1
|
Knopp BW, Baran J, Casey R. Childhood-Onset Granulomatosis With Polyangiitis as a Palatal Defect: A Case Report. Cureus 2023; 15:e42855. [PMID: 37664394 PMCID: PMC10473442 DOI: 10.7759/cureus.42855] [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: 06/13/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
Granulomatosis with polyangiitis (GPA) is a necrotizing systemic vasculitis of small and medium-sized vessels with renal and sinopulmonary involvement. Its symptoms include chronic sinusitis, recurrent pneumonia, glomerulonephritis, constitutional symptoms, and skin manifestations with a typical onset in the fourth to sixth decade of life. We present a rare case of GPA in a 16-year-old female who presented with facial numbness and nasal regurgitation via a palatal defect. The patient reported a several-month history of recurrent epistaxis and chronic nasal congestion accompanied by several weeks of night sweats, lower right-sided facial numbness and pain, nasal regurgitation of food and liquids, and a 30-pound weight loss. A physical exam found a 3-cm defect on the right side of her palate. CT of the sinuses showed significant sinonasal destruction and petrous apicitis. GPA was confirmed via pathognomonic chest X-ray findings and biopsy results. The patient was treated with maxillary antrostomy and anterior ethmoidectomy and a follow-up was scheduled to address sequelae of the destructive sinopulmonary lesions. This case report highlights a unique presentation of GPA with an insidious development of autoimmune sinonasal destruction in an adolescent female. This presentation is rare and highlights the importance of considering autoimmune disease in cases of tissue destruction where the etiology is not apparent, even in patients at low risk for autoimmune conditions.
Collapse
Affiliation(s)
- Brandon W Knopp
- Endocrinology, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Jessica Baran
- Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA
| | - Robert Casey
- Pediatrics, Joe DiMaggio Children's Hospital, Hollywood, USA
| |
Collapse
|
2
|
Bhatia S, Pappo AS, Acquazzino M, Allen-Rhoades WA, Barnett M, Borinstein SC, Casey R, Choo S, Chugh R, Dinner S, Ermoian R, Fair D, Federman N, Folbrecht J, Gandhi S, Germann J, Goldsby R, Hayashi R, Huang AY, Huang MS, Jacobs LA, Lee-Miller C, Link MP, Livingston JA, Lustberg M, Malogolowkin M, Oeffinger KC, Pratilas CA, Reed D, Skiles J, von Mehren M, Yeager N, Montgomery S, Hang L. Adolescent and Young Adult (AYA) Oncology, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2023; 21:851-880. [PMID: 37549914 DOI: 10.6004/jnccn.2023.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
This selection from the NCCN Guidelines for Adolescent and Young Adult (AYA) Oncology focuses on considerations for the comprehensive care of AYA patients with cancer. Compared with older adults with cancer, AYA patients have unique needs regarding treatment, fertility counseling, psychosocial and behavioral issues, and supportive care services. The complete version of the NCCN Guidelines for Adolescent and Young Adult (AYA) Oncology addresses additional aspects of caring for AYA patients, including risk factors, screening, diagnosis, and survivorship.
Collapse
Affiliation(s)
| | - Alberto S Pappo
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | | | | | - Sun Choo
- UC San Diego Moores Cancer Center
| | | | - Shira Dinner
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | - Douglas Fair
- Huntsman Cancer Institute at the University of Utah
| | | | | | | | | | | | - Robert Hayashi
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Alex Y Huang
- University Hospitals Rainbow Babies & Children's Hospital/Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Mary S Huang
- Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center
| | - Linda A Jacobs
- Abramson Cancer Center at the University of Pennsylvania
| | | | | | | | | | | | | | | | | | - Jodi Skiles
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | - Nicholas Yeager
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | - Lisa Hang
- National Comprehensive Cancer Center
| |
Collapse
|
3
|
Wiener L, Bedoya SZ, Gordon M, Fry A, Casey R, Steele A, Ruble K, Ciampa D, Pao M. Checking IN: Development, Acceptability, and Feasibility of a Pediatric Electronic Distress Screener. Clin Pract Pediatr Psychol 2023; 11:94-107. [PMID: 37251422 PMCID: PMC10211261 DOI: 10.1037/cpp0000450] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Objective Chronic illness in children and adolescents is associated with significant stress and risk of psychosocial problems. In busy pediatric clinics, limited time and resources are significant barriers to providing mental health assessment for every child. A brief, real-time self-report measure of psychosocial problems is needed. Methods An electronic distress screening tool, Checking IN, for ages 8-21 was developed in 3 phases. Phase I used semi-structured cognitive interviews (N = 47) to test the wording of items assessing emotional, physical, social, practical, and spiritual concerns of pediatric patients. Findings informed the development of the final measure and an electronic platform (Phase II). Phase III used semi-structured interviews (N = 134) to assess child, caregiver and researcher perception of the feasibility, acceptability, and barriers of administering Checking IN in the outpatient setting at 4 sites. Results Most patients and caregivers rated Checking IN as "easy" or "very easy" to complete, "feasible" or "somewhat feasible," and the time to complete the measure as acceptable. Most providers (n = 68) reported Checking IN elicited clinically useful and novel information. Fifty-four percent changed care for their patient based on the results. Conclusions Checking IN is a versatile and brief distress screener that is acceptable to youth with chronic illness and feasible to administer. The summary report provides immediate clinically meaningful data. Electronic tools like Checking IN can capture a child's current psychosocial wellbeing in a standardized, consistent, and useful way, while allowing for the automation of triaging referrals and psychosocial documentation during outpatient visits.
Collapse
Affiliation(s)
- Lori Wiener
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Sima Z Bedoya
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mallorie Gordon
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Abigail Fry
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Amii Steele
- Levine Children's Hospital, Charlotte, North Carolina
| | | | | | - Maryland Pao
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
4
|
Dawam D, Motiwala H, Abdalazeez M, Pavlakis P, Massanova M, Casey R, Dimopoulos P, Kampantais S, Carr T, Dooldeniya M, Hegarty H. A UK urological cancer centre cystectomy service - What lessons can we learn? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
5
|
Muheilan M, Scanlon L, Barea B, Smyth L, Thomas A, Flynn R, Manecksha R, Casey R. A Comparison of Urology Service Provision Between the First and the Third Waves of the COVID-19 Pandemic. Ir Med J 2022; 115:659. [PMID: 36327989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- M Muheilan
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - L Scanlon
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - B Barea
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - L Smyth
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - A Thomas
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| | - R Flynn
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R Manecksha
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R Casey
- Department of Urology, Tallaght University Hospital, Dublin, Ireland
| |
Collapse
|
6
|
Lefort M, Sharmin S, Andersen JB, Vukusic S, Casey R, Debouverie M, Edan G, Ciron J, Ruet A, De Sèze J, Maillart E, Zephir H, Labauge P, Defer G, Lebrun-Frenay C, Moreau T, Berger E, Clavelou P, Pelletier J, Stankoff B, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Wahab A, Camdessanché JP, Maurousset A, Ben Nasr H, Hankiewicz K, Pottier C, Maubeuge N, Dimitri-Boulos D, Nifle C, Laplaud DA, Horakova D, Havrdova EK, Alroughani R, Izquierdo G, Eichau S, Ozakbas S, Patti F, Onofrj M, Lugaresi A, Terzi M, Grammond P, Grand'Maison F, Yamout B, Prat A, Girard M, Duquette P, Boz C, Trojano M, McCombe P, Slee M, Lechner-Scott J, Turkoglu R, Sola P, Ferraro D, Granella F, Shaygannejad V, Prevost J, Maimone D, Skibina O, Buzzard K, Van der Walt A, Karabudak R, Van Wijmeersch B, Csepany T, Spitaleri D, Vucic S, Koch-Henriksen N, Sellebjerg F, Soerensen PS, Hilt Christensen CC, Rasmussen PV, Jensen MB, Frederiksen JL, Bramow S, Mathiesen HK, Schreiber KI, Butzkueven H, Magyari M, Kalincik T, Leray E. Impact of methodological choices in comparative effectiveness studies: application in natalizumab versus fingolimod comparison among patients with multiple sclerosis. BMC Med Res Methodol 2022; 22:155. [PMID: 35637426 PMCID: PMC9150358 DOI: 10.1186/s12874-022-01623-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Natalizumab and fingolimod are used as high-efficacy treatments in relapsing–remitting multiple sclerosis. Several observational studies comparing these two drugs have shown variable results, using different methods to control treatment indication bias and manage censoring. The objective of this empirical study was to elucidate the impact of methods of causal inference on the results of comparative effectiveness studies. Methods Data from three observational multiple sclerosis registries (MSBase, the Danish MS Registry and French OFSEP registry) were combined. Four clinical outcomes were studied. Propensity scores were used to match or weigh the compared groups, allowing for estimating average treatment effect for treated or average treatment effect for the entire population. Analyses were conducted both in intention-to-treat and per-protocol frameworks. The impact of the positivity assumption was also assessed. Results Overall, 5,148 relapsing–remitting multiple sclerosis patients were included. In this well-powered sample, the 95% confidence intervals of the estimates overlapped widely. Propensity scores weighting and propensity scores matching procedures led to consistent results. Some differences were observed between average treatment effect for the entire population and average treatment effect for treated estimates. Intention-to-treat analyses were more conservative than per-protocol analyses. The most pronounced irregularities in outcomes and propensity scores were introduced by violation of the positivity assumption. Conclusions This applied study elucidates the influence of methodological decisions on the results of comparative effectiveness studies of treatments for multiple sclerosis. According to our results, there are no material differences between conclusions obtained with propensity scores matching or propensity scores weighting given that a study is sufficiently powered, models are correctly specified and positivity assumption is fulfilled. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01623-8.
