with teriparatide. Compared to a control group, they reported less physical activity and impaired QOL. For this uncommon yet severe condition, a multidisciplinary effort should be exerted for early identification and treatment, to alleviate back pain, prevent subsequent fractures and improve QOL.
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Affiliation(s)
- Naama Peltz-Sinvani
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Hadar Milloh Raz
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pinchas Klein
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Iris Vered
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liana Tripto-Shkolnik
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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5
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Moláček J, Vištejnová L, Klein P, Suchý T, Horný L, Kuželová Košťáková E, Kindermann M, Chlup H, Jenčová V, Lukáš D, Šupová M, Říha I, Soukupová V, Třeška V. Experimental surgery as part of the development of degradable biomaterials for cardiovascular surgery. Rozhl Chir 2022; 101:599-606. [PMID: 36759207 DOI: 10.33699/pis.2022.101.12.599-606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Introduction: Cardiovascular diseases are responsible for significant morbidity and mortality in the population. Artificial vascular grafts are often essential for surgical procedures in radical or palliative treatment. Many new biodegradable materials are currently under development. Preclinical testing of each new material is imperative, both in vitro and in vivo, and therefore animal experiments are still a necessary part of the testing process before any clinical use. The aim of this paper is to present the options of using various experimental animal models in the field of cardiovascular surgery including their extrapolation to clinical medicine. Methods: The authors present their general experience in the field of experimental surgery. They discuss the selection process of an optimal experimental animal model to test foreign materials for cardiovascular surgery and of an optimal region for implantation. Results: The authors present rat, rabbit and porcine models as optimal experimental animals for material hemocompatibility and degradability testing. Intraperitoneal implantation in the rat is a simple and feasible procedure, as well as aortic banding in the rabbit or pig. The carotid arteries can also be used, as well. Porcine pulmonary artery banding is slightly more difficult with potential complications. The banded vessels, explanted after a defined time period, are suitable for further mechanical testing using biomechanical analyses, for example, the inflation-extension test. Conclusion: An in vivo experiment cannot be avoided in the last phases of preclinical research of new materials. However, we try to strictly observe the 3R concept – Replacement, Reduction and Refinement; in line with this concept, the potential of each animal should be used as much as possible to reduce the number of animals.
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Růžička J, Grajciarová M, Vištejnová L, Klein P, Tichánek F, Tonar Z, Dejmek J, Beneš J, Bolek L, Bajgar R, Kuncová J. Hyperbaric oxygen enhances collagen III formation in wound of ZDF rat. Physiol Res 2021; 70:787-798. [PMID: 34505531 PMCID: PMC8820531 DOI: 10.33549/physiolres.934684] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/21/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetic foot ulcer (DFU) is a serious complication of diabetes and hyperbaric oxygen therapy (HBOT) is also considered in comprehensive treatment. The evidence supporting the use of HBOT in DFU treatment is controversial. The aim of this work was to introduce a DFU model in ZDF rat by creating a wound on the back of an animal and to investigate the effect of HBOT on the defect by macroscopic evaluation, quantitative histological evaluation of collagen (types I and III), evaluation of angiogenesis and determination of interleukin 6 (IL6) levels in the plasma. The study included 10 rats in the control group (CONT) and 10 in the HBOT group, who underwent HBOT in standard clinical regimen. Histological evaluation was performed on the 18th day after induction of defect. The results show that HBOT did not affect the macroscopic size of the defect nor IL6 plasma levels. A volume fraction of type I collagen was slightly increased by HBOT without reaching statistical significance (1.35+/-0.49 and 1.94+/-0.67 %, CONT and HBOT, respectively). In contrast, the collagen type III volume fraction was ~120 % higher in HBOT wounds (1.41+/-0.81 %) than in CONT ones (0.63+/-0.37 %; p=0.046). In addition, the ratio of the volume fraction of both collagens in the wound ((I+III)w) to the volume fraction of both collagens in the adjacent healthy skin ((I+III)h) was ~65 % higher in rats subjected to HBOT (8.9+/-3.07 vs. 5.38+/-1.86 %, HBOT and CONT, respectively; p=0.028). Vessels density (number per 1 mm2) was found to be higher in CONT vs. HBOT (206.5+/-41.8 and 124+/-28.2, respectively, p<0.001). Our study suggests that HBOT promotes collagen III formation and decreases the number of newly formed vessels at the early phases of healing.
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Affiliation(s)
- J Růžička
- Department of Biophysics, Faculty of Medicine in Pilsen, Pilsen, Czech Republic.
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7
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Klein P, Van Kuijk J, Swaans M. Updated results of hybrid transcatheter and minimally invasive left ventricular reconstruction for the treatment of ischemic cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Remodelling of the left ventricle (LV) after anterior myocardial infarction can result in a pathological increase in LV volume and reduction in LV ejection fraction (EF). We describe the updated results of an l hybrid transcatheter and minimally invasive surgical technique to reconstruct the negatively remodelled LV by myocardial scar plication and exclusion to rehape and reduce the excess volume, decrease the wall stress and increase LVEF.
Methods and results
Patients were considered eligible for the procedure when they presented with symptomatic heart failure (NYHA-class ≥II or more) and ischemic cardiomyopathy (EF<40%) after anterior myocardial infarction. All patients had a dilated LV with either a- or dyskinetic scar in the anteroseptal wall and/or apex of ≥50% transmurality. Hybrid transcatheter and minimally technique that relies on micro-anchoring technology is used to reconstruct the LV by plication of the fibrous scar. A series of internal and external micro anchors are brought together over a PEEK (poly-ether-ether-ketone) tether to form a longitudinal line of apposition between the LV free wall and the anterior septum from the mid-ventricle to the apex. Internal anchors are deployed by transcatheter technique on the right side of the ventricular septum through the right internal jugular vein. Paired external anchors are advanced through a left sided mini-thoracotomy and deployed on the LV epicardium (figure 1). A specialized Force Gauge is used to bring these “RV-LV” anchors together under measured compression forces. “LV-LV” anchor pairs through the LV apex beyond the distal tip of the RV complete the reconstruction.
Between October 2016 and March 2021 28 patients (23 males, 5 females; mean age 61±12 years) were operated in a single Dutch centre. Procedural success was 100%. On average 2.3±0.8 anchor-pairs were used to reconstruct the LV. Comparing echocardiographic data pre- and directly postoperatively, LVEF increased from 33±8% to 44±10% (change +35%, P<0.0001) and LV-volumes decreased: LVESV 116 ml ± 52 ml to 69±39 ml (change −35%, P<0.0001) and LVEDV 170 ml ± 72 ml to 118±55 ml (change −29%, P<0.0001). Hospital mortality was 0%. Also no strokes occurred. Median duration of ICU–stay was 2 days (IQR 1–48 days) and median length of hospital stay was 7 days (IQR 5–61 days). Survival at 48 months was 84%. At latest follow-up, 9670% of surviving patients were in NYHA-class I-II compared to 18% preoperatively.
Conclusions
Hybrid transcatheter and minimally invasive LV reconstruction is a promising novel treatment option for patients with symptomatic heart failure and ischemic cardiomyopathy after anteroseptal myocardial infarction. Updated results demonstrate that the procedure is safe and results in significant improvement in EF, reduction in LV volumes and sustained improvement in heart failure symptoms.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- P Klein
- St Antonius Hospital, Nieuwegein, Netherlands (The)
| | | | - M.J Swaans
- St Antonius Hospital, Nieuwegein, Netherlands (The)
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8
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Klein P, Van Kuijk J, Swaans M. Hybrid transcatheter and minimally invasive left ventricular reconstruction for the treatment of ischemic cardiomyopathy: mid-term results. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Remodelling of the left ventricle (LV) after anterior myocardial infarction can result in a pathological increase in LV volume and reduction in LV ejection fraction (EF).
Purpose
We describe the mid-term results of a novel hybrid transcatheter and minimally invasive surgical technique to reconstruct the remodelled LV by plication and exclusion of the scar and reduction of the excess volume, resulting in decreased wall stress and increased EF.
Methods
Patients were considered eligible for the procedure when the presented with symptomatic heart failure (NYHA-class II or more) and ischemic cardiomyopathy (EF<40%) after anterior myocardial infarction. All patients had a dilated LV with either an a- or dyskinetic scar in the anteroseptal wall and/or apex of >50% transmurality. An hybrid transcatheter and minimally technique was used that relies on deploying a series of paired internal and external micro-anchors to plicate fibrous scar of infarcted anterior wall myocardial tissue to reconstruct the LV.
Results
Between October 2016 and January 2020 24 patients (21 males, 3 females; mean age 61±13 years) were operated in a single Dutch centre. Procedural success was 100%. On average 2.3±0.9 anchor-pairs were used to reconstruct the LV. Comparing echocardiographic data pre- and directly postoperatively, LVEF increased from 34±9% to 44±11% (change +34%, P<0.0001) and LV-volumes decreased: LVESV 113 ml ± 54 ml to 68±41 ml (change −39%, P<0.0001) and LVEDV 166 ml ± 75 ml to 116±57 ml (change −30%, P<0.0001). One patient was converted peroperatively to full sternotomy, ECC and cardioplegic arrest because of partial dislodgement of an apical mural thrombus. After removal of the thrombus, the LV was reconstructed with 2 anchor-pairs. One patient underwent a postoperative revision because of RV restriction. After removal of 1 “RV-LV” anchor-pair, the patient made a full recovery. One patient underwent an uncomplicated minimally invasive tricuspid valve replacement because of a lesion to the tricuspid valve during the procedure. Hospital mortality was 0%. Median duration of ICU–stay was 2 days (IQR 1–46 days) and median length of hospital stay was 7 days (IQR 5–57 days). Survival at 36 months was 88%. At latest follow-up, 86% of surviving patients were in NYHA-class I-II compared to 21% preoperatively.
