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Abankwa A, Sansone S, Aligbe O, Hickner A, Segal S. The Role of Ureaplasma and Mycoplasma Species in Recurrent Lower Urinary Tract Infection in Females: A Scoping Review. Reprod Sci 2024:10.1007/s43032-024-01513-y. [PMID: 38509400 DOI: 10.1007/s43032-024-01513-y] [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: 11/30/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024]
Abstract
It is unknown if recurrent urinary tract infection in the gynecologic population is associated with Mycoplasma and Ureaplasma genitourinary infections. The purpose of this scoping review is to highlight the literature surrounding Mycoplasma and Ureaplasma infections in the setting of recurrent urinary tract infections in the gynecologic population. MEDLINE ALL and Embase were searched to retrieve articles published in or after 1950 through 2024. Studies included were those with adults over age 18, non-pregnant, diagnosed with recurrent urinary tract infection and concurrent genitourinary infection with Ureaplasma or Mycoplasma published in English. Study designs eligible were quantitative, qualitative, and mixed methods studies. Publication types were also extended to conference abstracts and unpublished data. 2 independent investigators systematically performed title/abstract screening and full-text review using standardized inclusion criteria. For disagreements in either title and abstracts or full-text articles, consensus was reached through discussion by the 2 screeners and/or a 3rd final adjudicator. Screening and data extraction were performed on Covidence, a web-based platform for systematic review management. There were 1170 studies identified before title and abstract screening. 26 full-text articles were reviewed for eligibility. Of these, 23 full-text studies were excluded. 3 studies met full inclusion criteria and data extraction was performed on these 3 studies. There were 2 additional studies included after identification via other methods. There is a need for more recent and robust studies examining the role of Ureaplasma and Mycoplasma genitourinary infections amongst gynecologic patients with recurrent urinary tract infections.
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Affiliation(s)
- A Abankwa
- Department of Obstetrics and Gynecology and Department of Urology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - S Sansone
- Department of Obstetrics and Gynecology, Hackensack Meridian Jersey Shore Medical Center, Neptune, NJ, USA
| | - O Aligbe
- Department of Obstetrics and Gynecology and Department of Urology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA
| | - A Hickner
- Weill Cornell Medicine - Samuel J. Wood Library & C.V. Starr Biomedical Information Center, New York, NY, USA
| | - S Segal
- Department of Obstetrics and Gynecology and Department of Urology, New York Presbyterian - Weill Cornell Medicine, New York, NY, USA.
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Sansone S, Ramos Y, Segal S, Asfaw TS, Morales DK. Uncovering Surface Penetration by Enterococci From Urinary Tract Infection Patients. Urogynecology (Phila) 2024; 30:320-329. [PMID: 38484249 DOI: 10.1097/spv.0000000000001476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
IMPORTANCE The relationship between Enterococcus faecalis vaginal colonization and urinary tract infections (UTIs) remains uncertain. OBJECTIVE We aimed to evaluate the surface invasion capability of E faecalis isolates from patients with and without UTIs as a potential readout of pathogenicity. STUDY DESIGN Participants were females from urogynecology clinics, comprising symptomatic UTI and asymptomatic non-UTI patients, categorized by the presence or absence of E faecalis-positive cultures identified via standard urine culture techniques. Vaginal and urine samples from patients were plated on enterococci selective medium, and E faecalis isolates detected in both cohorts were species specific identified using 16S rRNA sequencing. Clinical isolates were inoculated on semisolid media, and both external colonies and underneath colony prints formed by agar-penetrating enterococci were imaged. External growth and invasiveness were quantified by determining colony-forming units of the noninvading and agar-penetrating cells and compared with the E faecalis OG1RF. RESULTS We selected E faecalis isolates from urine and vaginal samples of 4 patients with and 4 patients without UTIs. Assays demonstrated that most isolates formed similarly sized external colonies with comparable colony-forming unit. Surface invasion differed across patients and isolation sites compared with OG1RF. The vaginal isolate from UTI patient 1, who had the most recurrences, exhibited significantly greater agar-invading capacity compared with OG1RF. CONCLUSIONS Our pilot study indicates that ex vivo invasion assays may unveil virulence traits in E faecalis from UTI patients. Enhanced enterococcal surface penetration could increase urogenital invasion risk. Further research is needed to correlate penetration with disease severity in a larger patient group.