Collapse
Affiliation(s)
- M Lefort
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France.,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France
| | - S Sharmin
- Department of Medicine, University of Melbourne, Melbourne, Australia.,Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - J B Andersen
- Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Rigshospitalet Glostrup, Denmark
| | - S Vukusic
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France
| | - R Casey
- Service de Neurologie, Sclérose en Plaques, Pathologies de La Myéline Et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Lyon/Bron, France.,Centre Des Neurosciences de Lyon, UMR5292, Observatoire Français de La Sclérose en Plaques, INSERM, 1028 et CNRS, 69003, Lyon, France.,Université, Claude Bernard Lyon 1, Faculté de médecine Lyon Est, 69000, Lyon, France.,Eugene Devic EDMUS Foundation, 69677, Lyon/Bron, France
| | - M Debouverie
- Centre Hospitalier Régional Universitaire de Nancy, Hôpital Central, Service de neurologie, Nancy, France
| | - G Edan
- Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, Service de neurologie, Rennes, France
| | - J Ciron
- Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, CRC-SEP, Département de neurologie, Toulouse, France
| | - A Ruet
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Service de neurologie, Bordeaux, France
| | - J De Sèze
- Service des maladies inflammatoires du système nerveux - neurologie, centre d'investigation clinique de Strasbourg, Hôpitaux Universitaire de Strasbourg, Hôpital de Hautepierre, INSERM 1434, Strasbourg, France
| | - E Maillart
- Assistance Publique Des Hôpitaux de Paris, Hôpital de La Pitié-Salpêtrière, Service de neurologie, Paris, France
| | - H Zephir
- Centre Hospitalier Universitaire de Lille, Hôpital Salengro, Service de neurologie D, Lille, France
| | - P Labauge
- Centre Hospitalier Universitaire de Montpellier, Hôpital Gui de Chauliac, Service de neurologie, Montpellier, France
| | - G Defer
- Centre Hospitalier Universitaire de Caen Normandie, Hôpital Côte de Nacre, Service de neurologie, Caen, France
| | - C Lebrun-Frenay
- Centre Hospitalier Universitaire de Nice, UR2CA-URRIS,, Université Nice Côte d'Azur, Hôpital, Pasteur 2, Service de neurologie, Nice, France
| | - T Moreau
- Centre Hospitalier Universitaire Dijon Bourgogne, Hôpital François Mitterrand, Maladies Inflammatoires du Système Nerveux Et Neurologie Générale, Service de neurologie, Dijon, France
| | - E Berger
- Centre Hospitalier Régional Universitaire de Besançon, Hôpital Jean Minjoz, Service de neurologie, Besançon, France
| | - P Clavelou
- Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de neurologie, Clermont-Ferrand, France
| | - J Pelletier
- Service de Neurologie, Aix Marseille Univ, APHM, Hôpital de La Timone, Pôle de Neurosciences Cliniques, 13005, Marseille, France
| | - B Stankoff
- Assistance Publique Des Hôpitaux de Paris, Hôpital Saint-Antoine, Service de neurologie, Paris, France
| | - O Gout
- Fondation Adolphe de Rothschild de L'œil Et du Cerveau, Service de neurologie, Paris, France
| | - E Thouvenot
- Centre Hospitalier Universitaire de Nîmes, Hôpital Carémeau, Service de neurologie, Nîmes, France
| | - O Heinzlef
- Centre Hospitalier Intercommunal de Poissy Saint-Germain-en-Laye, Service de neurologie, Poissy, France
| | - A Al-Khedr
- Centre Hospitalier Universitaire d'Amiens Picardie, Site sud, Service de neurologie, Amiens, France
| | - B Bourre
- Rouen University Hospital, 76000, Rouen, France
| | - O Casez
- Centre Hospitalier Universitaire Grenoble-Alpes, Site nord, Service de neurologie, Grenoble/La Tronche, France
| | - P Cabre
- Centre Hospitalier Universitaire de Martinique, Hôpital Pierre Zobda-Quitman, Service de neurologie, Fort-de-France, France
| | - A Montcuquet
- Centre Hospitalier Universitaire Limoges, Hôpital Dupuytren, Service de neurologie, Limoges, France
| | - A Wahab
- Assistance Publique Des Hôpitaux de Paris, Hôpital Henri Mondor, Service de neurologie, Créteil, France
| | - J P Camdessanché
- Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Service de neurologie, Saint-Étienne, France
| | - A Maurousset
- Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Service de neurologie, Tours, France
| | - H Ben Nasr
- Centre Hospitalier Sud Francilien, Service de neurologie, Corbeil-Essonnes, France
| | - K Hankiewicz
- Centre Hospitalier de Saint-Denis, Hôpital Casanova, Service de neurologie, Saint-Denis, France
| | - C Pottier
- Centre Hospitalier de Pontoise, Service de neurologie, Pontoise, France
| | - N Maubeuge
- Centre Hospitalier Universitaire de Poitiers, Site de La Milétrie, Service de neurologie, Poitiers, France
| | - D Dimitri-Boulos
- Assistance Publique Des Hôpitaux de Paris, Hôpital Bicêtre, Service de neurologie, Le Kremlin-Bicêtre, France
| | - C Nifle
- Centre Hospitalier de Versailles, Hôpital André-Mignot, Service de neurologie, Le Chesnay, France
| | - D A Laplaud
- CHU de Nantes, Service de Neurologie & CIC015 INSERM, 44093, Nantes, France.,INSERM CR1064, 44000, Nantes, France
| | - D Horakova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - E K Havrdova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
| | - R Alroughani
- Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
| | - G Izquierdo
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Eichau
- Hospital Universitario Virgen Macarena, Seville, Spain
| | - S Ozakbas
- Dokuz Eylul University, Konak/Izmir, Turkey
| | - F Patti
- GF Ingrassia Department, University of Catania, Catania, Italy.,Policlinico G Rodolico, Catania, Italy
| | - M Onofrj
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - A Lugaresi
- Dipartimento Di Scienze Biomediche E Neuromotorie, Università Di Bologna, Bologna, Italy.,IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy
| | - M Terzi
- Medical Faculty, 19 Mayis University, Samsun, Turkey
| | - P Grammond
- CISSS Chaudiere-Appalache, Levis, Canada
| | | | - B Yamout
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Prat
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - M Girard
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - P Duquette
- Hopital Notre Dame, Montreal, Canada.,CHUM and Universite de Montreal, Montreal, Canada
| | - C Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | - M Trojano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - P McCombe
- University of Queensland, Brisbane, Australia.,Royal Brisbane and Women's Hospital, Herston, Australia
| | - M Slee
- Flinders University, Adelaide, Australia
| | - J Lechner-Scott
- School of Medicine and Public Health, University Newcastle, Newcastle, Australia.,Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, Australia
| | - R Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - P Sola
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - D Ferraro
- Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
| | - F Granella
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Department of Emergency and General Medicine, Parma University Hospital, Parma, Italy
| | | | - J Prevost
- CSSS Saint-Jérôme, Saint-Jerome, Canada
| | | | - O Skibina
- Monash University, Melbourne, Australia
| | - K Buzzard
- Monash University, Melbourne, Australia
| | | | | | - B Van Wijmeersch
- Rehabilitation and MS-Centre Overpelt and Hasselt University, Hasselt, Belgium
| | - T Csepany
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - D Spitaleri
- Azienda Ospedaliera Di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy
| | - S Vucic
- Westmead Hospital, Sydney, Australia
| | - N Koch-Henriksen
- Department of Clinical Epidemiology, Aarhus University Hospital Aarhus, Aarhus, Denmark
| | - F Sellebjerg
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - P S Soerensen
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - C C Hilt Christensen
- Department of Neurology, Aalborg University Hospital, Multiple Sclerosis Unit, Aalborg, Denmark
| | - P V Rasmussen
- Aarhus University Hospital, Neurology, PJJ Boulevard, DK-8200, Aarhus N, Denmark
| | - M B Jensen
- Department of Neurology, University Hospital of Northern Sealand, Copenhagen, Denmark
| | - J L Frederiksen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - S Bramow
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H K Mathiesen
- Department of Neurology, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - K I Schreiber
- Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - H Butzkueven
- Central Clinical School, Monash University, Melbourne, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, Australia.,Department of Neurology, Box Hill Hospital, Monash University, Melbourne, Australia
| | - M Magyari
- Melbourne MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia.,Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet Glostrup, 2600, Glostrup, Denmark
| | - T Kalincik
- Department of Medicine, University of Melbourne, Melbourne, Australia.
| | - E Leray
- Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Univ Rennes, EHESP, CNRS, Inserm, Rennes, France. .,Univ Rennes, CHU Rennes, Investigation Clinique de Rennes)], CIC 1414 [(Centre d, 35000, InsermRennes, France.
| |
Collapse
|
7
|
Wong W, Pitfield D, Challis B, Casey R, Kosmoliaptsis V. 313 Importance of Surgical Approach and Resection Status on Outcomes of Patients with Adrenocortical Carcinoma (ACC). Br J Surg 2022. [DOI: 10.1093/bjs/znac039.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with overall poor prognosis. We aimed to examine the relationship between tumour resection margins (R0/R1), surgical approach (laparoscopic vs. open) and clinical outcomes in our practice.
Method
We conducted a retrospective review of patients diagnosed with histology-proven ACC (01/2015–12/2020) who proceeded to surgery and were followed up at Addenbrooke’s hospital (n = 24). We examined overall and progression-free survival (PFS) censored at date of death or at last follow-up.
Results
Patients had a median(SD) age at presentation of 58.5(11.0), were female in 62.5%; median(SD) length of follow-up was 29(20.1) months. The tumour histology was oncocytic variant in 50% of cases. R0 resection was achieved in 16/23 cases and was associated with better PFS [median(SD): 28.5(19.3) months for R0 vs. 8(25.0) for R1] and overall survival [median(SD): 33(18.4) months for R0 vs. 29(22.6) for R1]. 15/16 and 1/7 patients with R0 and R1 resection respectively were alive at end of follow-up. R1 resection status and survival were associated with ENSAT stage (85.7% stage III-IV for R1 vs. 25.1% for R0) although tumour size was not significantly different. A greater proportion of R1 patients (57.1%) had laparoscopic surgery (3 of those had tumour size>6cm) than R0 patients (25%). Outcomes for oncocytic ACC tumours were not different.
Conclusions
R0 resection is of paramount importance for ACC outcomes. Careful pre-operative work-up of indeterminate adrenal lesions to raise suspicion for ACC and consideration of open surgery for large tumours may help improve outcomes.