Conclusions
Hybrid transcatheter and minimally invasive LV reconstruction is a promising novel treatment option for patients with symptomatic heart failure and ischemic cardiomyopathy after anteroseptal myocardial infarction. Mid-term results demonstrate that the procedure is safe and results in significant improvement in EF, reduction in LV volumes and improvement in heart failure symptoms.
Revivent TC technique
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Klein
- St Antonius Hospital, Nieuwegein, Netherlands (The)
| | | | - M.J Swaans
- St Antonius Hospital, Nieuwegein, Netherlands (The)
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9
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Hodges-Gallagher L, Sun R, Myles D, Klein P, Zujewski J, Harmon C, Kushner P. OP-1250: A potent orally available complete antagonist of estrogen receptor-mediated signaling that shrinks wild type and mutant breast tumors. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31223-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Fischer A, Klein P, Radulescu P, Gulsun M, Mohamed Ali A, R.S V, Schoebinger M, Sahbaee P, Sharma P, Schoepf U. Deep Learning Based Automated Coronary Labeling For Structured Reporting Of Coronary CT Angiography In Accordance With SCCT Guidelines. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Berger N, Fitzpatrick K, Klein P. Abstract P6-16-10: Is pregnancy testing during chemotherapy standardized? Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-16-10] [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
The initiative to improve awareness about the risks of infertility for premenopausal patients receiving chemotherapy has improved significantly over time. While the risks for infertility are high, there is still a small risk of pregnancy during chemotherapy. The incidence of cancer diagnosed during pregnancy is 0.1-0.2%. The incidence of women who become pregnant while on chemotherapy is less clear but does occur. Amenorrhea commonly occurs during chemotherapy but this does not necessarily correlate with lack of ovarian function. Treating a patient with an unidentified pregnancy is an adverse event which must be avoided given the high risk it poses to the fetus, especially during the first trimester. Pregnancy testing prior to the initiation of chemotherapy is recommended by the NCCN and ASCO. However, recommendations on how to monitor for pregnancy after an initial screen are inconsistent and lack standardization. Formal guidelines and policies are needed to prevent and/or identify pregnancies while on chemotherapy.
We surveyed five breast medical oncologists and six infusion nurses at a busy urban breast center to determine their baseline practices in regards to pregnancy counseling and testing. Of physicians and nurses surveyed, 40% (2/5) and 33% (2/6) respectively have diagnosed a pregnancy while on chemotherapy. When surveyed about counseling patients on the risks of pregnancy, 80% of physicians counsel patients prior to initiation of chemotherapy, but one physician and one infusion nurse said they do not counsel patients about the risk of pregnancy at any time but do discuss the risks of infertility. All physicians surveyed check a pregnancy test prior to the initiation of chemotherapy, but 60% check urine and 40% check serum. Thereafter 60% will check a pregnancy test after initial screen if the patient is concerned and 40% will check intermittently during chemotherapy. Of the nurses surveyed, 33% will check a pregnancy test after initial screen if the patient is concerned and 50% check intermittently during treatment. Half of the infusion nurses said they ask patients if they are concerned they may be pregnant intermittently during chemotherapy and 50% answered that they do not ask again after the initial screen. On subsequent screens the choice of urine or serum hCG testing varies and is not standardized.
These survey results demonstrate that both pregnancy counseling and pregnancy screening practices vary widely even within the same institution. A standardized approach is essential to increase awareness of pregnancy risk while on chemotherapy, improve education of this risk to patients, prevent unwanted pregnancies, and identify pregnancies as soon as possible. We have initiated a quality improvement project to check urine pregnancy tests monthly in all premenopausal patients (age <55) receiving chemotherapy for breast cancer. Based on our findings we will institute a protocol at our institution for uniform teaching on the small risk of pregnancy and uniform pregnancy testing while on chemotherapy.
Citation Format: Berger N, Fitzpatrick K, Klein P. Is pregnancy testing during chemotherapy standardized? [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 P6-16-10.
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Affiliation(s)
- N Berger
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Fitzpatrick
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - P Klein
- Icahn School of Medicine at Mount Sinai, New York, NY
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12
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Rugo HS, Klein P, Melin SA, Hurvitz SA, Melisko ME, Moore A, D'Agostino RB, Deluca A, Cigler T. Abstract P1-17-04: Long-term safety follow-up of patients with early stage breast cancer treated with scalp cooling on the Dignitana scalp cooling trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-17-04] [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
Scalp cooling has demonstrated efficacy in preventing hair loss in women with early stage breast cancer receiving neo/adjuvant chemotherapy. Data from 2 prospective trials (Rugo et al, and Nangia et al, JAMA 2017) led to FDA clearance of 2 automated scalp-cooling devices to prevent chemotherapy induced alopecia (CIA). Although scalp metastases from breast cancer are rare, historical concerns about scalp cooling included a theoretical increase in risk of recurrence in scalp due to reduced delivery of chemotherapy to the scalp.
Methods
We conducted a multicenter prospective trial evaluating the efficacy and safety of the DigniCap in women with stage I-II breast cancer receiving neo/adjuvant chemotherapy excluding sequential or combination anthracycline/taxanes with concurrent matched controls. The primary endpoint was unblinded patient self-assessment of 5 photographs using the Dean scale to estimate hair loss 4 weeks following the last dose of chemotherapy, with success defined as a Dean score of 0-2 (≤ 50% hair loss); additional endpoints included quality of life (QOL) and both short and long-term safety.
Results
106 patients using the scalp cooling device and 16 concurrent controls were enrolled. As previously reported, the use of scalp cooling was associated with less alopecia and improvement in several measures of QOL (Rugo et al, JAMA 2017). 91 patients have follow-up (FU) out to 3 years; 73 with estrogen receptor (ER) positive and 18 with ER negative disease. 5 DigniCap patients have developed recurrent breast cancer in breast (n=1), liver (n=1), bone, liver and breast (n=1), bone, liver, lung, and nodes (1), and bone, breast, GI tract and bladder (n=1). Of 12 control patients with available FU, 1 developed metastases to liver. 2 patients have died of metastatic disease, one in the DigniCap arm and one in the control arm. No new safety signals have been detected.
Conclusion
Scalp cooling using the DigniCap system in patients with early stage breast cancer receiving taxane based neo/adjuvant chemotherapy is safe and effective. No scalp metastases have been reported 3 years following completion of study treatment. 4 year FU data will be presented.
The study was funded by The Lazlo Tauber Family Foundation (UCSF), the Anne Moore Breast Cancer Research Fund (Weil Cornell), and the Friedman Family Foundation (Mount Sinai Beth Israel), as well as partially by Dignitana.
Citation Format: Rugo HS, Klein P, Melin SA, Hurvitz SA, Melisko ME, Moore A, D'Agostino, Jr. RB, Deluca A, Cigler T. Long-term safety follow-up of patients with early stage breast cancer treated with scalp cooling on the Dignitana scalp cooling trial [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 P1-17-04.
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Affiliation(s)
- HS Rugo
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - P Klein
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - SA Melin
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - SA Hurvitz
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - ME Melisko
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - A Moore
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - RB D'Agostino
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - A Deluca
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
| | - T Cigler
- University of California San Francisco Comprehensive Cancer Centere, San Francisco; Wake Forest School of Medicine, Winton Salem; Icahn School of Medicine at Mount Sinai, New York; University of California Los Angeles, Los Angeles; Weill Cornell Medical College, New York
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13
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Le Bot A, Duval G, Klein P, Lelong J. Analytical solution for bending vibration of a thin-walled cylinder rolling on a time-varying force. R Soc Open Sci 2018; 5:180639. [PMID: 30109107 PMCID: PMC6083697 DOI: 10.1098/rsos.180639] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
This paper presents the analytical solution of radial vibration of a rolling cylinder submitted to a time-varying point force. In the simplest situation of simply supported edges and zero in-plane vibration, the cylinder is equivalent to an orthotropic pre-stressed plate resting on a visco-elastic foundation. We give the closed-form solution of vibration as a series of normal modes whose coefficients are explicitly calculated. Cases of both deterministic and random forces are examined. We analyse the effect of rolling speed on merging of vibrational energy induced by Doppler's effect for the example of rolling tyre.