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Affiliation(s)
- Stephanie Sansone
- From the Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY
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Pancaro C, Balonov K, Herbert K, Shah N, Segal S, Cassidy R, Engoren MC, Manica V, Habib AS. Role of cosyntropin in the management of postpartum post-dural puncture headache: a two-center retrospective cohort study. Int J Obstet Anesth 2023; 56:103917. [PMID: 37625985 DOI: 10.1016/j.ijoa.2023.103917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/31/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Research suggests that postpartum post-dural puncture headache (PDPH) might be prevented or treated by administering intravenous cosyntropin. METHODS In this retrospective cohort study, we questioned whether prophylactic (1 mg) and therapeutic (7 µg/kg) intravenous cosyntropin following unintentional dural puncture (UDP) was effective in decreasing the incidence of PDPH and therapeutic epidural blood patch (EBP) after birth. Two tertiary-care American university hospitals collected data from November 1999 to May 2017. Two hundred and fifty-three postpartum patients who experienced an UDP were analyzed. In one institution 32 patients were exposed to and 32 patients were not given prophylactic cosyntropin; in the other institution, once PDPH developed, 36 patients were given and 153 patients were not given therapeutic cosyntropin. The primary outcome for the prophylactic cosyntropin analysis was the incidence of PDPH and for the therapeutic cosyntropin analysis in exposed vs. unexposed patients, the receipt of an EBP. The secondary outcome for the prophylactic cosyntropin groups was the receipt of an EBP. RESULTS In the prophylactic cosyntropin analysis no significant difference was found in the risk of PDPH between those exposed to cosyntropin (19/32, 59%) and unexposed patients (17/32, 53%; odds ratio (OR) 1.37, 95% CI 0.48 to 3.98, P = 0.56), or in the incidence of EBP between exposed (12/32, 38%) and unexposed patients (6/32, 19%; OR 2.6, 95% CI 0.83 to 8.13, P = 0.095). In the therapeutic cosyntropin analysis, in patients exposed to cosyntropin the incidence of EBP was significantly higher (20/36, 56% vs. 43/153, 28%; OR 3.20, 95% CI 1.52 to 6.74, P = 0.002). CONCLUSIONS Our data show no benefits from the use of cosyntropin for preventing or treating postpartum PDPH.
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Affiliation(s)
- C Pancaro
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA.
| | - K Balonov
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - K Herbert
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - N Shah
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - S Segal
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - R Cassidy
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - M C Engoren
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - V Manica
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
| | - A S Habib
- Departments of Anesthesiology at the University of Michigan, Tufts, Duke University School of Medicine, Wake Forest University School of Medicine and Medical University of South Carolina, USA
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Sansone S, Lu J, Drangsholt S, Asfaw TS, Segal S. No pelvic exam, no problem: patient satisfaction following the integration of comprehensive urogynecology telemedicine. Int Urogynecol J 2022; 33:2401-2407. [PMID: 35238948 PMCID: PMC8892397 DOI: 10.1007/s00192-022-05104-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/15/2022] [Indexed: 11/26/2022]
Abstract
Introduction and hypothesis The COVID-19 pandemic revolutionized the practice of medicine, requiring rapid adoption of telemedicine. However, patient satisfaction has not been well characterized for telemedicine visits for a broad range of urogynecologic conditions. Methods We performed a cross-sectional survey study following a retrospective review of all urogynecologic telemedicine visits from March 1, 2020, to March 31, 2021, at a tertiary care center. The survey queried patient satisfaction using the Likert scale. Descriptive statistics and Fisher’s exact analyses were performed. Results There were 256 telemedicine visits at our institution during the study period, and 88 patients (34% unadjusted response rate) completed the survey. The average age of study participants was 55 (SD 17; 24, 84) years old. The majority of patients were white (69%), lived within the five boroughs of NYC (81%), and had higher levels of education (72% with a bachelor’s or professional degree). Most visits were for urinary complaints (68%), with those patients reporting greater fulfillment of urogynecologic needs compared to patients presenting with pelvic complaints (p = 0.02). There were no significant differences in satisfaction among other demographics (p > 0.05). Altogether, high satisfaction rates were noted for scheduling (99%), technology (90%), provider interaction (96%), fulfillment of personal needs (91%), and overall satisfaction (94%). Conclusions We demonstrate high patient satisfaction for telemedicine visits in a tertiary urogynecology clinic for a variety of indications, with greater fulfillment of urogynecologic needs observed for those visits which may not necessitate an in-person exam (e.g., urinary complaint).
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Affiliation(s)
- Stephanie Sansone
- Department of Obstetrics & Gynecology, NewYork-Presbyterian/Weill Cornell Medicine, 525 E 68th St, J130, New York, NY, 10065, USA.