Collapse
Affiliation(s)
- W.Y.K. Wong
- University of Cambridge, Cambridge, United Kingdom
| | - D. Pitfield
- Addenbrooke's hospital, Cambridge, United Kingdom
| | - B. Challis
- University of Cambridge, Cambridge, United Kingdom
| | - R. Casey
- University of Cambridge, Cambridge, United Kingdom
| | | |
Collapse
|
8
|
Reinman L, Coons HL, Sopfe J, Casey R. Psychosexual Care of Adolescent and Young Adult (AYA) Cancer Survivors. Children 2021; 8:children8111058. [PMID: 34828771 PMCID: PMC8618923 DOI: 10.3390/children8111058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 01/23/2023]
Abstract
Adolescent and young adult (AYA) survivors of cancer have diverse psychosocial and medical needs, including those related to fertility and sexual health. Much of the focus of care around issues such as fertility and sexual health tends to be filtered through a biomedical lens. However, it is essential that health care providers assess and support AYA survivors using a biopsychosocial and contextual framework to ensure the most comprehensive and accurate understanding of AYA survivor needs, especially those related to psychosexual health. A trusting relationship between the multi-disciplinary medical team and the AYA survivor that allows for open discussion about the physical and psychosocial components of sexual health is key to providing best care and outcomes.
Collapse
Affiliation(s)
- Laura Reinman
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA;
- Correspondence:
| | - Helen L. Coons
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Jenna Sopfe
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (R.C.)
| | - Robert Casey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (R.C.)
| |
Collapse
|
9
|
Raissi G, Patel N, Casey R, Corcoran B, Sadeghi H. 152: Weekly patient-family-staff-volunteer during COVID-19. J Cyst Fibros 2021. [PMCID: PMC8518465 DOI: 10.1016/s1569-1993(21)01577-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Chevalier LL, Zwemer EK, Casey R, Recklitis CJ. The Effect of Pediatric Cancer on Identity in Young Adult Survivors: Results from Project REACH. J Adolesc Young Adult Oncol 2021; 11:297-303. [PMID: 34677115 DOI: 10.1089/jayao.2021.0071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: Living through cancer can have a profound effect on identity. Among those treated for adult-onset cancer, identifying as a cancer survivor is common and has been linked to positive mental and physical health outcomes. Although childhood is a critical period for identity formation, comparatively less is known about identity development after pediatric cancers. Methods: One hundred seventy young adults previously treated for pediatric cancer enrolled in Project REACH, a prospective cohort study, and completed self-report measures on effect of cancer on identity (e.g., cancer victim and survivor identity), frequency of thoughts of cancer, health outcomes (i.e., anxiety, depression, and health-related quality of life), and health behaviors (i.e., smoking, sun protection, exercise, and binge drinking). Results: The majority of participants identified as a survivor (n = 146, 85.9%), and survivor identity was linked to significantly higher anxiety (p = 0.01) and worse overall mental health (p = 0.04), but no other health outcomes or behaviors. Only 14 participants (8.2%) endorsed the victim identity, and they were significantly more likely to report binge drinking (p = 0.03) and worse overall mental health (p = 0.02) than nonvictims. Frequency of thoughts of cancer and effect of cancer on identity were also significantly associated with health outcomes (e.g., more frequent thoughts associated with higher anxiety). Conclusions: Our findings suggest that what is known about the relationship between identity and health outcomes after adult-onset cancer cannot be generalized to pediatric cancers, and that clinicians should not assume survivor identity is associated with better health outcomes in this group.
Collapse
Affiliation(s)
- Lydia L Chevalier
- Perini Family Survivors' Center, Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Eric K Zwemer
- Perini Family Survivors' Center, Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Robert Casey
- Perini Family Survivors' Center, Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christopher J Recklitis
- Perini Family Survivors' Center, Department of Pediatric Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
11
|
Collins P, O'Connell C, Omer SA, Inder MS, Madden A, Smyth L, Casey R, Manecksha R, Thomas A, Browne R, O'Neill A, Tierney S, Flynn R. 401 Three Birds with One Stone: Ureteric Calculus Precipitates Diagnosis and Resection of Three Primary Neoplasms. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.271] [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: 11/13/2022]
Abstract
Abstract
A 67 year-old female presented to our centre with a 2 day history of right flank pain, clinically suggestive of ureteric colic. Computed tomography (CT) confirmed a 6mm right ureteric calculus. However, CT also revealed a large 13cm ipsilateral renal mass, concerning for renal cell carcinoma (RCC). At ureteroscopy for management of the obstructing calculus, a small papillary lesion was noted in the bladder, and excised. Histology confirmed pTa low-grade transitional cell carcinoma.
Following discussion at the Urology multidisciplinary tumour board, MRI venogram (MRV) was recommended to delineate the extension of tumour into the renal vein, and to characterise a pelvic mass seen on original CT. MRV showed enhancing material extending into the IVC, consistent with tumour thrombus. However, it also identified a concerning 6cm solid ovarian mass.
The patient proceeded to open right radical nephrectomy and IVC thrombectomy, hysterectomy, bilateral salpingo-oopherectomy, and omental biopsy, with combined input from Urological, Gynaecological and Vascular surgical teams. Post-operative course was uneventful. Histology showed an 11cm pT3a G2 clear cell RCC, and 7.5cm ovarian fibroma, both fully excised. This case demonstrated the serendipity of a simple ureteric calculus precipitating a cascade of investigations, that ultimately led to complete resection of three primary neoplasms.
Collapse
Affiliation(s)
- P Collins
- Tallaght University Hospital, Dublin, Ireland
| | - C O'Connell
- Tallaght University Hospital, Dublin, Ireland
| | - S A Omer
- Tallaght University Hospital, Dublin, Ireland
| | - M S Inder
- Tallaght University Hospital, Dublin, Ireland
| | - A Madden
- Tallaght University Hospital, Dublin, Ireland
| | - L Smyth
- Tallaght University Hospital, Dublin, Ireland
| | - R Casey
- Tallaght University Hospital, Dublin, Ireland
| | - R Manecksha
- Tallaght University Hospital, Dublin, Ireland
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - A Thomas
- Tallaght University Hospital, Dublin, Ireland
| | - R Browne
- Tallaght University Hospital, Dublin, Ireland
| | - A O'Neill
- Tallaght University Hospital, Dublin, Ireland
| | - S Tierney
- Tallaght University Hospital, Dublin, Ireland
| | - R Flynn
- Tallaght University Hospital, Dublin, Ireland
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
12
|
Singh R, Creamer A, Jesus DD, Chavez M, Pudlo M, Bionat S, Casey R, Dumlao N, Salgado B, Saldana R, Bhimaraj A. Improvement In Post Discharge Appointment Scheduling For Patients with Heart Failure Using A Designated Scheduler. J Card Fail 2020. [DOI: 10.1016/j.cardfail.2020.09.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Kennedy K, Cal R, Casey R, Lopez C, Adelfio A, Molloy B, Wall AM, Holton TA, Khaldi N. The anti-ageing effects of a natural peptide discovered by artificial intelligence. Int J Cosmet Sci 2020; 42:388-398. [PMID: 32453870 DOI: 10.1111/ics.12635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/20/2020] [Revised: 04/08/2020] [Accepted: 05/20/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE As skin ages, impaired extracellular matrix (ECM) protein synthesis and increased action of degradative enzymes manifest as atrophy, wrinkling and laxity. There is mounting evidence for the functional role of exogenous peptides across many areas, including in offsetting the effects of cutaneous ageing. Here, using an artificial intelligence (AI) approach, we identified peptide RTE62G (pep_RTE62G), a naturally occurring, unmodified peptide with ECM stimulatory properties. The AI-predicted anti-ageing properties of pep_RTE62G were then validated through in vitro, ex vivo and proof of concept clinical testing. METHODS A deep learning approach was applied to unlock pep_RTE62G from a plant source, Pisum sativum (pea). Cell culture assays of human dermal fibroblasts (HDFs) and keratinocytes (HaCaTs) were subsequently used to evaluate the in vitro effect of pep_RTE62G. Distinct activities such as cell proliferation and ECM protein production properties were determined by ELISA assays. Cell migration was assessed using a wound healing assay, while ECM protein synthesis and gene expression were analysed, respectively, by immunofluorescence microscopy and PCR. Immunohistochemistry of human skin explants was employed to further investigate the induction of ECM proteins by pep_RTE62G ex vivo. Finally, the clinical effect of pep_RTE626 was evaluated in a proof of concept 28-day pilot study. RESULTS In vitro testing confirmed that pep_RTE62G is an effective multi-functional anti-ageing ingredient. In HaCaTs, pep_RTE62G treatment significantly increases both cellular proliferation and migration. Similarly, in HDFs, pep_RTE62G consistently induced the neosynthesis of ECM protein elastin and collagen, effects that are upheld in human skin explants. Lastly, in our proof of concept clinical study, application of pep_RTE626 over 28 days demonstrated anti-wrinkle and collagen stimulatory potential. CONCLUSION pep_RTE62G represents a natural, unmodified peptide with AI-predicted and experimentally validated anti-ageing properties. Our results affirm the utility of AI in the discovery of novel, functional topical ingredients.