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Affiliation(s)
- A. Le Bot
- Université de Lyon, Lyon, France
- CNRS, Laboratoire de Tribologie et Dynamique des Systèmes, Ecole centrale de Lyon, Ecully, France
| | - G. Duval
- Université de Lyon, Lyon, France
- CNRS, Laboratoire de Tribologie et Dynamique des Systèmes, Ecole centrale de Lyon, Ecully, France
| | - P. Klein
- Université de Lyon, Lyon, France
- IFSTTAR, Laboratoire d'acoustique environnementale, Bron, France
| | - J. Lelong
- Université de Lyon, Lyon, France
- IFSTTAR, Laboratoire d'acoustique environnementale, Bron, France
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14
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Abstract
Standardized clinical diagnostic procedures cannot assess the functionality of the anatomical structures in sport-specific movement. Biomechanical screening is able to detect deficits but is not sufficiently and objectively precise with the current clinical examination tools including conventional imaging techniques. The fields of use of functional testing methods are versatile and range from injury prevention analysis, screening during rehabilitation phases up to the return-to-play decision. Using simple musculoskeletal function analysis it is difficult to assess the risk of injuries. The main advantage of instrumented 3D-motion analysis is its potential to generate objective, reliable and reproducible data with exact joint angles, muscle activity, as well as loading inside the joints during movement. These marker-based motion analysis procedures are more time-consuming and more cost intensive and necessitate in particular biomechanical and medical knowledge to assess the analytical data in terms of clinical relevance. In the absence of scientific studies on biomechanical analyses in professional sports, this study shows preliminary approaches to this topic.
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Affiliation(s)
- H Dewitz
- Institut für Funktionelle Diagnostik (IFD Cologne), Im MediaPark 2, 50670, Köln, Deutschland.
| | - B Yildirim
- Institut für Funktionelle Diagnostik (IFD Cologne), Im MediaPark 2, 50670, Köln, Deutschland
| | - P Klein
- Institut für Funktionelle Diagnostik (IFD Cologne), Im MediaPark 2, 50670, Köln, Deutschland
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15
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Lee LM, Klein P, Velazy R. Abstract P3-12-13: Breast atypical hyperplasia and guideline compliance. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-12-13] [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: Atypical hyperplasia of the breast is a high-risk benign lesion that is found in approximately 10% of benign breast biopsies[1]and confers a risk for future breast cancer[2]. The American Society of Clinical Oncology guideline states that pharmacologic risk reduction with the use of a selective estrogen receptor modulator or an aromatase inhibitor should be discussed with women with a 5-year projected absolute risk of breast cancer of 1.7% or higher[3]. The NCCN guideline for risk reduction recommends consideration of risk-reduction interventions, including the use of pharmacologic agents in women with a 5-year risk of 1.7% or higher and a life expectancy of 10 years or longer [4] .The majority of women with atypical hyperplasia meet this risk criterion with their cumulative risk of approximately 1% per year.
Method: We retrospectively reviewed excisional biopsy pathology reports between January 2016 and June 2016 with the diagnosis of atypical ductal or lobular hyperplasia to identify patients with pure atypical hyperplasia. Medical records of these patients were then reviewed to identify the percentage of patients referred to a medical oncologist for chemoprevention discussion and the percentage of patients who received chemoprevention following excisional biopsy.
Results: Two hundred seventy six patients with the diagnosis of atypical ductal or lobular hyperplasia were identified. Two hundred and sixteen patients were excluded from the analysis due to the presence of other histologies such as carcinoma in situ and invasive carcinoma. Medical records of the remaining sixty patients with pure atypical hyperplasia were reviewed. Eighteen patients' charts were unavailable for review. All of the remaining forty two patients had a 5-year breast cancer risk of 1.7% or higher. Five of these patients (8.3%) were referred to a medical oncologist for chemoprevention discussion. Two of these five patients (2.3%) received chemoprevention with tamoxifen. For patients who were not referred to medical oncologist, there was one documented discussion of chemoprevention with patient by her surgical oncologist. One patient underwent prophylactic bilateral mastectomies, and therefore, chemoprevention was not recommended.
Conclusion: Multidisciplinary strategies need to be implemented to bridge the gap between guidelines and clinical practices which may lead to improved patient outcomes.
References:
1. 1. Simpson JF. Update on atypical epithelial hyperplasia and ductal carcinoma in situ. Pathology 2009;41:36-39.
2. 2. Hartmann LC, Sellers TA, Frost MH, et al. Benign breast disease and the risk of breast cancer. N Engl J Med 2005;353:229-237.
3. Visvanathan K, Hurley P, Bantug E, et al. Use of pharmacologic interventions for breast cancer risk reduction: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2013;31:2942-2962. J Clin Oncol 2013;31:4383.
Citation Format: Lee LM, Klein P, Velazy R. Breast atypical hyperplasia and guideline compliance [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-12-13.
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Affiliation(s)
- LM Lee
- Icahn School of Medicine at Mount Sinai Downtown, New York, NY
| | - P Klein
- Icahn School of Medicine at Mount Sinai Downtown, New York, NY
| | - R Velazy
- Icahn School of Medicine at Mount Sinai Downtown, New York, NY
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16
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Malerba A, Klein P, Bachtarzi H, Jarmin S, Cordova G, Ferry A, Strings V, Espinoza MP, Mamchaoui K, Blumen S, Guily JLS, Mouly V, Graham M, Butler-Browne G, Suhy D, Trollet C, Dickson G. Gene therapy for oculopharyngeal muscular dystrophy. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.541] [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: 12/01/2022]
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17
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Abstract
Medical healthcare for refugees is strictly regulated by law in Germany but the great regional variation in the implementation is currently a huge challenge for healthcare providers. Providers are often not familiar with the specific local regulations and especially in emergencies it is often not possible to clarify open questions before treating patients. The high influx of refugees in the summer and fall of 2015 led to a situation that could only be managed with the voluntary and pragmatic help of all healthcare personnel involved. This article explains the most relevant regulations covering medical healthcare for refugees and asylum seekers. In addition, the procedure for the approval of asylum status in itself can have a direct or indirect impact on the health status of these individuals; therefore, some comments are made regarding this aspect.
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Affiliation(s)
- P Klein
- Sächsische Landesärztekammer, Schützenhöhe 16, 01099, Dresden, Deutschland.
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18
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Petrus A, Klein P, Tops L, Hoogervorst L, Versteegh M, Klautz R, Braun J. P3548Rethinking functional mitral regurgitation at the time of left ventricular reconstruction: A landmark analysis of late clinical outcome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Nijenhuis VJ, Sanchis L, van der Heyden JAS, Klein P, Rensing BJWM, Latib A, Maisano F, Ten Berg JM, Agostoni P, Swaans MJ. The last frontier: transcatheter devices for percutaneous or minimally invasive treatment of chronic heart failure. Neth Heart J 2017; 25:536-544. [PMID: 28741245 PMCID: PMC5612866 DOI: 10.1007/s12471-017-1018-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Heart failure has a high prevalence in the general population. Morbidity and mortality of heart failure patients remain high, despite improvements in drug therapy, implantable cardioverter-defibrillators and cardiac resynchronisation therapy. New transcatheter implantable devices have been developed to improve the treatment of heart failure. There has been a rapid development of minimally invasive or transcatheter devices used in the treatment of heart failure associated with aortic and mitral valve disease and these devices are being incorporated into routine clinical practice at a fast rate. Several other new transcatheter structural heart interventions for chronic heart failure aimed at a variety of pathophysiologic approaches are currently being developed. In this review, we focus on devices used in the treatment of chronic heart failure by means of left ventricular remodelling, left atrial pressure reduction, tricuspid regurgitation reduction and neuromodulation. The clinical evaluations of these devices are early-stage evaluations of initial feasibility and safety studies and additional clinical evidence needs to be gathered in appropriately designed clinical trials.
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Affiliation(s)
- V J Nijenhuis
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
| | - L Sanchis
- Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | | | - P Klein
- Department of Cardio-Thoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - B J W M Rensing
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - A Latib
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
- Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
| | - F Maisano
- University Heart Centre, University Hospital Zurich, Zurich, Switzerland
| | - J M Ten Berg
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - P Agostoni
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - M J Swaans
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
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20
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Janssen PWA, Claassens DMF, Willemsen LM, Bergmeijer TO, Klein P, Ten Berg JM. Perioperative management of antiplatelet treatment in patients undergoing isolated coronary artery bypass grafting in Dutch cardiothoracic centres. Neth Heart J 2017; 25:482-489. [PMID: 28612281 PMCID: PMC5571594 DOI: 10.1007/s12471-017-1006-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND International guidelines do not provide uniform recommendations regarding the use of antiplatelet treatment in the perioperative period in patients undergoing coronary artery bypass grafting (CABG). METHODS A questionnaire was sent to all 16 cardiothoracic centres in the Netherlands to determine which antiplatelet treatment is used in the perioperative setting. Furthermore, a single-centre prospective observational cohort study was performed which included all patients undergoing isolated CABG in July 2014. RESULTS Eleven centres responded to the survey. Acetylsalicylic acid monotherapy was discontinued before surgery in 6 centres. In patients with an acute coronary syndrome receiving dual antiplatelet therapy (DAPT), most centres discontinued the P2Y12 inhibitor preoperatively. DAPT was restarted after surgery in 4 centres. However, 6 centres continued DAPT in patients who had undergone coronary stenting within one month of surgery. In patients with coronary stents, variation in the management of antiplatelet therapy increased in proportion to the interval between stenting and surgery. A total of 70 patients were included in the registry. Acetylsalicylic acid monotherapy was discontinued in 51% of patients and restarted in all patients. P2Y12 inhibitor treatment was discontinued before surgery in 70% of patients and re-initiated after CABG in 29%. CONCLUSIONS Major differences were observed in the preoperative and postoperative management of antiplatelet treatment between different Dutch cardiothoracic centres and within a single centre. Part of this variation is probably due to lack of evidence and differences between the current guidelines; however, many of the strategies were not in accordance with any of these guidelines.