- Department of Urology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY, 10065, USA.
| | - Jessica Lu
- Department of Obstetrics & Gynecology, NewYork-Presbyterian/Weill Cornell Medicine, 525 E 68th St, J130, New York, NY, 10065, USA
| | - Siri Drangsholt
- Department of Urology, New York Medical College, Valhalla, NY, USA
- Department of Obstetrics & Gynecology, New York Medical College, Valhalla, NY, USA
| | - Tirsit S Asfaw
- Department of Obstetrics & Gynecology, NewYork-Presbyterian/Weill Cornell Medicine, 525 E 68th St, J130, New York, NY, 10065, USA
| | - Saya Segal
- Department of Obstetrics & Gynecology, NewYork-Presbyterian/Weill Cornell Medicine, 525 E 68th St, J130, New York, NY, 10065, USA
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Gilboa M, Houri-Levi E, Cohen C, Tal I, Rubin C, Feld-Simon O, Brom A, Eden-Friedman Y, Segal S, Rahav G, Regev-Yochay G. Environmental shedding of toxigenic Clostridioides difficile by asymptomatic carriers: A prospective observational study. Clin Microbiol Infect 2020; 26:1052-1057. [PMID: 31904567 DOI: 10.1016/j.cmi.2019.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The aim was to compare the burden of environmental shedding of toxigenic Clostridioides difficile among asymptomatic carriers, C. difficile-infected (CDI) patients and non-carriers in an inpatient non-epidemic setting. METHODS C. difficile carriage was determined by positive toxin-B PCR from rectal swabs of asymptomatic patients. Active CDI was defined as a positive two-step enzyme immunoassay/polymerase chain reaction (EIA/PCR) test in patients with more than three unformed stools/24 hr. C. difficile environmental contamination was assessed by obtaining specimens from ten sites in the patients' rooms. Toxigenic strains were identified by PCR. We created a contamination scale to define the overall level of room contamination that ranged from clean to heavy contamination. RESULTS One hundred and seventeen rooms were screened: 70 rooms inhabited by C. difficile carriers, 30 rooms by active CDI patients and 17 rooms by non C. difficile -carriers (control). In the carrier rooms 29 (41%) had more than residual contamination, from which 17 (24%) were heavily contaminated. In the CDI rooms 12 (40%) had more than residual contamination from which three (10%) were heavily contaminated, while in the control rooms, one room (6%) had more than residual contamination and none were heavily contaminated. In a multivariate analysis, the contamination score of rooms inhabited by carriers did not differ from rooms of CDI patients, yet both were significantly more contaminated than those of non-carriers odd ratio 12.23 and 11.16 (95% confidence interval 1.5-99.96 p 0.0195, and 1.19-104.49 p 0.035), respectively. DISCUSSION Here we show that the rooms of C. difficile carriers are as contaminated as those of patients with active CDI and significantly more than those of non-carriers.
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Affiliation(s)
- M Gilboa
- Internal Medicine D, Sheba Medical Centre, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Disease Unit, Sheba Medical Centre, Ramat Gan, Israel.
| | - E Houri-Levi
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Internal Medicine B, Sheba Medical Centre, Ramat Gan, Israel
| | - C Cohen
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infection Control & Prevention Unit, Sheba Medical Centre, Ramat Gan, Israel
| | - I Tal
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infection Control & Prevention Unit, Sheba Medical Centre, Ramat Gan, Israel
| | - C Rubin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Biostatistics Unit, Gertner Institute, Ramat Gan, Israel
| | - O Feld-Simon
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Disease Unit, Sheba Medical Centre, Ramat Gan, Israel; Internal Medicine F, Sheba Medical Centre, Ramat Gan, Israel
| | - A Brom
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infection Control & Prevention Unit, Sheba Medical Centre, Ramat Gan, Israel; Internal Medicine T, Sheba Medical Centre, Ramat Gan, Israel
| | - Y Eden-Friedman
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Internal Medicine E, Sheba Medical Centre, Ramat Gan, Israel
| | - S Segal
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infection Control & Prevention Unit, Sheba Medical Centre, Ramat Gan, Israel
| | - G Rahav
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Disease Unit, Sheba Medical Centre, Ramat Gan, Israel
| | - G Regev-Yochay
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Infectious Disease Unit, Sheba Medical Centre, Ramat Gan, Israel; Infection Control & Prevention Unit, Sheba Medical Centre, Ramat Gan, Israel