Collapse
Affiliation(s)
- K Kennedy
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - R Cal
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - R Casey
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - C Lopez
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - A Adelfio
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - B Molloy
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - A M Wall
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - T A Holton
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| | - N Khaldi
- Nuritas Ltd, Joshua Dawson House, Dawson St, Dublin 2, D02 RY95, Ireland
| |
Collapse
|
14
|
Brisset JC, Kremer S, Hannoun S, Bonneville F, Durand-Dubief F, Tourdias T, Barillot C, Guttmann C, Vukusic S, Dousset V, Cotton F, Ameli R, Anxionnat R, Audoin B, Attye A, Bannier E, Barillot C, Ben Salem D, Boncoeur-Martel MP, Bonhomme G, Bonneville F, Boutet C, Brisset J, Cervenanski F, Claise B, Commowick O, Constans JM, Cotton F, Dardel P, Desal H, Dousset V, Durand-Dubief F, Ferre JC, Gaultier A, Gerardin E, Glattard T, Grand S, Grenier T, Guillevin R, Guttmann C, Krainik A, Kremer S, Lion S, Champfleur NMD, Mondot L, Outteryck O, Pyatigorskaya N, Pruvo JP, Rabaste S, Ranjeva JP, Roch JA, Sadik JC, Sappey-Marinier D, Savatovsky J, Stankoff B, Tanguy JY, Tourbah A, Tourdias T, Brochet B, Casey R, Cotton F, De Sèze J, Douek P, Guillemin F, Laplaud D, Lebrun-Frenay C, Mansuy L, Moreau T, Olaiz J, Pelletier J, Rigaud-Bully C, Stankoff B, Vukusic S, Debouverie M, Edan G, Ciron J, Lubetzki C, Vermersch P, Labauge P, Defer G, Berger E, Clavelou P, Gout O, Thouvenot E, Heinzlef O, Al-Khedr A, Bourre B, Casez O, Cabre P, Montcuquet A, Créange A, Camdessanché JP, Bakchine S, Maurousset A, Patry I, De Broucker T, Pottier C, Neau JP, Labeyrie C, Nifle C. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol 2020; 47:250-258. [DOI: 10.1016/j.neurad.2020.01.083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023]
|
15
|
Nash E, Brokaar E, Casey R, Castellani C, Cotton C, Doe S, Duckers J, Edenborough F, Faulkner R, Garavaglia L, Hadjiliadis D, Singh C, Sutharsan S, Taylor-Cousar J. WS12-2-1 Pregnancy outcomes in women with cystic fibrosis on ivacaftor - an international survey. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30186-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
16
|
Glaser A, Stahmann A, Meissner T, Flachenecker P, Horáková D, Zaratin P, Brichetto G, Pugliatti M, Rienhoff O, Vukusic S, de Giacomoni A, Battaglia M, Brola W, Butzkueven H, Casey R, Drulovic J, Eichstädt K, Hellwig K, Iaffaldano P, Ioannidou E, Kuhle J, Lycke K, Magyari M, Malbaša T, Middleton R, Myhr K, Notas K, Orologas A, Otero-Romero S, Pekmezovic T, Sastre-Garriga J, Seeldrayers P, Soilu-Hänninen M, Stawiarz L, Trojano M, Ziemssen T, Hillert J, Thalheim C. Multiple sclerosis registries in Europe – An updated mapping survey. Mult Scler Relat Disord 2019; 27:171-178. [DOI: 10.1016/j.msard.2018.09.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 09/30/2018] [Indexed: 01/25/2023]
|
17
|
Leray E, Roux J, Rollot F, Casey R, de Sèze J, Laplaud D, Vukusic S. Quelle utilisation des traitements de fond chez des patients ayant une sclérose en plaques rémittente en France sur la période 1990–2017 ? Étude des données de l’Observatoire français de la SEP. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.033] [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: 10/16/2022] Open
|
18
|
Laplaud DA, Barbin L, Casey R, Debouverie M, Vukusic S, Labauge P, Brassat D, Wiertlewski S, De Seze J, Edan G, Brochet B, Moreau T, Berger E, Clavelou P, Castelnovo G, Ciron J, Pelletier J, Bourre B, Lubetzki C, Al Khedr A, Vermersch P, Lebrun-Frenay C, Defer G, Tourbah A, Camdessanche JP, Stankoff B, Labeyrie C, Patry I, Creange A, Gout O, Heinzlef O, Casez O, Magy L, Guennoc AM, De Broucker T, Nifle C, Dupel-Pottier C, Leray E, Rollot F, Foucher Y. Efficacité comparée du Teriflunomide et du Dimethyl-Fumarate : une étude observationnelle française multicentrique. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.009] [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: 10/16/2022] Open
|
19
|
Plemmons G, Hall M, Doupnik S, Gay J, Brown C, Browning W, Casey R, Freundlich K, Johnson DP, Lind C, Rehm K, Thomas S, Williams D. Hospitalization for Suicide Ideation or Attempt: 2008-2015. Pediatrics 2018; 141:peds.2017-2426. [PMID: 29769243 DOI: 10.1542/peds.2017-2426] [Citation(s) in RCA: 227] [Impact Index Per Article: 37.8] [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] [Accepted: 03/09/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Suicide ideation (SI) and suicide attempts (SAs) have been reported as increasing among US children over the last decade. We examined trends in emergency and inpatient encounters for SI and SA at US children's hospitals from 2008 to 2015. METHODS We used retrospective analysis of administrative billing data from the Pediatric Health Information System database. RESULTS There were 115 856 SI and SA encounters during the study period. Annual percentage of all visits for SI and SA almost doubled, increasing from 0.66% in 2008 to 1.82% in 2015 (average annual increase 0.16 percentage points [95% confidence intervals (CIs) 0.15 to 0.17]). Significant increases were noted in all age groups but were higher in adolescents 15 to 17 years old (average annual increase 0.27 percentage points [95% CI 0.23 to 0.30]) and adolescents 12 to 14 years old (average annual increase 0.25 percentage points [95% CI 0.21 to 0.27]). Increases were noted in girls (average annual increase 0.14 percentage points [95% CI 0.13 to 0.15]) and boys (average annual increase 0.10 percentage points [95% CI 0.09 to 0.11]), but were higher for girls. Seasonal variation was also observed, with the lowest percentage of cases occurring during the summer and the highest during spring and fall. CONCLUSIONS Encounters for SI and SA at US children's hospitals increased steadily from 2008 to 2015 and accounted for an increasing percentage of all hospital encounters. Increases were noted across all age groups, with consistent seasonal patterns that persisted over the study period. The growing impact of pediatric mental health disorders has important implications for children's hospitals and health care delivery systems.
Collapse
Affiliation(s)
- Gregory Plemmons
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee;
| | - Matthew Hall
- Children's Hospital Association, Lenexa, Kansas; and
| | | | - James Gay
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Charlotte Brown
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Whitney Browning
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert Casey
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Katherine Freundlich
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David P Johnson
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Carrie Lind
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kris Rehm
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Susan Thomas
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Derek Williams
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
20
|
Zarnegar S, Gosiengfiao Y, Rademaker A, Casey R, Albritton KH. Recall of Fertility Discussion by Adolescent Female Cancer Patients: A Survey-Based Pilot Study. J Adolesc Young Adult Oncol 2017; 7:249-253. [PMID: 29058500 DOI: 10.1089/jayao.2017.0079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Many adolescent female cancer patients will survive into their reproductive years. Pediatric oncologists are advised to discuss oncofertility during treatment planning. In this pilot study, 19 adolescent females completed a retrospective survey assessing recall of a fertility discussion, satisfaction with fertility knowledge, and multiple factors that may influence recall, including parental involvement in decision-making. Eleven respondents (58%) remembered a discussion about infertility risk and 9 (47%) about fertility preservation. Most who recalled a discussion were satisfied with their fertility knowledge (10/11, 90.9%). In this study, we validated the feasibility of survey administration and identified trends in oncofertility counseling at our center.
Collapse
Affiliation(s)
- Sara Zarnegar
- 1 Department of Pediatrics, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Yasmin Gosiengfiao
- 2 Pediatric Hematology, Oncology & Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago, Illinois
| | - Alfred Rademaker
- 3 Department of Preventive Medicine, Northwestern University Feinberg School of Medicine , Chicago, Illinois
| | - Robert Casey
- 4 Center for Cancer and Blood Disorders , Children's Hospital Colorado, Aurora, Colorado
| | - Karen H Albritton
- 5 Department of Hematology and Oncology, Cook Children's Hospital , Fort Worth, Texas
| |
Collapse
|
21
|
Casey R, Griffin TP, Wall D, Dennedy MC, Bell M, O'Shea PM. Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted/seated patients. Ann Clin Biochem 2016; 54:170-173. [PMID: 27166307 DOI: 10.1177/0004563216646395] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The Endocrine Society Clinical Practice Guideline on Phaeochomocytoma and Paraganglioma recommends phlebotomy for plasma-free metanephrines with patients fasted and supine using appropriately defined reference intervals. Studies have shown higher diagnostic sensitivities using these criteria. Further, with seated-sampling protocols, for result interpretation, reference intervals that do not compromise diagnostic sensitivity should be employed. Objective To determine the impact on diagnostic performance and financial cost of using supine reference intervals for result interpretation with our current plasma-free metanephrines fasted/seated-sampling protocol. Methods We conducted a retrospective cohort study of patients who underwent screening for PPGL using plasma-free metanephrines from 2009 to 2014 at Galway University Hospitals. Plasma-free metanephrines were measured using liquid chromatography-tandem mass spectrometry. Supine thresholds for plasma normetanephrine and metanephrine set at 610 pmol/L and 310 pmol/L, respectively, were used. Results A total of 183 patients were evaluated. Mean age of participants was 53.4 (±16.3) years. Five of 183 (2.7%) patients had histologically confirmed PPGL (males, n=4). Using seated reference intervals for plasma-free metanephrines, diagnostic sensitivity and specificity were 100% and 98.9%, respectively, with two false-positive cases. Application of reference intervals established in subjects supine and fasted to this cohort gave diagnostic sensitivity of 100% with specificity of 74.7%. Financial analysis of each pretesting strategy demonstrated cost-equivalence (€147.27/patient). Conclusion Our cost analysis, together with the evidence that fasted/supine-sampling for plasma-free metanephrines, offers more reliable exclusion of PPGL mandates changing our current practice. This study highlights the important advantages of standardized diagnostic protocols for plasma-free metanephrines to ensure the highest diagnostic accuracy for investigation of PPGL.