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Affiliation(s)
- P W A Janssen
- St. Antonius Center for Platelet Function Research, Nieuwegein, The Netherlands. .,Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
| | - D M F Claassens
- St. Antonius Center for Platelet Function Research, Nieuwegein, The Netherlands.,Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - L M Willemsen
- St. Antonius Center for Platelet Function Research, Nieuwegein, The Netherlands.,Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - T O Bergmeijer
- St. Antonius Center for Platelet Function Research, Nieuwegein, The Netherlands.,Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - P Klein
- Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - J M Ten Berg
- St. Antonius Center for Platelet Function Research, Nieuwegein, The Netherlands.,Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
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21
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Malerba A, Klein P, Bachtarzi H, Jarmin SA, Cordova G, Ferry A, Strings V, Espinoza MP, Mamchaoui K, Blumen SC, St Guily JL, Mouly V, Graham M, Butler-Browne G, Suhy DA, Trollet C, Dickson G. PABPN1 gene therapy for oculopharyngeal muscular dystrophy. Nat Commun 2017; 8:14848. [PMID: 28361972 PMCID: PMC5380963 DOI: 10.1038/ncomms14848] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/07/2017] [Indexed: 01/14/2023] Open
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is an autosomal dominant, late-onset muscle disorder characterized by ptosis, swallowing difficulties, proximal limb weakness and nuclear aggregates in skeletal muscles. OPMD is caused by a trinucleotide repeat expansion in the PABPN1 gene that results in an N-terminal expanded polyalanine tract in polyA-binding protein nuclear 1 (PABPN1). Here we show that the treatment of a mouse model of OPMD with an adeno-associated virus-based gene therapy combining complete knockdown of endogenous PABPN1 and its replacement by a wild-type PABPN1 substantially reduces the amount of insoluble aggregates, decreases muscle fibrosis, reverts muscle strength to the level of healthy muscles and normalizes the muscle transcriptome. The efficacy of the combined treatment is further confirmed in cells derived from OPMD patients. These results pave the way towards a gene replacement approach for OPMD treatment. Oculopharyngeal muscular dystrophy is caused by trinucleotide repeat expansions in the PABPN1 gene. Here the authors use AAV-based gene therapy to knockdown the mutant gene and replace it with a wild-type allele, and show effectiveness in mice and in patient cells.
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Affiliation(s)
- A Malerba
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
| | - P Klein
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - H Bachtarzi
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
| | - S A Jarmin
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
| | - G Cordova
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - A Ferry
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, 75006 Paris, France
| | - V Strings
- Benitec Biopharma, 3940 Trust Way, Hayward, California 94545, USA
| | - M Polay Espinoza
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - K Mamchaoui
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - S C Blumen
- Department of Neurology, Hillel Yaffe Medical Center, Hadera and Rappaport Faculty of Medicine, The Technion, 1 Efron Street, Haifa 31096, Israel
| | - J Lacau St Guily
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and University Pierre-et-Marie-Curie, Paris VI, Tenon Hospital, Assistance Publique des Hopitaux de Paris, 75252 Paris, France
| | - V Mouly
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - M Graham
- Benitec Biopharma, 3940 Trust Way, Hayward, California 94545, USA
| | - G Butler-Browne
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - D A Suhy
- Benitec Biopharma, 3940 Trust Way, Hayward, California 94545, USA
| | - C Trollet
- Sorbonne Universités, UPMC Univ Paris 06, UM76, INSERM U974, Institut de Myologie, CNRS FRE3617, 47 bd de l'Hôpital, 75013 Paris, France
| | - G Dickson
- School of Biological Sciences, Royal Holloway, University of London, Egham Hill, Egham, TW20 0EX Surrey, UK
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22
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Cigler T, Melin SA, Klein P, Hurvitz SA, Melisko M, Moore A, Park GD, Bageman E, Ver Hoeve ES, Rugo HS. Abstract P5-11-17: Body image in women with breast cancer using a scalp cooling system to reduce chemotherapy induced alopecia. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-11-17] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Most women consider hair to be an important part of body image. Alopecia is an emotionally traumatic side effect for breast cancer patients undergoing adjuvant chemotherapy. The DigniCap™ Scalp Cooling System is the first scalp cooling system cleared by the US Food and Drug Administration to reduce the likelihood of chemotherapy induced alopecia.
Methods: Quality of Life (QOL) data were collected as part of a prospective clinical trial evaluating the clinical performance of scalp cooling in women with early stage BC receiving adjuvant chemotherapy.
The study's primary endpoint was hair loss as evaluated by patient self-assessment. Treatment success was defined as ≤ 50% hair loss. QOL was evaluated by the EORTC-QLQ-BR23 (BR23) administered at baseline, last chemotherapy cycle, and one month later. For BR23, 4 response categories were collapsed to 2 categories (Not at all/A little bit and Quite a bit/Very much) for analysis. QOL was compared between those with success vs. failure of scalp cooling.
Results: 101 patients were evaluable for the primary endpoint: Success was seen in 67 (66.3%) pts. QOL at study entry was comparable between pts with scalp cooling success or failure for each item in the BR23 questionnaire. Results reported as percentages of patients in each group who answered either quite a bit or very much to body image-related questions on the BR23 questionnaire are displayed in Table 1.
BR23 results (% quite a bit/very much) one month after chemotherapyBR23 ItemsTreatment Success % (95% CI)Treatment Failure % (95% CI)Felt physically less attractive18.5% (9.0%, 27.9%)52.2% (31.8%, 72.6%)Felt less feminine15.4% (6.6%, 24.2%)29.1% (19.2%, 59.1%)Found it difficult to see themselves naked13.8% (5.5%, 22.2%)21.7% (4.9%, 38.6%)Felt dissatisfied with their body12.3% (4.3%, 20.3%)26.1% (8.1%, 44.0%)
Conclusions: Women with breast cancer using scalp cooling during chemotherapy who had hair preservation experienced improved quality of life, according to self-assessment of body image, compared to women who had significant hair loss.
Citation Format: Cigler T, Melin SA, Klein P, Hurvitz SA, Melisko M, Moore A, Park GD, Bageman E, Ver Hoeve ES, Rugo HS. Body image in women with breast cancer using a scalp cooling system to reduce chemotherapy induced alopecia [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-11-17.
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Affiliation(s)
- T Cigler
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - SA Melin
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - P Klein
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - SA Hurvitz
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - M Melisko
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - A Moore
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - GD Park
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - E Bageman
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - ES Ver Hoeve
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
| | - HS Rugo
- Weill Cornell Medical College, New York, NY; Wake Forest School of Medicine, Winston Salem, NC; Icahn School of Medicine at Mount Sinai, New York, NY; University of California Los Angeles, Lost Angeles, CA; Univeristy of California San Francisco Helen Diller Comprehensive Cancer Center, San Francisco, CA; Target Health Inc., New York, NY; Dignitana AB, Lund, Sweden
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Suhrmann R, Klein P. Über die Struktur der 2. CH-Oberschwingung und die Ermittlung integraler Extinktionsäquivalente flüssiger aliphatischer und aromatischer Kohlenwasserstoffe im Ultrarotspektrum. ACTA ACUST UNITED AC 2017. [DOI: 10.1515/zpch-1941-5004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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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Malerba A, Klein P, Bachtarzi H, Jarmin S, Ferry A, Graham M, Strings V, Butler-Browne G, Suhy D, Dickson G, Trollet C. Gene replacement therapy as a novel approach for the treatment of oculopharyngeal muscular dystrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.199] [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: 11/27/2022]
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Klein P, Kipke R. Asylbewerber und ihre Versorgungssituation. Notf Rett Med 2016. [DOI: 10.1007/s10049-016-0196-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mayr P, Kuhn K, Klein P, Stover J, Pestana E. A Diabetes-specific Oral Nutritional Supplement Improves Glycaemic Control in Type 2 Diabetes Patients. Exp Clin Endocrinol Diabetes 2016; 124:401-9. [DOI: 10.1055/s-0042-100909] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- P. Mayr
- Diabetology, Health Care Centre, Stockach, Germany
| | - K. Kuhn
- Medical Writing, Stuttgart, Germany
| | - P. Klein
- d.s.h. Statistical Services, Rohrbach, Germany
| | - J. Stover
- Fresenius Kabi Deutschland GmbH, Bad Homburg, Germany
| | - E. Pestana
- Fresenius Kabi Deutschland GmbH, Bad Homburg, Germany
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Chen J, Klein P, Shao T. Abstract P3-07-07: The updated ASCO/CAP guidelines for HER2 testing create more uncertainty for clinicians. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-07] [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: Accurate assessment of the Human Epidermal Growth Factor Receptor 2 (HER2) status has been an integral part of clinical decision making in treatments of breast cancer. In 2007, American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) published a series of guidelines on how to determine the status of HER2. The guidelines were updated in 2013 with the goal of reducing the numbers of false negative cases. The new guidelines are based on a combination of HER2:CEP17 ratio and average HER2 copy number. We sought to assess the overall effect of the new guidelines.