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Binkley M, Rauf M, Milgrom S, Pinnix C, Tsang R, Ng A, Roberts K, Gao S, Ricardi U, Levis M, Casulo C, Stolten M, Kelsey C, Brady J, Mikhaeel N, Hoppe B, Terezakis S, Kirova Y, Akhtar S, Maghfoor I, Koenig J, Jackson C, Song E, Segal S, Advani R, Natkunam Y, Constine L, Eich H, Wirth A, Hoppe R. STAGE I-II NODULAR LYMPHOCYTE-PREDOMINANT HODGKIN LYMPHOMA IN THE MODERN ERA: A MULTI-INSTITUTIONAL EXPERIENCE OF ADULT PATIENTS BY ILROG. Hematol Oncol 2019. [DOI: 10.1002/hon.103_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M.S. Binkley
- Radiation Oncology; Stanford University School of Medicine; Stanford United States
| | - M. Rauf
- Medical Oncology; King Faisal Specialist Hospital and Research Centre; Riyadh Saudi Arabia
| | - S.A. Milgrom
- Radiation Oncology; University of Texas MD Anderson Cancer Center; Houston United States
| | - C.C. Pinnix
- Radiation Oncology; University of Texas MD Anderson Cancer Center; Houston United States
| | - R. Tsang
- Radiation Oncology; Princess Margaret Cancer Center; Toronto Canada
| | - A. Ng
- Radiation Oncology; Dana Farber and Harvard University School of Medicine; Boston United States
| | - K.B. Roberts
- Radiation Oncology; Yale University; New Haven United States
| | - S. Gao
- Radiation Oncology; Yale University; New Haven United States
| | - U. Ricardi
- Oncology; University of Turin; Torino Italy
| | - M. Levis
- Oncology; University of Turin; Torino Italy
| | - C. Casulo
- Medical Oncology; University of Rochester; Rochester United States
| | - M. Stolten
- Radiation Oncology; University of Rochester; Rochester United States
| | - C.R. Kelsey
- Radiation Oncology; Duke University School of Medicine; Durham United States
| | - J.L. Brady
- Radiation Oncology; Guy's Cancer Centre, Guy's and St Thomas’ NHS Hospital; London United Kingdom
| | - N. Mikhaeel
- Radiation Oncology; Guy's Cancer Centre, Guy's and St Thomas’ NHS Hospital; London United Kingdom
| | - B.S. Hoppe
- Radiation Oncology; University of Florida; Jacksonville United States
| | - S.A. Terezakis
- Radiation Oncology; The Johns Hopkins University School of Medicine; Baltimore United States
| | - Y. Kirova
- Radiation Oncology; Institut Curie; Paris France
| | - S. Akhtar
- Medical Oncology; King Faisal Specialist Hospital and Research Centre; Riyadh Saudi Arabia
| | - I. Maghfoor
- Medical Oncology; King Faisal Specialist Hospital and Research Centre; Riyadh Saudi Arabia
| | - J.L. Koenig
- Radiation Oncology; Stanford University School of Medicine; Stanford United States
| | - C. Jackson
- Radiation Oncology; Yale University; New Haven United States
| | - E. Song
- Radiation Oncology; Duke University School of Medicine; Durham United States
| | - S. Segal
- Radiation Oncology; The Johns Hopkins University School of Medicine; Baltimore United States
| | - R.H. Advani
- Medical Oncology; Stanford University School of Medicine; Stanford United States
| | - Y. Natkunam
- Pathology; Stanford University School of Medicine; Stanford United States
| | - L.S. Constine
- Radiation Oncology; University of Rochester; Rochester United States
| | - H. Eich
- Radiation Oncology; Munster University; Munster Germany
| | - A. Wirth
- Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - R.T. Hoppe
- Radiation Oncology; Stanford University School of Medicine; Stanford United States
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Rimon A, Segal S. Streptokinase - Induced Proteolytic Activity with Respect to Age in Two Ethnic Groups in Israel. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1654812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryStreptokinase-induced proteolytic (caseinolytic) activity was determined in the plasma and in the euglobulin fraction of Yemenite and Ashkenazi Jews, with respect to age.In the plasma it was found, that in both groups the activity increased with age. In Ashkenasim, however, the activity levelled off at about 30 years of age, whereas, in Yemenites, it continued to increase with age. This was true for both sexes.In the euglobulin fraction, the activity was also found to increase with age, but to a lesser extent, than in the plasma. This increase was more pronounced in Yemenite than in Ashkenazi Jews, and in both groups levelled off at about 30 years of age. The possible significance of these observations apropos regulation of the fibrinolytic activity in the blood, is dicussed. It is suggested that Yemenite Jews have a more effective mechanism for handling clots with advancing years.