Collapse
Affiliation(s)
- R Casey
- 1 Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland
| | - T P Griffin
- 1 Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland
| | - D Wall
- 2 School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland
| | - M C Dennedy
- 1 Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland.,3 Discipline of Pharmacology & Therapeutics, School of Medicine, National University of Ireland, Galway, Ireland
| | - M Bell
- 1 Department of Endocrinology, Centre of Diabetes, Endocrinology and Metabolism, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland
| | - P M O'Shea
- 4 Department of Clinical Biochemistry, Galway University Hospitals & Saolta Hospital Group, Galway, Ireland
| |
Collapse
|
22
|
Confavreux CB, Casey R, Varennes A, Goudable J, Chapurlat RD, Szulc P. Has sclerostin a true endocrine metabolic action complementary to osteocalcin in older men? Osteoporos Int 2016; 27:2301-2309. [PMID: 27007475 DOI: 10.1007/s00198-016-3540-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/13/2015] [Accepted: 02/11/2016] [Indexed: 01/27/2023]
Abstract
UNLABELLED The reported association between sclerostin and diabetes mellitus or abdominal fat may be biased by body size and bone mass. In older men, the association between serum sclerostin levels and metabolic syndrome lost significance after adjustment for bone mass. The association between sclerostin and energy metabolism needs further clarification. INTRODUCTION Sclerostin is associated with abdominal fat, but this relationship may be biased since both are associated with body size and bone mass. Osteocalcin is a bone-derived hormone regulating energy metabolism. We assessed the association between serum sclerostin and metabolic syndrome (MetS) accounting for whole body mineral content (BMC) and osteocalcin. METHODS We studied 694 men aged 51-85 who had serum osteocalcin and sclerostin measurements. RESULTS Sclerostin was higher in 216 men with MetS compared with those without MetS (p < 0.005). Average sclerostin level increased significantly across the increasing number of MetS components. In multivariable models, higher sclerostin was associated with higher odds of MetS (odds ratio (OR) = 1.24/1 standard deviation (SD) increase [95 % confidence interval (95 % CI), 1.01-1.51]; p < 0.05). After further adjustment for BMC, the association of MetS with sclerostin lost significance, whereas that with osteocalcin remained significant. Men who were simultaneously in the highest sclerostin quartile and the lowest osteocalcin quartile had higher odds of MetS (OR = 2.14 [95 % CI, 1.15-4.18]; p < 0.05) vs. men being in the three lower sclerostin quartiles and three upper osteocalcin quartiles. After adjustment for whole body BMC, the association lost significance. CONCLUSIONS Higher sclerostin level is associated with MetS severity; however, this association may be related to higher whole body BMC. The adjustment for BMC had no impact on the association between MetS and osteocalcin. Clinical cross-sectional studies do not elucidate the potential role of sclerostin in the regulation of energy metabolism and direct experimental approach is necessary.
Collapse
Affiliation(s)
- C B Confavreux
- INSERM UMR1033 - Université de Lyon, Department of Rheumatology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69003, France.
| | - R Casey
- OFSEP-Université de Lyon, Hospices Civils de Lyon, Lyon, 69003, France
| | - A Varennes
- Université de Lyon, Central Biochemical Laboratory, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69003, France
| | - J Goudable
- INSERM UMR1060 - Université de Lyon, Lyon, France
| | - R D Chapurlat
- INSERM UMR1033 - Université de Lyon, Department of Rheumatology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69003, France
| | - P Szulc
- INSERM UMR1033 - Université de Lyon, Department of Rheumatology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, 69003, France
| |
Collapse
|
23
|
Mongan AM, Lynam-Lennon N, Casey R, Maher S, Pidgeon G, Reynolds JV, O'Sullivan J. Visceral obesity stimulates anaphase bridge formation and spindle assembly checkpoint dysregulation in radioresistant oesophageal adenocarcinoma. Clin Transl Oncol 2015; 18:632-40. [PMID: 26474871 DOI: 10.1007/s12094-015-1411-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/14/2015] [Indexed: 01/04/2023]
Abstract
PURPOSE Oesophageal adenocarcinoma is an exemplar model of obesity-associated cancer. Locally advanced disease is treated with neoadjuvant chemoradiotherapy, and survival rates are highest in patients demonstrating a pathological response following neoadjuvant therapy. Given that 55 % of oesophageal adenocarcinoma patients are obese, uncovering the effect of adipose tissue on radioresponse is clinically relevant. This study investigates if adipose tissue activates genomic instability events in radioresponsive (OE33P) and radioresistant (OE33R) oesophageal cancer cell lines and tumour samples. METHODS OE33R and OE33P were cultured with adipose-conditioned media derived from oesophageal adenocarcinoma patients (n = 10). Anaphase bridges, a marker of genomic instability, were enumerated in both cell lines following treatment with adipose media, and normalised to cell number. Genomic instability is regulated by the spindle assembly complex. Expression of two spindle assembly complex genes (MAD2L2, BUB1B) was assessed using qPCR, and validated in patient tumour specimens from viscerally obese (n = 46) and nonobese patients (n = 41). RESULTS Adipose-conditioned media increased anaphase bridging in OE33R (p < 0.0001), with a threefold increase in OE33R compared to OE33P (p < 0.01). Levels of anaphase bridges in OE33R cells correlated with visceral obesity status as measured by waist circumference (R = 0.709, p = 0.03) and visceral fat area (R = 0.794, p = 0.006). Adipose tissue altered expression of MAD2L2 in vitro. In vivo, MAD2L2 expression was higher in viscerally obese oesophageal adenocarcinoma patients compared with nonobese patients (p < 0.05). CONCLUSIONS Anaphase bridge levels are influenced by obesity and radiosensitivity status in oesophageal adenocarcinoma. Furthermore, visceral adipose-conditioned media stimulates dysregulation of the spindle assembly complex in oesophageal adenocarcinoma patients.
Collapse
Affiliation(s)
- A M Mongan
- Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - N Lynam-Lennon
- Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - R Casey
- Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - S Maher
- Cancer Biology & Therapeutics Lab, School of Biological, Biomedical & Environmental Sciences, University of Hull, Cottingham road, Hull, HU6 76X, UK
| | - G Pidgeon
- Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - J V Reynolds
- Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - J O'Sullivan
- Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland.
| |
Collapse
|
24
|
Garrahy A, Casey R, Wall D, Bell M, O'Shea PM. A review of the management of positive biochemical screening for phaeochromocytoma and paraganglioma: a salutary tale. Int J Clin Pract 2015; 69:802-9. [PMID: 25651433 DOI: 10.1111/ijcp.12612] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Phaeochromocytomas (PC) and paragangliomas (PGL) are rare neuroendocrine tumours of chromaffin cells. Diagnosis depends on biochemical evidence of excessive production of catecholamines. This is straightforward when test results are orders of magnitude above the concentrations expected in healthy individuals and those with essential hypertension. Equivocal results pose a management dilemma. AIM We reviewed biochemical screens that were positive and the ensuing management for PC/PGL at our institution. The objective was to inform the development of a standardised approach to investigation and clinical follow-up. METHOD All records of positive biochemical screening for PC/PGL were extracted from the laboratory information system between January 2004 and June 2012. Clinical notes of patients with positive results were reviewed. RESULTS A total of 2749 biochemical screens were performed during the evaluation period. Of these, 106 (3.9%) performed on 82 patients were positive. Chart review determined that 12/82 patients had histologically confirmed PC/PG. Of the 70 patients remaining, the most common indication for biochemical screening was hypertension and the medical subspecialty most frequently requesting the test was Endocrinology. The primary team carried out repeat testing on 35/70 (50%) patients and in 29 results normalised. Notably, 35/70 (50%) patients did not have any follow-up of positive test results. CONCLUSION This study highlights the necessity for a standardised diagnostic protocol for PC/PGL. We suggest that appropriate follow-up of borderline-elevated results should first include repeat biochemical testing. This should be performed under standardised pre-analytical conditions and where possible off all potentially interfering medications, measuring plasma free metadrenalines.
Collapse
Affiliation(s)
- A Garrahy
- Department of Endocrinology, Galway University Hospital, Galway, Ireland
| | - R Casey
- Department of Endocrinology, Galway University Hospital, Galway, Ireland
| | - D Wall
- School of Mathematics, Statistics and Applied Maths, National University of Ireland Galway (NUIG), Galway, Ireland
| | - M Bell
- Department of Endocrinology, Galway University Hospital, Galway, Ireland
| | - P M O'Shea
- Department of Clinical Biochemistry, Galway University Hospital, Galway, Ireland
| |
Collapse
|
25
|
Casey R, O'Hara MC, Cunningham A, Wall D, Geoghegan R, Hynes L, McGuire B, Gately M, Bell M, Dinneen SF. Young adult type 1 diabetes care in the West of Ireland: an audit of hospital practice. QJM 2014; 107:903-8. [PMID: 24925824 DOI: 10.1093/qjmed/hcu103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It is well recognised that management of young adults with type 1 diabetes (T1DM) poses difficult challenges for physicians and health care organisations as a whole. In Ireland and in particular the west of Ireland there has been little audit or research on young adults with T1DM and the services available to them. DESIGN In 2011 a retrospective review of this patient population in our territory referral centre was carried out. RESULTS The average glycaemic control in this population was poor at 81mmols/mol and diabetes related complications were present in 32%. Engagement by this population with services was poor with an average of 3 missed clinic appointments over a 24 month period. CONCLUSION These results have prompted a re think of how health care professionals can deliver a service that better suits the needs of this challenging patient group.
Collapse
Affiliation(s)
- R Casey
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - M C O'Hara
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - A Cunningham
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - D Wall
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - R Geoghegan
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - L Hynes
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - B McGuire
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - M Gately
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - M Bell
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| | - S F Dinneen
- From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland From the Endocrinology and Diabetes Centre, Galway University Hospitals, Galway, Ireland, School of Medicine, NUI Galway, Galway, Ireland, School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland, Department of Paediatrics, Galway University Hospitals, Galway, Ireland and School of Psychology, NUI Galway, Galway, Ireland
| |
Collapse
|
26
|
Sirrs SM, Bichet DG, Casey R, Clarke JTR, Lemoine K, Doucette S, West ML. Outcomes of patients treated through the Canadian Fabry disease initiative. Mol Genet Metab 2014; 111:499-506. [PMID: 24534763 DOI: 10.1016/j.ymgme.2014.01.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [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: 12/12/2013] [Revised: 01/28/2014] [Accepted: 01/28/2014] [Indexed: 01/19/2023]
Abstract
BACKGROUND The Canadian Fabry disease initiative (CFDI) tracks outcomes of subjects with Fabry disease treated enzyme replacement therapy (ERT) given to subjects who meet evidence-based treatment guidelines and cardiovascular risk factor modification. METHODS We report 5 year follow-up data on 362 subjects for a composite endpoint (death, neurologic or cardiovascular events, development of end-stage renal disease or sustained increase in serum creatinine of 50% from baseline). RESULTS At enrollment, 86 subjects had previously received ERT (Cohort 1a) and 67 subjects were newly started (Cohort 1b) and randomized to agalsidase alfa or agalsidase beta. 209 subjects did not initially meet ERT criteria (Cohort 1c), 25 of whom met ERT criteria in follow-up and were moved to Cohort 1b (total N=178 ERT treated subjects). Use of supportive therapies such as aspirin (78%), renin-angiotensin blockade (59%), and statins (55%) was common in ERT treated subjects. In Cohort 1a, 32 subjects met the composite endpoint with 8 deaths. In Cohort 1b, 16 subjects met the composite endpoint with 1 death. Cohort 1b had fewer clinical events than Cohort 1a (p=0.039) suggesting that the treatment protocol was effective in targeting subjects at an earlier stage. 19.4% of Cohort 1b subjects on agalsidase alfa and 13.3% on agalsidase beta had a clinical event (p=0.57). 10 Cohort 1c subjects had clinical events, none of which would have been prevented by earlier use of ERT. CONCLUSIONS Cardiovascular risk factor modification and targeted use of ERT reduce the risk of adverse outcomes related to Fabry disease.