Methods: We retrospectively identified all cases of invasive breast cancer with HER2 testing done in 2014 from the pathology database of Mount Sinai Beth Israel, Mount Sinai St. Luke's and Roosevelt Hospitals. Our pathology department guideline is to perform initial testing for HER2 with immunohistochemistry (IHC) by the HercepTest (Dako) method. Those with IHC of 2+ would be followed by reflex HER2 dual probe FISH. The HER2:CEP 17 ratio and average HER2 copy number were then reviewed for each IHC 2+ case using the 2013 guidelines. These cases were then rescored using the 2007 guidelines. All equivocal cases as determined by the new 2013 guidelines (HER2:CEP17 ratio <2.0 with an average HER2 copy number ≥4.0 and <6.0 signals/cell) were further evaluated to determine whether repeat HER2 testing was performed as suggested by the new guidelines and whether HER2 directed therapy was recommended for patient.
Results: Among 853 cases identified in the database, 337 were IHC 2+. Using 2007 guidelines, 27/337 cases (8.0%) were amplified (HER2:CEP 17 ratio >2.2), 6 (1.8%) were equivocal (HER2:CEP 17 ratio 1.8-2.2), and 305 cases (90.2%) were non-amplified (HER2:CEP 17 ratio <1.8). Using the 2013 guidelines, 29/337 cases (8.6%) were amplified (HER2:CEP 17 ratio ≥2 or HER2 copy number ≥6), 23 (6.8%) were equivocal (HER2:CEP17 ratio <2.0 with an average HER2 copy number ≥4.0 and <6.0), and 284 (84.3%) were non-amplified (HER2:CEP 17 ratio <2 with an average HER2 copy number <4.0). The new guidelines resulted in change in HER2 status in 24 cases (7.1%): 2 cases changed from equivocal to amplified, 1 case changed from equivocal to non-amplified, but 20 cases changed from non-amplified to equivocal. Of the 23 equivocal cases determined using the 2013 guidelines, only 13 cases had repeat HER2 analysis. On repeat HER2 testing, one case was found to be HER2 amplified, 4 cases were non-amplified, and 8 cases remained equivocal. Only one equivocal case received HER2 directed treatment.
Conclusion: The 2013 ASCO/CAP guidelines for HER2 assessment identified a slightly increased number of patients eligible for HER2 directed therapy, but also resulted in a significant increase in the number of equivocal cases. The new guidelines appear to have generated more uncertainty for the clinician due to the rise in equivocal cases. Further studies are needed to determine whether patients with equivocal HER2 status would benefit from HER2 directed therapy.
Citation Format: Chen J, Klein P, Shao T. The updated ASCO/CAP guidelines for HER2 testing create more uncertainty for clinicians. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-07.
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Affiliation(s)
- J Chen
- Mount Sinai Beth Israel Medical Center, NY, NY
| | - P Klein
- Mount Sinai Beth Israel Medical Center, NY, NY
| | - T Shao
- Mount Sinai Beth Israel Medical Center, NY, NY
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Novitsky Y, Fayezizadeh M, Majumder A, Yee S, Petro C, Orenstein S, Woeste G, Reinisch A, Bechstein WO, Rosen M, Carbonell A, Cobb W, Bauer J, Selzer D, Chao J, Harmaty M, Poulose B, Matthews B, Goldblatt M, Jacobsen G, Rosman C, Hansson B, Prabhu A, Fathi A, Skipworth J, Younis I, Floyd D, Shankar A, Olmi S, Cesana G, Ciccarese F, Uccelli M, Carrieri D, Castello G, Legnani G, Lyo V, Irwin C, Xu X, Harris H, Zuvela M, Galun D, Petrovic J, Palibrk I, Koncar I, Basaric D, Tian W, Fei Y, Pittman M, Jones E, Schwartz J, Mikami D, Perrakis A, Knüttel D, Klein P, Croner RS, Hohenberger W, Perrakis E, Müller V, Grande M, Villa M, Lisi G, Esser A, De Sanctis F, Petrella G, Birolini C, Miranda JS, Tanaka EY, Utiyama EM, Rasslan S, Shi Y, Guo XB, Zhuo HQ, Li LP, Liu HJ, Bauder A, Gerety P, Epps G, Pannucci C, Fischer J, Kovach S. Incisional Hernia: Difficult Cases 2. Hernia 2015; 19 Suppl 1:S105-11. [PMID: 26518784 DOI: 10.1007/bf03355335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Y Novitsky
- Case Comprehensive Hernia Center, Cleveland, USA
| | | | - A Majumder
- Case Comprehensive Hernia Center, Cleveland, USA
| | - S Yee
- Case Comprehensive Hernia Center, Cleveland, USA
| | - C Petro
- Case Comprehensive Hernia Center, Cleveland, USA
| | - S Orenstein
- Case Comprehensive Hernia Center, Cleveland, USA
| | - G Woeste
- Department of Surgery, Goethe University, Frankfurt, Germany
| | - A Reinisch
- Department of Surgery, Goethe University, Frankfurt, Germany
| | - W O Bechstein
- Department of Surgery, Goethe University, Frankfurt, Germany
| | - M Rosen
- Cleveland Clinic Foundation, Cleveland, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Fathi
- Case Comprehensive Hernia Center, Cleveland, USA
| | - J Skipworth
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - I Younis
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - D Floyd
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - A Shankar
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - S Olmi
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - G Cesana
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - F Ciccarese
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - M Uccelli
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - D Carrieri
- General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - G Castello
- General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - G Legnani
- General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - V Lyo
- Division of General Surgery, University of California San Francisco, San Francisco, USA
| | - C Irwin
- Division of Plastic & Reconstructive Surgery, University of California San Francisco, San Francisco, USA
| | - X Xu
- Division of Plastic & Reconstructive Surgery, University of California San Francisco, San Francisco, USA
| | - H Harris
- Division of General Surgery, University of California San Francisco, San Francisco, USA
| | - M Zuvela
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia.,Medical School, University of Belgrade, Belgrade, Serbia
| | - D Galun
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia.,Medical School, University of Belgrade, Belgrade, Serbia
| | - J Petrovic
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
| | - I Palibrk
- Medical School, University of Belgrade, Belgrade, Serbia.,Clinical center of Serbia, Clinic for vascular and endovascular surgery, Belgrade, Serbia
| | - I Koncar
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia.,Medical School, University of Belgrade, Belgrade, Serbia
| | - D Basaric
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
| | - W Tian
- Department of General Surgery, 1st affiliated hospital of PLA general hospital, Beijing, China
| | | | - M Pittman
- The Ohio State University Medical Center, Columbus, USA
| | | | | | | | - A Perrakis
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - D Knüttel
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - P Klein
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - R S Croner
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - W Hohenberger
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - E Perrakis
- Department of Surgery, Omilos Iatrikoo Kentrou Athinon, Iatriko Kentro Peristeriou, Athens, Greece
| | - V Müller
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - M Grande
- University Hospital of Tor Vergata, Rome, Italy
| | - M Villa
- University Hospital of Tor Vergata, Rome, Italy
| | - G Lisi
- University Hospital of Tor Vergata, Rome, Italy
| | - A Esser
- University Hospital of Tor Vergata, Rome, Italy
| | | | - G Petrella
- University Hospital of Tor Vergata, Rome, Italy
| | - C Birolini
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - J S Miranda
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - E Y Tanaka
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - E M Utiyama
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - S Rasslan
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Y Shi
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
| | | | | | | | | | - A Bauder
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - P Gerety
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - G Epps
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - C Pannucci
- Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, USA
| | - J Fischer
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - S Kovach
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
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Klein P, Dedecek J, Thomas HM, Whittleton SR, Pashkova V, Brus J, Kobera L, Sklenak S. NMR crystallography of monovalent cations in inorganic matrixes: Li+ siting and the local structure of Li+ sites in ferrierites. Chem Commun (Camb) 2015; 51:8962-5. [DOI: 10.1039/c5cc01830g] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A new approach to the determination of the Li+ siting and the local structure of Li+ sites in zeolites is reported.