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Segal S, John G, Sammel M, Andy UU, Chu C, Arya LA, Brown J, Schmitz K. Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors. Maturitas 2017; 105:83-88. [PMID: 28396018 DOI: 10.1016/j.maturitas.2017.03.313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors. STUDY DESIGN We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation. RESULTS Of the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01). CONCLUSION Local or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors.
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Affiliation(s)
- Saya Segal
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, and Division of Urology, Department of Surgery, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
| | - Gabriella John
- Memorial Sloan-Kettering Cancer Center, New York, NY, United States
| | - Mary Sammel
- Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Uduak Umoh Andy
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania; Philadelphia, PA, United States
| | - Christina Chu
- Division of Gynecologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Lily A Arya
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania; Philadelphia, PA, United States
| | - Justin Brown
- Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Kathryn Schmitz
- Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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Segal S, Ben-David M, Anteby SO, Polishuk WZ. The Effect of Intra-Amniotic Injection of Hypertonic Urea on Human Placental Lactogen (HPL) Secretion. Int J Gynaecol Obstet 2016. [DOI: 10.1002/j.1879-3479.1975.tb00046.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Segal
- Departments of Obstetrics and Gynecology and Pharmacology; Hadassah Medical Center; Jerusalem Israel
| | - M. Ben-David
- Departments of Obstetrics and Gynecology and Pharmacology; Hadassah Medical Center; Jerusalem Israel
| | - S. O. Anteby
- Departments of Obstetrics and Gynecology and Pharmacology; Hadassah Medical Center; Jerusalem Israel
| | - W. Z. Polishuk
- Departments of Obstetrics and Gynecology and Pharmacology; Hadassah Medical Center; Jerusalem Israel
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Hough LH, Segal S. Effects of developmental hyperserotonemia on the morphology of rat dentate nuclear neurons. Neuroscience 2016; 322:178-94. [PMID: 26892293 DOI: 10.1016/j.neuroscience.2016.02.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/14/2016] [Accepted: 02/10/2016] [Indexed: 11/18/2022]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social cognition, disordered communication, restricted interests and repetitive behaviors. Furthermore, abnormalities in basic motor control, skilled motor gestures, and motor learning, are common in ASD. These characteristics have been attributed to a possible defect in the pre- and postnatal development of specific neural networks including the dentate-thalamo-cortical pathway, which is involved in motor learning, automaticity of movements, and higher cognitive functions. The current study utilized custom diolistic labeling and unbiased stereology to characterize morphological alterations in neurons of the dentate nucleus of the cerebellum in developing rat pups exposed to abnormally high levels of the serotonergic agonist 5-methyloxytryptamine (5-MT) pre-and postnatally. Occurring in as many as 30% of autistic subjects, developmental hyperserotonemia (DHS) is the most consistent neurochemical finding reported in autism and has been implicated in the pathophysiology of ASD. This exposure produced dramatic changes in dendritic architecture and synaptic features. We observed changes in the dendritic branching morphology which did not lead to significant differences (p>0.5) in total dendritic length. Instead, DHS groups presented with dendritic trees that display changes in arborescence, that appear to be short reaching with elaborately branched segments, presenting with significantly fewer (p>0.001) dendritic spines and a decrease in numeric density when compared to age-matched controls. These negative changes may be implicated in the neuropathological and functional/behavioral changes observed in ASD, such as delays in motor learning, difficulties in automaticity of movements, and deficits in higher cognitive functions.
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Affiliation(s)
- L H Hough
- Department of Biomedical Sciences, Missouri State University, Springfield, MO 65897, USA.
| | - S Segal
- Department of Surgery, Center for Anatomical Sciences and Education, Saint Louis University School of Medicine, St. Louis, MO, USA
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Hammer SM, Brown JC, Segal S, Chu CS, Schmitz KH. Cancer-related impairments influence physical activity in uterine cancer survivors. Med Sci Sports Exerc 2015; 46:2195-201. [PMID: 24781886 DOI: 10.1249/mss.0000000000000360] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The extent to which physical activity (PA) participation among uterine cancer survivors may be limited by physical and functional impairments (PFI) related to cancer treatment is unknown. We sought to describe PA participation, characterize the prevalence of PFI, and examine the association between PFI status and PA participation within this population. METHODS We conducted a study using a mailed survey among uterine cancer survivors who received treatment at a university hospital. We asked about PA and PFI using validated self-report questionnaires. PA was calculated using MET-hours per week (MET·h·wk). PFI was defined as having one or more of the following symptoms: lower limb lymphedema, general pain, fatigue, or severe bladder, bowel, or pelvic issues. Ordinal logistic regression was used to quantify the odds ratio (OR) between PA and PFI. RESULTS The response rate to our survey was 43%. Among the 213 study participants, 40%, 13%, 13%, 12%, and 23% reported participating in <3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, and ≥27.0 MET·h·wk of PA, respectively. Walking is the preferred mode of exercise for physically active uterine cancer survivors. Of the survivors, 53% experience at least one PFI. The most common PFI is lower limb lymphedema (36.2%), followed by general pain (22.5%). The OR of PFI decreased as MET-hours per week of PA increased (OR, 0.51; 95% confidence interval, 0.31-0.84; P = 0.009). CONCLUSIONS The majority of uterine cancer survivors experience PFI that significantly reduce the likelihood of PA participation. PA recommendations for uterine cancer survivors should take into account treatment-related impairments that can affect PA participation.