Collapse
Affiliation(s)
- S M Sirrs
- Department of Medicine University of British Columbia, Canada.
| | - D G Bichet
- Department of Medicine University of Montreal, Canada
| | - R Casey
- Department of Pediatrics University of Calgary, Canada
| | - J T R Clarke
- Department of Pediatrics, Hospital for Sick Children and Centre Hospitalier Universitaire de Sherbrooke, Canada
| | - K Lemoine
- Department of Pediatrics, Capital District Health Authority, Canada
| | - S Doucette
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - M L West
- Department of Medicine Dalhousie University, Canada
| |
Collapse
|
27
|
Gorecka M, Scott J, Casey R, Breen D. The journey of mesothelioma: from postmortem to FNA. BMJ Case Rep 2014; 2014:bcr-2013-203013. [PMID: 24515241 DOI: 10.1136/bcr-2013-203013] [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: 11/03/2022] Open
Abstract
A 73-year-old man, non-smoker presented with an 8-week history of left-sided chest pain and shortness of breath on exertion. He had no significant medical history. He worked in construction for 40 years, but denied definite asbestos exposure. His initial chest X-ray demonstrated a large left-sided pleural effusion. Subsequent CT thorax revealed circumferential thickening of the pleura with associated pleural plaques and calcification. A provisional diagnosis of mesothelioma was made. Initial ultrasound-guided thoracocentesis revealed a transudate with negative cytology. In addition, thoracoscopy and CT-guided pleural biopsy failed to obtain a definitive diagnosis. A surgical biopsy was planned, but at the time of admission, the patient developed unilateral neck swelling. Ultrasound-guided fine-needle aspiration (FNA) and core biopsies of the lymph node were diagnostic for pleural mesothelioma. Treatment with palliative chemotherapy was planned, but the patient's clinical status rapidly deteriorated and he passed away prior to the beginning of therapy.
Collapse
Affiliation(s)
- M Gorecka
- Interventional Respiratory Unit, Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland
| | | | | | | |
Collapse
|
28
|
Casey R, Slattery D, Prendeville S, Moore M, Maher M, O'Halloran D. SDHB gene positive metastatic paraganglioma associated with lesions which demonstrate both positive and negative uptake of 18FDG PET and 131MIBG. QJM 2013; 106:1035-7. [PMID: 23708795 DOI: 10.1093/qjmed/hct118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Casey
- Department of Endocrinology, Cork University Hospital, Cork, Ireland.
| | | | | | | | | | | |
Collapse
|
29
|
Casey R, Prendeville S, Joyce C, O'Halloran D. First reported case in Ireland of MEN2A due to a rare mutation in exon 8 of the RET oncogene. Endocrinol Diabetes Metab Case Rep 2013; 2013:130044. [PMID: 24616773 PMCID: PMC3922143 DOI: 10.1530/edm-13-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Revised: 08/11/2013] [Accepted: 08/23/2013] [Indexed: 11/24/2022] Open
Abstract
We present the case of a 30-year-old female who was diagnosed with hereditary phaeochromocytoma secondary to a rare gene mutation in exon 8 of the RET oncogene. This genetic mutation was picked up as part of an extended genetic screen using a method known as next generation sequencing. Detection of this genetic mutation prompted further screening for the manifestation of multiple endocrine neoplasia type 2A (MEN2A). The patient subsequently underwent a thyroidectomy with histology confirming C-cell hyperplasia.
Collapse
Affiliation(s)
- R Casey
- Department of Endocrinology Cork University Hospital Cork Ireland
| | - S Prendeville
- Department of Pathology Cork University Hospital Cork Ireland
| | - C Joyce
- Department of Biochemistry Cork University Hospital Cork Ireland
| | - D O'Halloran
- Department of Endocrinology Cork University Hospital Cork Ireland
| |
Collapse
|
30
|
Casey R, Bell M, Keane M, Smyth A. An unusual presentation of MEN2A. BMJ Case Rep 2013; 2013:bcr-2012-007171. [PMID: 23749818 DOI: 10.1136/bcr-2012-007171] [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: 11/04/2022] Open
Abstract
A 35-year-old woman presented with non-specific symptoms of fatigue and weight loss. Radiological investigations diagnosed a metastatic process and large bilateral adrenal masses. Histology from a liver biopsy and skin biopsy confirmed a diagnosis of metastatic medullary thyroid cancer. Further biochemical investigations revealed a positive 24-h urinary metanephrine collection and evidence of primary hyperparathyroidism. Genetic testing confirmed a mutant RET oncogene, confirming our clinical suspicion of multiple endocrine neoplasia type 2 (MEN2A) syndrome. The patient had no family history of endocrine disease and presented with widespread metastatic disease, making this an unusual presentation of MEN2A syndrome. Furthermore cutaneous metastases are rarely encountered in conjunction with metastatic medullary thyroid cancer. This case draws attention to the importance of genetic counselling in first-degree relatives of patients with confirmed MEN2A. This allows for timely diagnosis and reduced morbidity and mortality.
Collapse
Affiliation(s)
- R Casey
- Department of Medicine, University Hospital Galway, Galway, Ireland.
| | | | | | | |
Collapse
|
31
|
McDermott AM, Kidd P, Gately M, Casey R, Burke H, O'Donnell P, Kirrane F, Dinneen SF, O'Brien T. Restructuring of the Diabetes Day Centre: a pilot lean project in a tertiary referral centre in the West of Ireland. BMJ Qual Saf 2013; 22:681-8. [DOI: 10.1136/bmjqs-2012-001676] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
West M, Bichet D, Casey R, Clarke J, Sirrs S, LeMoine K, Auray-Blais C. P19—Influence of Anti-Agalsidase Antibodies on Clinical Outcomes in the Canadian Fabry Disease Initiative Study. Clin Ther 2012. [DOI: 10.1016/j.clinthera.2012.03.048] [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: 10/28/2022]
|
33
|
West M, Bichet D, Casey R, Clarke J, Sirrs S, LeMoine K, Auray-Blais C. P18—Agalsidase Alfa and Agalsidase Beta have Similar Effects on Outcomes in Fabry Disease: Results From the Canadian Fabry Disease Initiative. Clin Ther 2012. [DOI: 10.1016/j.clinthera.2012.03.047] [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: 10/28/2022]
|
34
|
Gallego G, Casey R, Norman R, Goodall S. Introduction and uptake of new medical technologies in the Australian health care system: A qualitative study. Health Policy 2011; 102:152-8. [DOI: 10.1016/j.healthpol.2011.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 03/25/2011] [Accepted: 04/20/2011] [Indexed: 11/16/2022]
|
35
|
Hothersall B, Casey R. Undesired behaviour in horses: A review of their development, prevention, management and association with welfare. EQUINE VET EDUC 2011. [DOI: 10.1111/j.2042-3292.2011.00296.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
36
|
Lysaght J, van der Stok EP, Allott EH, Casey R, Donohoe CL, Howard JM, McGarrigle SA, Ravi N, Reynolds JV, Pidgeon GP. Pro-inflammatory and tumour proliferative properties of excess visceral adipose tissue. Cancer Lett 2011; 312:62-72. [PMID: 21890265 DOI: 10.1016/j.canlet.2011.07.034] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 07/25/2011] [Accepted: 07/30/2011] [Indexed: 01/09/2023]
Abstract
Obesity has been associated with increased incidence and mortality of oesophageal and colorectal adenocarcinoma. Excess central adiposity may drive this association through an altered inflammatory milieu. Utilising a unique adipose tissue bioresource we aimed to determine the pro-tumour properties of visceral adipose tissue. Comparing subcutaneous and visceral adipose tissue depots, we observed significantly higher levels of VEGF and IL-6, along with significantly higher proportions of CD8(+) T cells and NKT cells in visceral adipose tissue. Significantly higher levels of VEGF were observed in the conditioned media from visceral adipose tissue of centrally obese compared to non-obese patients. We also report a significant increase in oesophageal and colorectal tumour cell proliferation following culture with conditioned media from visceral adipose tissue of centrally obese patients. Neutralising VEGF in the conditioned media significantly decreased tumour cell proliferation. This novel report highlights a potential mechanism whereby visceral adipose tissue from centrally obese cancer patients may drive tumour progression.