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Affiliation(s)
- P. Klein
- J. Heyrovský Institute of Physical Chemistry
- The Czech Academy of Sciences
- CZ 182 23 Prague 8
- Czech Republic
- Department of Inorganic Technology
| | - J. Dedecek
- J. Heyrovský Institute of Physical Chemistry
- The Czech Academy of Sciences
- CZ 182 23 Prague 8
- Czech Republic
| | - H. M. Thomas
- J. Heyrovský Institute of Physical Chemistry
- The Czech Academy of Sciences
- CZ 182 23 Prague 8
- Czech Republic
| | - S. R. Whittleton
- J. Heyrovský Institute of Physical Chemistry
- The Czech Academy of Sciences
- CZ 182 23 Prague 8
- Czech Republic
| | - V. Pashkova
- J. Heyrovský Institute of Physical Chemistry
- The Czech Academy of Sciences
- CZ 182 23 Prague 8
- Czech Republic
| | - J. Brus
- Institute of Macromolecular Chemistry
- The Czech Academy of Sciences
- Prague 6
- Czech Republic
| | - L. Kobera
- Institute of Macromolecular Chemistry
- The Czech Academy of Sciences
- Prague 6
- Czech Republic
| | - S. Sklenak
- J. Heyrovský Institute of Physical Chemistry
- The Czech Academy of Sciences
- CZ 182 23 Prague 8
- Czech Republic
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Coffin CS, Rezaeeaval M, Pang JX, Alcantara L, Klein P, Burak KW, Myers RP. The incidence of hepatocellular carcinoma is reduced in patients with chronic hepatitis B on long-term nucleos(t)ide analogue therapy. Aliment Pharmacol Ther 2014; 40:1262-9. [PMID: 25312649 DOI: 10.1111/apt.12990] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 08/07/2014] [Revised: 08/22/2014] [Accepted: 09/25/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND North American data are lacking on the effect of nucleos(t)ide analogues (NA) in preventing chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC). AIM To determine the incidence of HCC in NA-treated patients and compare this risk with that predicted without treatment based on the REACH-B model. METHODS In this retrospective study, the incidence of HCC was determined in CHB patients initiated on NA from 1999 to 2012. Pre-treatment data utilised in the REACH-B model were used to predict the annual HCC risk. The standardised incidence ratio (SIR) for HCC was calculated by comparing the observed to expected number of cases, and HCC risk factors determined by Cox proportional hazards regression. RESULTS Five hundred and forty nine initiated NA (14% lamivudine, 5% adefovir, 1.5% telbivudine, 39% entecavir, 41% tenofovir). Over a median follow-up of 3.2 years (IQR 1.9-4.6), 11 (3.2%) were diagnosed with HCC. Among 322 with data to calculate the REACH-B model, the median age at treatment initiation was 46 years (IQR 38-55), 65% were male, 32% HBeAg positive and 20% had cirrhosis. The median pre-treatment ALT was 71 U/L (IQR 41-127) and HBV DNA was 6.48 log10 copies/mL (4.95-8.04). The observed annual HCC incidence (0.9%; 95% CI 0.5-1.7) was significantly lower than predicted without treatment by the REACH-B model (SIR 0.46; 95% CI 0.23-0.82); this risk was reduced after 4 years of therapy (SIR 0.49; 95% CI 0.2-1.00). CONCLUSIONS In this Canadian study of nucleos(t)ide analogues-treated patients with chronic hepatitis B, the incidence of HCC was lower than expected, suggesting that NA reduce the risk of chronic hepatitis B-related HCC.
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Affiliation(s)
- C S Coffin
- Liver Unit, Division of Gastroenterology and Hepatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Trollet C, Chartier A, Klein P, Barbezier N, Gidaro T, Casas F, Carberry S, Dowling P, Maynadier L, Dickson G, Mouly V, Ohlendieck K, Butler-Browne G, Simonelig M. G.O.5. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.013] [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: 10/24/2022]
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Kucera J, Sojka M, Pavlik V, Szuszkiewicz K, Velebny V, Klein P. Multispecies biofilm in an artificial wound bed—A novel model for in vitro assessment of solid antimicrobial dressings. J Microbiol Methods 2014; 103:18-24. [DOI: 10.1016/j.mimet.2014.05.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/04/2014] [Accepted: 05/05/2014] [Indexed: 01/30/2023]
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Klein P, Muller-Rischart AK, Motori E, Schonbauer C, Schnorrer F, Winklhofer KF, Klein R. Ret rescues mitochondrial morphology and muscle degeneration of Drosophila Pink1 mutants. EMBO J 2014. [DOI: 10.1002/embj.201470060] [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: 11/12/2022] Open
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Pelz J, Farnbacher MJ, Raithel M, Hagel A, Herrmann O, Hohenberger W, Straube S, Klein P. Perforation of the splenic artery as a complication of endoscopic pancreatic stent placement in chronic obstructing pancreatitis. Endoscopy 2014; 45 Suppl 2 UCTN:E203-4. [PMID: 23832508 DOI: 10.1055/s-0033-1344158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J Pelz
- Department of Surgery I, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Lilly P, Klein P, Theibert A, Vaughan R, Pupillo M, Saxe K, Kimmel A, Devreotes PN. Receptor G-Protein Interactions in the Development ofDictyostelium. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/j.1438-8677.1988.tb00022.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Klein P, Polidori D, Twito O, Jaffe A. Impaired decline in renal threshold for glucose during pregnancy - a possible novel mechanism for gestational diabetes mellitus. Diabetes Metab Res Rev 2014; 30:140-5. [PMID: 24106177 DOI: 10.1002/dmrr.2474] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 09/03/2013] [Accepted: 09/11/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND The renal threshold for glucose (RT(G)) is determined by the nephron's reabsorptive capacity. Glucose is reabsorbed through sodium-coupled glucose cotransporters in the proximal tubules. During pregnancy, renal glucose reabsorptive capacity decreases, possibly, due to reduced glucose transporter expression. Our hypothesis is that inadequate decrease in RT(G) during pregnancy will make women more prone to develop gestational diabetes mellitus (GDM). METHODS Pregnant women (n = 40) who were referred to our center for oral glucose tolerance test (OGTT) were included in the analysis. Plasma glucose levels and urinary glucose excretion were measured for 4 h after 100 g oral glucose load. These data were used to calculate RT(G) . The subjects were divided into two cohorts, GDM and non-GDM, according to the OGTT results. Mean RT(G) was compared between the two groups. RESULTS Fifteen (37.5%) of the women were diagnosed with GDM. Seventeen participants had only trace amounts of urinary glucose excretion, and no value of RT(G) could be determined; RT(G) was determined in the other 23 subjects. Among these 23 women, 13 were diagnosed as GDM, and 10 had normal OGTT. RT(G) was lower in the non-GDM women (146 ± 14 mg/dL) than in the GDM women (182 ± 18 mg/dL), p < 0.001. CONCLUSIONS Gestational diabetes mellitus is associated with higher RT(G) during pregnancy compared with non-GDM. These results support our hypothesis that inadequate decrease of the RT(G) may have a pathophysiological role in the development of GDM.
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Affiliation(s)
- Pinchas Klein
- Diabetes and Endocrinology Unit, Hillel Yaffe Medical Center, Hadera, Israel
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Hadji P, Jackisch C, Bolten W, Blettner M, Hindenburg HJ, Klein P, König K, Kreienberg R, Rief W, Wallwiener D, Zaun S, Harbeck N. COMPliance and Arthralgia in Clinical Therapy: the COMPACT trial, assessing the incidence of arthralgia, and compliance within the first year of adjuvant anastrozole therapy. Ann Oncol 2013; 25:372-7. [PMID: 24355487 DOI: 10.1093/annonc/mdt513] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND This prospective study evaluated the relationship between arthralgia and compliance during the first year of adjuvant anastrozole therapy in postmenopausal women with hormone receptor-positive early breast cancer. PATIENTS AND METHODS COMPliance and Arthralgia in Clinical Therapy (COMPACT) was an open-label, multicenter, noninterventional study conducted in Germany. Patients had started adjuvant anastrozole 3-6 months before the study start. The primary end points were arthralgia, compliance, and the relationship between compliance and arthralgia, assessed at specific time points. RESULTS Overall, 1916 patients received upfront anastrozole. Mean arthralgia scores were increased from baseline at each visit up to 9 months. Compliance with anastrozole therapy gradually decreased over time from baseline to 9 months (P<0.001). At 9 months, investigators estimated that >95% of patients were compliant versus patient reports of <70%. There was a significant association between arthralgia mean scores and noncompliance at 6 months (P<0.0001), 9 months (P<0.0001), and overall (P<0.0001). Over time, new events or impairment of existing arthralgias were reported in 14% (3 months), 11% (6 months), and 9% (9 months) of patients. CONCLUSION Arthralgia is important in the clinical management of women with early breast cancer and may contribute to noncompliance and clinical outcomes. CLINICALTRIALSGOV IDENTIFIER NCT00857012.
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Affiliation(s)
- P Hadji
- Department of Gynecology, Endocrinology and Oncology, Philipps University of Marburg, Marburg
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Cate SP, Berger N, Boolbol SK, Klein P, Gillego A, Estabrook A, Malamud S, Chadha M, Lucido D, Shao T. Abstract P3-01-03: Vitamin D levels at breast cancer diagnosis: Association with patient and tumor characteristics. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-01-03] [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: Despite many preclinical studies showing the anti-neoplastic effects of vitamin D on breast cancer, findings from epidemiologic studies and randomized trials remain inconclusive. It is possible that tumor heterogeneity in breast cancer may mask these associations. Variations in vitamin D metabolism may explain some racial disparities in breast cancer. We aimed to examine the association of serum vitamin D levels with individual patient and tumor characteristics.
Methods: We conducted an IRB approved retrospective chart review, identifying all breast cancer patients with documented pretreatment serum levels of 25-hydroxyvitamin D (25(OH)D) between February 2011-May 2013. The following clinical data were collected for each patient: age at diagnosis, ethnicity, menopausal status, tumor size (mm), lymph node status, estrogen receptor (ER), progesterone receptor (PR), and HER2 status. Based on ER, PR, and HER2, patients were categorized into three molecular subtypes: 1) Hormone receptor (HR)+ (ER or PR positive, HER2 negative), 2) HER2+, and 3) triple negative (TN; ER, PR, and HER2 negative). Descriptive variables were analyzed using a one-way Anova test.