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Affiliation(s)
- Sean M Hammer
- 1Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; 2Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology; Department of Surgery (Urology), University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; and 3Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
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Abstract
Genitourinary syndrome of menopause is a common condition that left untreated can progress and negatively affect quality of life and sexual function. Laser therapy has a therapeutic role for several gynecologic conditions and most recently has gained interest as a non-hormonal treatment for genitourinary syndrome of menopause (GSM). The laser is well tolerated and may increase thickness of the squamous epithelium and improve vascularity of the vagina. These morphological changes presumably alleviate symptoms of dryness, dyspareunia, and irritation. However, the duration of therapeutic effects and safety of repeated applications at this point is not clear. Further research is needed in the form of controlled studies of the laser and other non-hormonal GSM therapies. The objective of this paper is to review the existing literature describing laser therapy for GSM.
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Affiliation(s)
- Juana Hutchinson-Colas
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
| | - Saya Segal
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Division of Urology, Department of Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Affiliation(s)
- S. Segal
- Hugo de Vries Laboratorium; University of Amsterdam
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Westhoff V, Bruijns MFM, Segal S. THE VEGETATION OF SCOTTISH PINE WOODLANDS AND DUTCH ARTIFICIAL COASTAL PINE FORESTS; WITH SOME REMARKS ON THE ECOLOGY OF LISTERA CORDATA. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/j.1438-8677.1959.tb00022.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Segal S, Westhoff V, von J. van Dijk UM. DIE VEGETATIONSKUNDLICHE STELLUNG VON CAREX BUXBAUMII WAHLENB. IN EUROPA, BESONDERS IN DEN NIEDERLANDEN. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/j.1438-8677.1959.tb00542.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S. Segal
- Hugo de Vries-Laboratorium; Amsterdam
| | - V. Westhoff
- R.I.V.O.N.: Reichsinstitut für ökologische; Grundlagenforschung des Naturschutzes; Bilthoven
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Foreman JW, Reynolds RA, Pepe LM, Segal S. Glutamine transport into isolated renal membrane vesicles from normal and acidotic rats. Contrib Nephrol 2015; 31:101-4. [PMID: 7105740 DOI: 10.1159/000406623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Yudkoff M, Nissim I, Pleasure D, Hummeler K, Segal S. Application of gas chromatography-mass spectrometry to in vitro studies of nitrogen metabolism. Contrib Nephrol 2015; 47:209-18. [PMID: 4064695 DOI: 10.1159/000411233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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18
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Nissim I, Yudkoff M, Segal S. Interrelationships between renal TCA-cycle metabolism and ammoniagenesis: studies with 13C-NMR and GC-MS. Contrib Nephrol 2015; 63:60-70. [PMID: 3191718 DOI: 10.1159/000415700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- I Nissim
- Division of Biochemical Development and Molecular Disease, Children's Hospital of Philadelphia, Pa
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States B, Harris D, Hummeler K, Segal S. Amino acid disorders in tissue culture cells: effects of mycoplasma and antibiotics on cystine metabolism. Monogr Hum Genet 2015; 9:131-4. [PMID: 732829 DOI: 10.1159/000401624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Meyersfeld N, Ngan Kee WD, Segal S, Dyer RA. Oxygen at Caesarean section: too much of a good thing? Southern African Journal of Anaesthesia and Analgesia 2014. [DOI: 10.1080/22201181.2014.993148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Brown JC, Lin LL, Segal S, Chu CS, Haggerty AE, Ko EM, Schmitz KH. Physical activity, daily walking, and lower limb lymphedema associate with physical function among uterine cancer survivors. Support Care Cancer 2014; 22:3017-25. [PMID: 24906839 DOI: 10.1007/s00520-014-2306-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/27/2014] [Indexed: 01/13/2023]