Collapse
Affiliation(s)
- J Lysaght
- Department of Surgery, Institute of Molecular Medicine, University of Dublin, Trinity College and St. James's Hospital Dublin, Dublin 8, Ireland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Schmidt A, Casey R, Schappell E, Thumar B, Bartlett E, Nutt A, Collins P, Murphy B, Karron R. Klinische Evaluierung neuer rekombinanter Lebendimpfstoffe gegen die Humanen Parainfluenzaviren Typ 1, 2 und 3 (HPIV1–3). Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
38
|
Sirrs S, Clarke JTR, Bichet DG, Casey R, Lemoine K, Flowerdew G, Sinasac DS, West ML. Baseline characteristics of patients enrolled in the Canadian Fabry Disease Initiative. Mol Genet Metab 2010; 99:367-73. [PMID: 20022777 DOI: 10.1016/j.ymgme.2009.11.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 11/10/2009] [Accepted: 11/10/2009] [Indexed: 01/06/2023]
Abstract
The Canadian Fabry Disease Initiative [CFDI] is a longitudinal study evaluating all Canadians diagnosed with Fabry disease [FD]. The study has 3 cohorts: Cohort 1A which includes 81 subjects who were on enzyme replacement therapy [ERT] prior to October 2006, Cohort 1B which has ongoing enrolment of subjects newly started on ERT who are randomized to agalsidase alfa or agalsidase beta, and Cohort 1C where subjects who do not meet nationally accepted Canadian criteria for ERT are followed to assess the natural history of disease complications. The study currently enrols 244 patients [95 males and 149 females] with a mean age of 41.9+/-14.5years. There is a high prevalence of the c.427G>C mutation. Cohort 1A contains 82 patients [59 males, 23 females] of whom 42% are known to have cardiac complications of FD and 38% renal complications. Cohort 1B at the time of writing contained 37 patients [15 males, 22 females] of whom the indications for ERT were cardiac in 55% and renal in 60%. Cohort 1C at the time of writing contained 125 patients [22 males, 103 females]. Enrolment is ongoing in both Cohorts 1B and 1C. When compared to subjects in the Fabry Outcome Survey and the Fabry Registry, subjects in the CFDI are less likely to be male reflecting less ascertainment bias. The CFDI is a robust national data set that will contribute to available data on the natural history of FD and on the comparative efficacy of the two commercially available ERT products.
Collapse
Affiliation(s)
- S Sirrs
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | | | | | | | | | | | | | | |
Collapse
|
39
|
Charreire H, Casey R, Salze P, Kesse-Guyot E, Simon C, Chaix B, Banos A, Badariotti D, Touvier M, Weber C, Oppert JM. Leisure-time physical activity and sedentary behavior clusters and their associations with overweight in middle-aged French adults. Int J Obes (Lond) 2010; 34:1293-301. [PMID: 20195284 DOI: 10.1038/ijo.2010.39] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To identify leisure-time physical activity (LTPA) and sedentary behavior patterns, as well as to investigate their relationships with overweight. DESIGN Cross-sectional study. SUBJECTS Men (n=2206) and women (n=2476) aged >45 years, living in France, enrolled in the SU.VI.MAX (Supplémentation en VItamines et Minéraux AntioXydants) study. MEASUREMENTS LTPA and sedentary behavior were assessed using the Modifiable Activity Questionnaire whereas weight and height were measured from study participants. Clusters were defined, by gender, with multiple correspondence analysis and cluster analysis successively, taking into account the type (walking, gardening, etc.) and duration of each physical activity performed, as well as the time spent watching television (TV) as typical sedentary behavior. Logistic regression models were used to assess associations with overweight. RESULTS Four physical activity and sedentary behavior clusters were identified among men and three among women. We chose as referent cluster the cluster associating 'walking and gardening-low TV' in men and the cluster associating 'walking and gardening-high TV' in women. Compared with the referent cluster and after adjustment for age, education level, smoking status and place of residence, the likelihood of overweight (defined as body mass index >or=25 kg m(-2)) in women was lower for a 'multiple activity-low TV' cluster (odds ratio (OR)=0.66, 95% confidence interval=0.54-0.81) and for a cluster associating 'endurance physical activity-low TV' (OR=0.42 (0.29-0.60)). Compared with the referent cluster and after adjustment, the likelihood of overweight in men was decreased for the 'endurance physical activity' cluster (OR=0.66, (0.52-0.84)), whereas no significant association was found with the other clusters. CONCLUSIONS Patterns combining specific types of physical activity and sedentary behavior were identified and differed in their relations to overweight in adults. The identification of global patterns of activity allows us to go beyond a simple decreased activity-increased body weight approach and adds to our understanding of the associations of specific forms and grouping of activity with overweight in adults.
Collapse
Affiliation(s)
- H Charreire
- UREN INSERM U557/INRA U1125/Cnam/Paris13 University, CRNH Ile-de-France, Bobigny, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Kornblith A, Archer L, Lan L, Kimmick G, Partridge A, Casey R, Bennett S, Hudis C, Winer E, Cohen H, Muss H. Quality of Life of Early Stage Breast Cancer Patients 65 Years Old or Older Randomized to Standard Chemotherapy or Capecitabine: A Cancer and Leukemia Group B Study (CALGB 49907). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-5035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CALGB conducted a randomized Phase III trial (49907) to test whether older cancer patients receiving capecitabine would have a similar clinical outcome as those receiving standard chemotherapy, but less toxicity. This represented an important quality of life (QoL) paradigm in which treatment recommendations might be based on QoL findings if there was less toxicity for capecitabine with similar clinical outcomes as those achieved with standard chemotherapy. Materials and Methods: A preplanned QoL assessment was preformed in 350 patients randomized to either standard chemotherapy (CMF or AC) (n= 182) or capecitabine (n=168). All patients were interviewed by telephone using standardized questionnaires conducted at baseline, mid-treatment, at 1 month post-treatment, and at 12, 18 and 24 months. Data were analyzed using pattern mixture models and analysis of covariance with repeated measures, in which the sample was divided into groups based on the period of time they had completed assessments. Results: Patients in the capecitabine arm reported a better overall QoL (EORTC p< 0.0001), less fatigue (EORTC p< 0.0001), less nausea and vomiting (EORTC, p< 0.0001), less constipation (EORTC, p< 0.0001), less systemic side effects (EORTC, p< 0.0001), better appetite (EORTC, p< 0.0001), better body image (EORTC, p< 0.0001), less psychological distress (Hospital Anxiety and Depression scale, p< 0.0001), better role (EORTC, p< 0.0001) and social functioning (EORTC, p< 0.0001) than did those in the standard chemotherapy arm at either mid-treatment and/or the end of treatment for those assessed through 24 months. Capecitabine patients reported worse diarrhea (EORTC, p< 0.0001) at mid-treatment, and worse hand–foot symptoms (p< 0.0001) at mid and end of treatment than did those receiving standard chemotherapy. There were no significant differences in most of these measures by 12 months. Discussion: With clinical results showing a significantly improved relapse-free and overall survival for patients who received standard chemotherapy vs. capecitabine (Muss et al., NEJM 2009; 360: 2118), the QoL results will not guide treatment recommendations. However, the QoL results largely confirmed that patients treated with capecitabine experience significantly better QoL vs. those treated with standard chemotherapy due to less toxicity during and at the end of treatment for the sizable group of patients who had completed interviews through 24 months (n=245). These results indicate that despite the worse clinical outcome of patients who receive capecitabine treatment, the majority of capecitabine patients did not experience a worsening QoL from 12 months through 24 months compared to patients receiving standard chemotherapy. Further, these findings are relevant in selecting treatments in the metastatic setting where QoL endpoints often drive decision-making and the goal is to achieve a reasonable level of efficacy while minimizing toxicity.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5035.
Collapse
Affiliation(s)
| | - L. Archer
- 2Duke University Medical Center, NC,
| | - L. Lan
- 3Duke University Medical Center, NC,
| | | | | | - R. Casey
- 6Yale University School of Nursing, CT, Johns Hopkins Hospital, MD,
| | - S. Bennett
- 6Yale University School of Nursing, CT, Johns Hopkins Hospital, MD,
| | - C. Hudis
- 8Memorial Sloan-Kettering Cancer Center, NY,
| | - E. Winer
- 9Dana-Farber Cancer Institute, MA,
| | - H. Cohen
- 10Duke University Medical Center, NC,
| | - H. Muss
- 11University of North Carolina-Chapel Hill, NC,
| |
Collapse
|
41
|
Casey R, Tesfaye F, Mudumbi R, Rothman M, Rivas D. EFFECTS OF DAPOXETINE (DPX) FOR THE TREATMENT OF PREMATURE EJACULATION (PE) ON THE ERECTILE FUNCTION AND SCALES OF MOOD AND AFFECT. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1569-9056(08)60459-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
42
|
McCready ME, Carson NL, Chakraborty P, Clarke JTR, Callahan JW, Skomorowski MA, Chan AKJ, Bamforth F, Casey R, Rupar CA, Geraghty MT. Development of a clinical assay for detection of GAA mutations and characterization of the GAA mutation spectrum in a Canadian cohort of individuals with glycogen storage disease, type II. Mol Genet Metab 2007; 92:325-35. [PMID: 17723315 DOI: 10.1016/j.ymgme.2007.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 07/06/2007] [Accepted: 07/06/2007] [Indexed: 10/22/2022]
Abstract
Glycogen storage disease, type II (GSDII; Pompe disease; acid maltase deficiency) is an autosomal recessive disease caused by mutations of the GAA gene that lead to deficient acid alpha-glucosidase enzyme activity and accumulation of lysosomal glycogen. Although measurement of acid alpha-glucosidase enzyme activity in fibroblasts remains the gold standard for the diagnosis of GSDII, analysis of the GAA gene allows confirmation of clinical or biochemical diagnoses and permits predictive and prenatal testing of individuals at risk of developing GSDII. We have developed a clinical molecular test for the detection of GAA mutations based on cycle sequencing of the complete coding region. GAA exons 2-20 are amplified in six independent PCR using intronic primers. The resulting products were purified and sequenced. Preliminary studies using this protocol were conducted with DNA from 21 GSDII-affected individuals from five centers across Canada. In total, 41 of 42 mutations were detected (96.7% detection rate). Mutations spanned intron 1 through exon 19 and included nine novel mutations. Haplotype analysis of recurrent mutations further suggested that three of these mutations are likely to have occurred independently at least twice. Additionally, we report the identification of the c.-32-13T>G GAA mutation in an individual with infantile variant GSDII, despite reports of this mutation being associated almost exclusively with late-onset forms of the disease. The development of a clinical molecular test provides an important tool for the management and counseling of families and individuals with GSDII, and has provided useful information about the GAA mutation spectrum in Canada.