Results: Among the 200 breast cancer patients identified, the mean age was 55.9 years (range 29-90). Ethnicities of the patients were as follows: 104 (52%) Caucasian, 43 (22%) African American, 29 (15%) Hispanic, and 16 (8%) Asian. Seventy six patients (38%) were premenopausal, and 124 (62%) were postmenopausal. African Americans were found to have higher rates of triple negative tumors compared to all other ethnicities (24.4% vs. 11.6%, p = 0.029). Younger women had lower mean serum 25(OH)D levels compared to older women (p = 0.033). Lower mean 25(OH)D levels were seen in ER negative tumors compared to ER positive tumors (p = 0.0102). Mean 25(OH)D levels were lower in African American, Hispanic, and Asian breast cancer patients when compared to Caucasians (p = 0.0004). When stratifying by menopausal status, serum 25(OH)D levels differed more by tumor characteristics among premenopausal women than postmenopausal women. In premenopausal women, lower vitamin D levels were seen in patients who were African Americans (p = 0.0185), and with tumors that were ER negative (p = 0.0083). There was also a trend toward lower mean vitamin D levels in those with TN breast cancer compared to other molecular subtypes.
Conclusion: In premenopausal women, lower vitamin D levels were associated with African American race, younger age, and ER negative tumors. This may suggest that African Americans have defective vitamin D metabolism that may contribute to a more aggressive breast cancer phenotype. Further studies are warranted.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-01-03.
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Affiliation(s)
- SP Cate
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - N Berger
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - SK Boolbol
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - P Klein
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - A Gillego
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - A Estabrook
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - S Malamud
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - M Chadha
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - D Lucido
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
| | - T Shao
- Beth Israel, New York, NY; University of Connecticut, Farmington, CT; St. Luke's-Roosevelt Hospital, New York, NY
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Güçlü A, Germans T, Witjas-Paalberends ER, Stienen GJM, Brouwer WP, Harms HJ, Marcus JT, Vonk ABA, Stooker W, Yilmaz A, Klein P, Ten Berg JM, Kluin J, Asselbergs FW, Lammertsma AA, Knaapen P, van Rossum AC, van der Velden J. ENerGetIcs in hypertrophic cardiomyopathy: traNslation between MRI, PET and cardiac myofilament function (ENGINE study). Neth Heart J 2013; 21:567-71. [PMID: 24114686 PMCID: PMC3833912 DOI: 10.1007/s12471-013-0478-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Hypertrophic cardiomyopathy (HCM) is an autosomal dominant heart disease mostly due to mutations in genes encoding sarcomeric proteins. HCM is characterised by asymmetric hypertrophy of the left ventricle (LV) in the absence of another cardiac or systemic disease. At present it lacks specific treatment to prevent or reverse cardiac dysfunction and hypertrophy in mutation carriers and HCM patients. Previous studies have indicated that sarcomere mutations increase energetic costs of cardiac contraction and cause myocardial dysfunction and hypertrophy. By using a translational approach, we aim to determine to what extent disturbances of myocardial energy metabolism underlie disease progression in HCM. Methods Hypertrophic obstructive cardiomyopathy (HOCM) patients and aortic valve stenosis (AVS) patients will undergo a positron emission tomography (PET) with acetate and cardiovascular magnetic resonance imaging (CMR) with tissue tagging before and 4 months after myectomy surgery or aortic valve replacement + septal biopsy. Myectomy tissue or septal biopsy will be used to determine efficiency of sarcomere contraction in-vitro, and results will be compared with in-vivo cardiac performance. Healthy subjects and non-hypertrophic HCM mutation carriers will serve as a control group. Endpoints Our study will reveal whether perturbations in cardiac energetics deteriorate during disease progression in HCM and whether these changes are attributed to cardiac remodelling or the presence of a sarcomere mutation per se. In-vitro studies in hypertrophied cardiac muscle from HOCM and AVS patients will establish whether sarcomere mutations increase ATP consumption of sarcomeres in human myocardium. Our follow-up imaging study in HOCM and AVS patients will reveal whether impaired cardiac energetics are restored by cardiac surgery.
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Affiliation(s)
- A Güçlü
- Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU, VU University Medical Center, ZH 5F-13, PO Box 7057, 1007MB, Amsterdam, the Netherlands,
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Twito O, Ahron E, Jaffe A, Afek S, Cohen E, Granek-Catarivas M, Klein P, Hermoni D. New-onset diabetes in elderly subjects: association between HbA1c levels, mortality, and coronary revascularization. Diabetes Care 2013; 36:3425-9. [PMID: 23877985 PMCID: PMC3816853 DOI: 10.2337/dc12-2503] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE New-onset diabetes mellitus (DM) in elderly patients is associated with increased risk of diabetes complications and mortality. It is unknown whether glycemic control in this population influences the mortality risk. RESEARCH DESIGN AND METHODS The current study was conducted using the computerized database of the Sharon-Shomron District of Clalit Health Services in Israel. Included in the study were subjects 65 years of age and above with new-onset DM. The primary outcome measures were all-cause mortality and coronary revascularization procedures with either percutaneous coronary intervention or coronary artery bypass grafting. RESULTS Participants (n = 2,994) were stratified into four groups according to their mean HbA1c levels during the follow-up period (<6.5% [48 mmol/mol], 6.5-6.99% [48-52 mmol/mol], 7-7.49% [53-57 mmol/mol], and ≥7.5% [58 mmol/mol]). During a mean follow-up of 5.54 ± 2.1 years, 1,173 (39.17%) participants died and 285 (9.51%) underwent coronary revascularization. An HbA1c level >7.5% (58 mmol/mol) was associated with a significantly increased all-cause mortality rate (hazard ratio [HR] 1.74 [95% CI 1.2-1.8], P < 0.0001). This difference remained statistically significant after a multivariate model adjusted for the conventional cardiovascular risk factors and for the use of hypoglycemic agents and statins. Kaplan-Meier survival plots revealed lower survival rates in this group of patients. Coronary revascularization rates were highest among subjects with HbA1c 6.5-6.99% (48-52 mmol/mol) (HR 1.6 [1.01-2.4], P < 0.05) and lowest in patients with HbA1c ≥7.5% (58 mmol/mol). CONCLUSIONS An HbA1c level >7.5% (58 mmol/mol) is associated with increased risk for all-cause mortality and with a lower revascularization rate in elderly patients with new-onset DM.
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Gidaro T, Negroni E, Klein P, Oloko M, Lesnik M, Bigot A, Mamchaoui K, Périé S, Guily JS, Butler-Browne G, Mouly V, Trollet C. P.16.12 OPMD from the myoblast’s and fibroblast’s point of view. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saint Pierre F, Durand M, Bellot-Samson V, Baillacq JL, Blanchard PY, Dujarric F, Fusari JP, Goudot P, Guyot L, Jammet P, Klein P, Pouyat X, Schaudel F. [Editorial]. ACTA ACUST UNITED AC 2013; 114:121-2. [PMID: 23827264 DOI: 10.1016/j.revsto.2013.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bolten W, Blettner M, Harbeck N, Hindenburg HJ, Jackisch C, Klein P, König K, Rief W, Wallwiener D, Zaun S, Kreienberg R, Hadji P. AB1394 Compliance and arthralgias in clinical therapy (compact): Assessment of the incidence of arthralgia, therapy costs and compliance within the first year of anastrozole therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Shao T, Olszewski AJ, Boolbol SK, Migdady Y, Boachie-Adjei K, Sakr BJ, Klein P, Sikov W. Abstract P6-07-34: Disease-related outcomes with adjuvant chemotherapy in HER2 positive or triple negative T1a/bN0 breast cancers. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p6-07-34] [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: Previous studies reported higher relapse rates in T1a/bN0 breast cancers characterized by high-risk biology (HER2 positive or triple negative). The benefits of adjuvant chemotherapy in this group have not been evaluated. The purpose of our study was to determine potential impact of chemotherapy on incidence of relapses and to define the population appropriate for treatment based on observational data.
Methods: We pooled data from two multi-institutional databases spanning the period of 1996–2008 (Beth Israel Medical Center) and 2000–2010 (Brown University). We fitted a propensity score model to adjust for unbalanced confounders between the groups treated or untreated with adjuvant chemotherapy and, in case of HER2+ disease, with trastuzumab. Competing risk analysis was employed to study the effect of chemotherapy on cancer relapses in the matched population.
Results: The study included 321 patients (160 from Beth Israel and 161 from Brown) with a median age of 57 years (range 28–88). 111 (35%) cases were triple negative (TN) and 210 (65%) were HER2+ (of which 64% were ER+). 41% patients received adjuvant chemotherapy and 22% of HER2+ cases received trastuzumab. The treated group differed from untreated with regards to distribution of age, menopausal status, year of diagnosis, histological subtype and grade, tumor size, rates of mastectomy, and adjuvant endocrine therapy. All confounders were successfully balanced with the propensity score analysis. With a median follow-up of 56 months, 20 relapses (12 locoregional and 8 distant) and 10 unrelated deaths occurred. The cumulative incidence of relapse at 5 years was 7.3% (95% CI, 4.3–11.4) and relapse-free survival was 90.2% (95% CI, 85.2–93.6). Age less then 35 years (46.4% vs. 6.1%, p = 0.0004) and TN status (12.9% for TN versus 4.8% for HER2+, p = 0.03) were associated with higher risk of relapse. No significant differences with regards to tumor size (T1a or T1b), surgery type and other variables were observed. There was no significant effect of chemotherapy on incidence of relapse (Hazard ratio 1.2, 95% CI 0.34–4.23, p = 0.78), relapse-free survival or distant recurrence-free interval after propensity score adjustment. Additionally in the HER2+ patients, no benefit of trastuzumab was detected (hazard ratio 0.78, 95% CI 0.06–9.85, p = 0.85). Adjuvant endocrine therapy was associated with lower risk of relapse in the ER+ subgroup (p = 0.04).