Abstract
PURPOSE We sought to quantify the proportion of uterine cancer survivors who self-report poor physical function. We then sought to quantify the association of poor physical function with physical activity (PA), walking, and lower limb lymphedema (LLL), among women with a history of uterine cancer. METHODS Physical function was quantified using the Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) questionnaire. PA, walking, and LLL were measured using self-report questionnaire. PA was calculated using metabolic equivalent hours per week (MET-h week(-1)), and walking was calculated using blocks per day (blocks day(-1)). Logistic regression estimated odds ratios (OR) and 95 % confidence intervals (95 % CI). RESULTS Among the 213 uterine cancer survivors in our survey (43 % response rate), 35 % self-reported poor physical function. Compared to participants who reported <3.0 MET-h week(-1) of PA, participants who reported ≥18.0 MET-h week(-1) of PA were less likely to have poor physical function (OR 0.03, 95 % CI 0.01-0.10; P trend < 0.0001). Compared to participants who reported <4.0 blocks day(-1) of walking, participants who reported ≥12.0 blocks day(-1) of walking were less likely to have poor physical function (OR 0.07, 95 % CI 0.03-0.19; P trend < 0.0001). Compared to participants who did not have LLL, participants with LLL were more likely to have poor physical function (OR 5.25, 95 % CI 2.41-11.41; P < 0.0001). CONCLUSION Higher levels of PA and walking associate with a lower likelihood of reporting poor physical function. The presence of LLL associates with a higher likelihood of reporting poor physical function. These findings are hypothesis-generating and should be evaluated in future prospective studies.
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Affiliation(s)
- Justin C Brown
- Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, 8th Floor, Blockley Hall, Philadelphia, PA, 19104, USA
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Bragatti J, Torres C, Cherubini P, Segal S, Bianchin M. P789: Interictal EEG activity is associated with mood disorders in temporal lobe epilepsy. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50828-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Athanasiou Y, Zavros M, Arsali M, Papazachariou L, Demosthenous P, Savva I, Voskarides K, Deltas C, Pierides A, Feriozzi S, Perrin A, West M, Nicholls K, Sunder-Plassmann G, Torras J, Neumann P, Cybulla M, Cofiell R, Kukreja A, Bedard K, Yan Y, Mickle A, Ogawa M, Bedrosian C, Faas S, Meszaros K, Pruess L, Gondan M, Ritz E, Schaefer F, Testa A, Spoto B, Leonardis D, Sanguedolce MC, Pisano A, Parlongo MR, Tripepi G, Mallamaci F, Zoccali C, Trujillano D, Bullich G, Ballarin J, Torra R, Estivill X, Ars E, Kleber ME, Delgado G, Grammer TB, Silbernagel G, Kraemer BK, Maerz W, Riccio E, Pisani A, Abdalla AA, Malone AF, Winn MP, Goodship T, Cronin C, Conlon PJ, Casserly LF, Nishio S, Sakuhara Y, Matsuoka N, Yamamoto J, Nakazawa D, Nakagakaki T, Abo D, Shibazaki S, Atsumi T, Mazzinghi B, Giglio S, Provenzano A, Becherucci F, Sansavini G, Ravaglia F, Roperto RM, Murer L, Lasagni L, Materassi M, Romagnani P, Schmidts M, Christou S, Cortes C, McInerney-Leo A, Kayserili H, Zankl A, Peter S, Duncan E, Wicking C, Beales PL, Mitchison H, Magestro M, Vekeman F, Nichols T, Karner P, Duh MS, Srivastava B, Van Doorn-Khosrovani SBVW, Zonnenberg BA, Musetti C, Quaglia M, Ghiggeri GM, Fogazzi GB, Settanni F, Boldorini RL, Lazzarich E, Airoldi A, Izzo C, Giordano M, Stratta P, Garrido P, Fernandes JC, Ribeiro S, Belo L, Costa EC, Reis F, Santos-Silva A, Youssef DM, Alshal AS, Salah K, Rashed AE, Kingswood JC, Jozwiak S, Belousova E, Frost M, Kuperman R, Bebin EM, Korf B, Flamini JR, Kohrman MH, Sparagana