Collapse
Affiliation(s)
- M E McCready
- Children's Hospital of Eastern Ontario, Canada K1H 8L1
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Morales A, Spevack M, Emerson L, Kuzmarov I, Casey R, Black A, Tremblay R. Adding to the controversy: pitfalls in the diagnosis of testosterone deficiency syndromes with questionnaires and biochemistry. Aging Male 2007; 10:57-65. [PMID: 17558969 DOI: 10.1080/13685530701342686] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To determine the value of available questionnaires used for the diagnosis of testosterone deficiency syndromes (TDS) by correlating their ratings with a panel of hormonal determinations in a male population. MATERIALS AND METHODS Participants completed the ADAM questionnaire and underwent biochemical evaluation at the local site. Assessments determined entry into Group A (symptomatic) or Group B (non-symptomatic). After stratification, subjects provided a morning sample of blood, completed the Aging Male Survey (AMS) and the newly developed Canadian Society for the Study of the Aging Male (CSAM-Q) questionnaires. Serum aliquots were analysed at a central lab for 8 putative markers commonly associated with symptomatic testosterone deficiency associated with aging: total testosterone (T); bioavailable T (BT); dehydroepiandrosterone sulphate (DHEA-S); sex-hormone binding globulin (SHBG); luteinizing hormone (LH), prolactin (PRL); thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1). RESULTS 92 men were screened; of these 59 (mean age of 58+/-11 years) completed the study, 30 (51%) scored positively (mean 61.5 years) to the ADAM while 29 (49%) did not (mean 54.1 years). For the AMS the weight of the three domains (psychological, somato-vegetative and sexual) was significantly greater in Group A (p<0.001) than in Group B. Equally, for the CAS questionnaire, the scores for the variables energy, global performance, frequency of intercourse, mood and quality of sleep were lower in Group A than in their asymptomatic counterparts (p<0.001). The domain of memory assessment within the CSSAM-Q was not discriminatory. ADAM and AMS are self-administered and completed within 10 minutes. CSSAM-Q is more time consuming, requires an investigator to administer, and memory domain is biased in favour of specific professional training. No difference was found between the two groups in 6 of 8 biochemical tests. However, significant lower values (p<0.001) were found for DHEA-S and IGF-1 in the symptomatic group as compared with the non-symptomatic cohort. CONCLUSIONS This study confirms that newer, more complex tools perform similarly to the simpler ADAM questionnaire. The lack of correlation between the clinical picture and the most commonly used biochemical confirmatory tests, again, clearly points to the paramount importance of the clinical evaluation. An emphasis and reliance on serum T alone hinders the clinician's ability to manage testosterone deficiency syndromes (TDS).
Collapse
Affiliation(s)
- A Morales
- Centre for Applied Urological Research, Kingston General Hospital and Queen's University, Kingston, Ontario, Canada
| | | | | | | | | | | | | |
Collapse
|
44
|
Hughes RK, Belfield EJ, Casey R. CYP74C3 and CYP74A1, plant cytochrome P450 enzymes whose activity is regulated by detergent micelle association, and proposed new rules for the classification of CYP74 enzymes. Biochem Soc Trans 2007; 34:1223-7. [PMID: 17073790 DOI: 10.1042/bst0341223] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
CYP74C3 (cytochrome P450 subfamily 74C3), an HPL (hydroperoxide lyase) from Medicago truncatula (barrel medic), and CYP74A1, an AOS (allene oxide synthase) from Arabidopsis thaliana, are key membrane-associated P450 enzymes in plant oxylipin metabolism. Both recombinant detergent-free enzymes are monomeric proteins with dual specificity and very low enzyme activity that can be massively activated with detergent. This effect is a result of the formation of a complex between the protein monomer and a single detergent micelle and, in the case of CYP74A1, has a major effect on the substrate specificity of the enzyme. Association with a detergent micelle without an effect on protein oligomeric state represents a new mechanism of activation for membrane-associated P450 enzymes. This may represent a second unifying feature of CYP74 enzymes, in addition to their known differences in reaction mechanism, which separates them functionally from more classical P450 enzymes. Highly concentrated and monodispersed samples of detergent-free CYP74C3 and CYP74A1 proteins should be suitable for structural resolution. On the basis of recent evidence for incorrect assignment of CYP74 function, using the current rules for CYP74 classification based on sequence relatedness, we propose an alternative based on substrate and product specificity for debate and discussion.
Collapse
Affiliation(s)
- R K Hughes
- John Innes Centre, Norwich Research Park, Norwich NR4 7UH, UK.
| | | | | |
Collapse
|
45
|
Casey R, Aktar M, Hegarty P, Butler M, Thornhill J. MP-11.20. Urology 2006. [DOI: 10.1016/j.urology.2006.08.511] [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]
|
46
|
Quinlan M, Casey R, Flynn R, Grainger R, McDermott T, Thornhill J. MP-10.07. Urology 2006. [DOI: 10.1016/j.urology.2006.08.365] [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]
|
47
|
Gleave M, Qian J, Andreou C, Pommerville P, Chin J, Casey R, Steinhoff G, Fleshner N, Bostwick D, Thomas L, Rittmaster R. The effects of the dual 5alpha-reductase inhibitor dutasteride on localized prostate cancer--results from a 4-month pre-radical prostatectomy study. Prostate 2006; 66:1674-85. [PMID: 16927304 DOI: 10.1002/pros.20499] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND As dihydrotestosterone (DHT) is the most potent androgen in the prostate, inhibition of the 5alpha-reductase isoenzymes, which convert testosterone to DHT, could be an appropriate target for the treatment of prostate cancer. METHODS Eighty-one men with clinically localized prostate cancer received daily dutasteride 3.5 or 0.5 mg, or no therapy for 4 months before radical prostatectomy. Histopathological assessments were conducted on prostatectomy specimens. RESULTS Treatment with dutasteride was associated with reductions in serum and intraprostatic DHT of >or=90%, and a decrease in total prostate and tumor volumes. No effect of dutasteride was noted on Gleason grade. Histopathological effects on benign tissue were similar but less prominent than those seen with androgen ablation, whereas there was no significant difference in cancer histology among the groups. CONCLUSIONS Dutasteride treatment results in similar but less marked changes compared with androgen ablation.
Collapse
Affiliation(s)
- M Gleave
- Prostate Centre at Vancouver General Hospital, Vancouver, British Columbia, Canada.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Davey KM, Parboosingh JS, McLeod DR, Chan A, Casey R, Ferreira P, Snyder FF, Bridge PJ, Bernier FP. Mutation of DNAJC19, a human homologue of yeast inner mitochondrial membrane co-chaperones, causes DCMA syndrome, a novel autosomal recessive Barth syndrome-like condition. J Med Genet 2006; 43:385-93. [PMID: 16055927 PMCID: PMC2564511 DOI: 10.1136/jmg.2005.036657] [Citation(s) in RCA: 188] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND A novel autosomal recessive condition, dilated cardiomyopathy with ataxia (DCMA) syndrome, has been identified in the Canadian Dariusleut Hutterite population, characterised by early onset dilated cardiomyopathy with conduction defects, non-progressive cerebellar ataxia, testicular dysgenesis, growth failure, and 3-methylglutaconic aciduria. OBJECTIVE To map DCMA syndrome and identify the mutation underlying this condition. METHODS A genome wide scan was undertaken on consanguineous Hutterite families using a homozygosity mapping approach in order to identify the DCMA associated chromosomal region. Mutation analysis was carried out on positional candidate genes in this region by sequencing. Reverse transcriptase polymerase chain reaction and bioinformatics analyses were then used to characterise the mutation and determine its effect on the protein product. RESULTS The association of DCMA syndrome with a 2.2 Mb region of chromosome 3q26.33 was found. A disease associated mutation was identified: IVS3-1 G-->C in the DNAJC19 gene, encoding a DNAJ domain containing protein of previously unknown function (Entrez Gene ID 131118). CONCLUSIONS The DNAJC19 protein was previously localised to the mitochondria in cardiac myocytes, and shares sequence and organisational similarity with proteins from several species including two yeast mitochondrial inner membrane proteins, Mdj2p and Tim14. Tim14 is a component of the yeast inner mitochondrial membrane presequence translocase, suggesting that the unique phenotype of DCMA may be the result of defective mitochondrial protein import. It is only the second human disorder caused by defects in this pathway that has been identified.
Collapse
Affiliation(s)
- K M Davey
- Molecular Diagnostic Laboratory, Alberta Children's Hospital, Calgary, Alberta 2T 5C7, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Casey R, Love W, Mendoza C, Reymond D, Zarenda M. ZOLEDRONIC ACID AS ADJUNCT TO ANDROGEN DEPRIVATION THERAPY REDUCES BONE LOSS IN MEN WITH PROSTATE CANCER. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s1569-9056(06)60146-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Casey R, Tarride JE, Keresteci MA, Torrance GW. The Erectile Function Visual Analog Scale (EF-VAS): a disease-specific utility instrument for the assessment of erectile function. Can J Urol 2006; 13:3016-25; discussion 3026. [PMID: 16672112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
UNLABELLED This article presents the responsiveness results of the Erectile Function Visual Analog Scale (EF-VAS) and reports, for the first time, utilities associated with erectile dysfunction (ED), as calculated by a disease-specific utility assessment. The EF-VAS is a new quality of life (QoL) instrument specific to ED that combines the strengths of the disease-specific approach to measuring QoL (greater disease relevance and responsiveness, with relevance to clinicians and patients) with those of preference-based assessments (generalizability and relevance to decision makers). The EF-VAS has demonstrated feasibility, reliability, and validity as reported in a recent publication. METHODS Standard instrument development methodology was utilized and the finalized content was integrated into a preference based scoring instrument comprised of two visual analogue scales (VAS). The EF-VAS was implemented in a clinical trial and data from the trial was subjected to validation analysis. Three methods were used to evaluate the responsiveness of the EF-VAS: Spearman correlations, effect size and standardized response means. VAS scores were converted to von Neumann-Morgenstern (vNM) utilities through a conversion curve. RESULTS The EF-VAS was established to be responsive to changes in disease state within and between patients with ED. The EF-VAS allowed the calculation of vNM utility values and a significant increase in utility was observed in the sildenafil group compared to placebo at study end. CONCLUSION The EF-VAS represents an important advance in the understanding of the impact of ED on patients' QoL and in providing a mechanism to allow the quantification of the health status that patients associate with ED. Based on its responsiveness, the EF-VAS will provide an important clinical tool to assess and contribute to the understanding of the impact of treatment for ED. The EF-VAS represents a major advance in the science of health-related quality of life (HRQol) assessment, as it is the first validated ED-specific utility assessment reported in the literature.
Collapse
Affiliation(s)
- R Casey
- Male Health Centre, Oakville, Ontario, Canada
| | | | | | | |
Collapse
|