Conclusion: Survival outcomes in very early stage breast cancer are excellent with current therapy even in biologically aggressive subtypes. Triple negative status and very young age correlate with higher incidence of relapse. While adjuvant endocrine therapy may be effective in ER positive subset, the risk/benefit ratio of chemotherapy with or without trastuzumab remains uncertain.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-07-34.
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Affiliation(s)
- T Shao
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - AJ Olszewski
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - SK Boolbol
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - Y Migdady
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - K Boachie-Adjei
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - BJ Sakr
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - P Klein
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
| | - W Sikov
- Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; The Warren Alpert Medical School of Brown University, Providence, RI
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Harbeck N, Blettner M, Bolten WW, Hindenburg HJ, Jackisch C, Klein P, König K, Kreienberg R, Rief W, Wallwiener D, Zaun S, Hadji P. Abstract P6-09-08: COMPliance and Arthralgia in Clinical Therapy: The COMPACT trial, assessing the incidence of arthralgia, therapy costs and compliance within the first year of adjuvant anastrozole therapy. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p6-09-08] [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: Aromatase Inhibitors (AI) are well established as adjuvant treatment for postmenopausal (PMP) women with hormone receptor positive (HR+) early breast cancer (EBC). However, phase III clinical trials have reported higher rates of arthralgia associated with AI than tamoxifen. This study aims to collect real world data on the effects of AI-associated arthralgia on patient compliance, patient outcomes and on treatment of arthralgia.
Methods: COMPACT is an open, prospective, non-interventional, non-randomized study (NCT00857012) run in Germany. PMP women with HR+ EBC who had been on adjuvant anastrozole (ANA) for 3–6 months were enrolled and stratified by initial adjuvant ANA or switch from tamoxifen. All patients received regular standardized information about breast cancer from baseline to week 20 to support treatment compliance. Data on demographics, arthralgia, related therapies, other side effects and QoL were collected at baseline, 3, 6 and 9 months. Primary endpoints are scaled data on arthralgia and compliance within the first year of ANA therapy. Secondary endpoints include incidence of arthralgia, therapy costs, reasons for non-compliance, and influence of arthralgia on clinical outcome.
Results: Between Apr 2009 and Mar 2011, 2313 patients were enrolled, 2007 on upfront ANA and 306 on switch from tamoxifen. The mean age at baseline was 64.5 years, mean BMI 27.7. Only 17.0% of patients had received HRT prior to their EBC. At baseline, 41.9% reported symptoms relating to skeleton or musculature. 12.0% reported arthralgia existing prior to ANA treatment and 13.2% stated a worsening of pre-existing arthralgia or new arthralgia after starting ANA. Predictors for non-adherence to AI therapy were former non-adherence, general symptom load on the side effect scale GASE, and low benefit expectation at treatment start. Risk of arthralgia was related to BMI (lowest for patients with BMI ≤24.1 kg/m2, highest with BMI >30.5 kg/m2 at all time points; OR>1) and upfront therapy (switch patients had a reduced risk of 68% at 6 and 61% at 9 months compared to patients with ANA upfront, p = 0.002). Patients with prior chemotherapy had lower rates of arthralgia before start of ANA (10.4% vs 13.3%, p = 0.036) but higher rates after the start of ANA and before study start (27.0% vs 22.5%, p = 0.013). Patients with arthralgia showed higher compliance rates at all time points (p < 0.001).
Conclusion: COMPACT identified arthralgia and musculoskeletal symptoms as common complaints in PMP women with EBC. ANA treatment both increased the number of women with such symptoms and aggravated these in some patients. Higher BMI and upfront AI predicted for risk of AI associated arthralgia. However, COMPACT also showed that AI-associated arthralgia did not lead to non-compliance in most patients. This data may help to better understand compliance issues with adjuvant AI treatment.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-09-08.
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Affiliation(s)
- N Harbeck
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - M Blettner
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - WW Bolten
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - H-J Hindenburg
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - C Jackisch
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - P Klein
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - K König
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - R Kreienberg
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - W Rief
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - D Wallwiener
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - S Zaun
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
| | - P Hadji
- University of Munich, Germany; University of Mainz, Germany; Klaus-Miehlke-Hospital for Rheumatology, Wiesbaden, Germany; Head of BNGO e.V., Germany; Hospital for Gynecology and Obstetrics, Offenbach, Germany; d.s.h. Statistical Services, Rohrbach, Germany; Gynecological Society Germany e.V., Germany; University Women's Hospital, Ulm, Germany; Outpatient Clinic for Psychotherapy, Philipps-University, Marburg, Germany; University Women's Hospital, Tübingen, Germany; AstraZeneca GmbH, Wedel, Germany; Women's Hospital Phillips-University, Marburg, Germany
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Berger N, Klein P, Boolbol SK, Gillego A, Estabrook A, Malamud S, Chadha M, Boachie-Adjei K, Shao T. Abstract P3-08-08: Vitamin D status at breast cancer diagnosis: correlation with patient and tumor characteristics. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-08-08] [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: Despite many preclinical studies showing anti-neoplastic activities of vitamin D on breast cancer, findings from epidemiologic studies and randomized trials on the relationship between vitamin D and breast cancer remains inconclusive. It is possible that tumor heterogeneity in breast cancer may mask these associations. Variations in vitamin D metabolism might explain some racial disparities in breast cancer. We aimed to examine the association of serum vitamin D levels with patient and tumor characteristics.
Methods: We conducted an IRB approved retrospective chart review, identifying all breast cancer patients with documented pretreatment serum level of 25-hydroxyvitamin D (25(OH)D) between February 2011-May 2012. The following clinical data were collected for each patient: age at diagnosis, ethnicity, menopausal status, largest tumor size (mm), lymph node status, estrogen receptor (ER), progesterone receptor (PR), and HER2 status. Based on ER, PR, and HER2, patients were categorized into three molecular subtypes: 1) Hormone receptor (HR)+ (ER or PR positive, HER2 negative), HER2+, triple negative (TN) (ER, PR, and HER2 negative). Vitamin D deficiency, insufficiency, and sufficiency were defined as 25(OH)D <20 ng/mL, 20–29 ng/mL, and ≥30 ng/mL, respectively. Descriptive variables were analyzed using one-way Anova test. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from logistic regression models.
Results: Among 86 breast cancer patients identified, median age was 60 years (range 27–88). Ethnicities of the patients: 47 (55%) Caucasian, 18 (21%) African American, 15 (17%) Hispanic, and 6 (7%) Asian. Twenty eight (33%) were premenopausal, and 58 (67%) were postmenopausal. African Americans had the lowest mean 25(OH)D levels among different ethnicities (p = 0.0042). Patients with tumors >2 cm had lower mean vitamin D levels compared to those with tumors ≤ 2 cm (p = 0.037). When stratifying by menopausal status, serum 25(OH)D levels differed more by tumor characteristics among premenopausal women than postmenopausal women. In premenopausal women, lower vitamin D levels were seen in patients who were African Americans (p < 0.001), with large tumor size (p < 0.001), and with tumors that were ER negative (p = 0.003). There was also a trend toward lower mean vitamin D levels in those with TN breast cancer compared to other molecular subtypes. In subgroup analysis, being African American and having TN breast cancer significantly correlates with having vitamin D deficiency (p = 0.0001).
Conclusion: In premenopausal women, lower vitamin D levels were associated with African American race, larger tumor size, and ER negativity. African Americans with TN breast cancer were more likely to be vitamin D deficient. This might support the hypothesis that African Americans have defective vitamin D metabolism that may contribute to a more aggressive breast cancer phenotype. Further studies are warranted.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-08-08.
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Affiliation(s)
- N Berger
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - P Klein
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - SK Boolbol
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - A Gillego
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - A Estabrook
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - S Malamud
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - M Chadha
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - K Boachie-Adjei
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
| | - T Shao
- Lutheran Medical Center, Brooklyn, NY; Beth Israel Medical Center, Continuum Cancer Centers of New York, New York, NY; St. Luke's-Roosevelt Hospital center, Continuum Cancer Centers of New York, New York, NY
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Klein P, Varga R, Badini Confalonieri GA, Vazquez M. Domain wall dynamics in amorphous and nanocrystalline FeCoMoB microwires. J Nanosci Nanotechnol 2012; 12:7464-7467. [PMID: 23035496 DOI: 10.1166/jnn.2012.6526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We have studied the domain wall dynamics in amorphous and nanocrystalline FeCoMoB microwires. The domain wall propagation velocity has been found very fast (up to 5000 m/s) for the as-cast sample. Annealing at 575 K/1 h leads to the stress relief and sample homogenization and the domain wall velocity even increases to 5300 m/s. However, the domain wall dynamics is highly sensible to the temperature of a measurement. Annealing at 775 K/1 h leads to the appearance of the nanocrystalline structure with much higher temperature stability. The maximum domain wall velocity decreases (2800 m/s), however the domain wall dynamics is much stable with the temperature.
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Affiliation(s)
- P Klein
- Institute of Physics, Faculty of Science, UPJS, Park Angelinum 9, 04154 Kosice, Slovakia
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