S, Wu JY, Berkowitz N, Miao S, Segal S, Ridolfi A, Bissler JJ, Franz DN, Oud MM, Van Bon BW, Bongers EM, Hoischen A, Marcelis CL, De Leeuw N, Mol SJ, Mortier G, Knoers NV, Brunner HG, Roepman R, Arts HH, Van Eerde AM, Van Der Zwaag B, Lilien MR, Renkema KY, De Borst MH, Van Haaften G, Giles RH, Navis GJ, Knoers NVAM, Lu KC, Su SL, Gigante M, Santangelo L, Diella S, Argentiero L, Cianciotta F, Martino M, Ranieri E, Grandaliano G, Giordano M, Gesualdo L, Fernandes J, Ribeiro S, Garrido P, Sereno J, Costa E, Reis F, Santos-Silva A, Chub O, Aires I, Polidori D, Santos AR, Brito Costa A, Simoes C, Rueff J, Nolasco F, Calado J, Van Der Tol L, Biegstraaten M, Florquin S, Vogt L, Van Den Bergh Weerman MA, Hollak CE, Hughes DA, Lachmann RH, Oliveira JP, Ortiz A, Svarstad E, Terryn W, Tondel C, Waldek S, Wanner C, West ML, Linthorst GE, Kaesler N, Brandenburg V, Theuwissen E, Vermeer C, Floege J, Schlieper G, Kruger T, Xydakis D, Goulielmos G, Antonaki E, Stylianoy K, Sfakianaki M, Papadogiannakis A, Dafnis E, Mdimegh S, Ben Hadj Mbarek - Fredj I, Moussa A, Omezzine A, Zellama D, Mabrouk S, Zouari N, Hassayoun S, Chemli J, Achour A, Bouslama A, Abroug S, Spoto B, Leonardis D, Politi C, Pisano A, Cutrupi S, Testa A, Parlongo RM, D'Arrigo G, Tripepi G, Mallamaci F, Zoccali C, Mdimegh S, Ben Hadj Mbarek - Fredj I, Moussa A, Omezzine A, Mabrouk S, Zouari N, Hassayoun S, Chemli J, Zellama D, Achour A, Bouslama A, Abroug S, Hohenstein-Scheibenecker K, Schmidt A, Stylianou KG, Kyriazis J, Androvitsanea A, Tzanakakis M, Maragkaki E, Petrakis J, Stratakis S, Poulidaki R, Vardaki E, Petra C, Statigis S, Perakis K, Daphnis E, Cybulla M, West M, Nicholls K, Torras J, Neumann P, Sunder-Plassmann G, Feriozzi S, Metzinger-Le Meuth V, Taibi F, M'Baya-Moutoula E, Louvet L, Massy Z, Metzinger L, Mani LY, Sidler D, Vogt B, Nikolskaya N, Cox JA, Kingswood JC, Smirnov A, Zarayski M, Kayukov I, Karunnaya H, Sipovski V, Kukoleva L, Dobronravov V. GENETIC DISEASES AND MOLECULAR GENETICS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kottgen A, Sallustio F, Cox SN, Serino G, Pesce F, De Palma G, Falchi M, Schena FP, Schena FP, Serino G, Sallustio F, Pesce F, De Palma G, Cox SN, Lai KN, Leung JC, Papagianni A, Stangou M, Goumenos D, Gerolymos M, Takahashi K, Yuzawa Y, Maruyama S, Imai E, Karras A, Mami I, Schmitt C, Nochy D, Rabant M, Hertig A, Vincent M, Thervet E, Puy H, Pallet N, Zonnenberg B, Eijkemans MJC, Reijnders L, Khosrovani S, Magestro M, Bissler JJ, Kingswood JC, Zonnenberg BA, Frost M, Belousova E, Sauter M, Berkowitz N, Miao S, Segal S, Brechenmacher T, Budde K, Franz DN. GENETICS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu128] [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: 11/13/2022] Open
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Bissler J, Kingswood J, Radzikowska E, Zonnenberg B, Frost M, Belousova E, Sauter M, Nonomura N, Brakemeier S, De Vries P, Berkowitz N, Segal S, Anak O, Peyard S, Budde K. 1139 Everolimus for renal angiomyolipoma associated with tuberous sclerosis complex (TSC): EXIST-2 3-year follow-up. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/s1569-9056(14)61119-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Greer JA, Segal S, Salva CR, Arya LA. Development and Validation of Simulation Training for Vaginal Hysterectomy. J Minim Invasive Gynecol 2014; 21:74-82. [DOI: 10.1016/j.jmig.2013.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/13/2013] [Accepted: 06/24/2013] [Indexed: 11/24/2022]
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Abstract
PURPOSE Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. METHODS We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. RESULTS The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET · h · wk of PA, participants who reported ≥ 18.0 MET · h · wk of PA had an odds ratio of LLL of 0.32 (95% confidence interval, 0.15-0.69; P trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg · m (P trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥ 12 blocks per day of walking had an odds ratio of LLL of 0.19 (95% confidence interval, 0.09-0.43; P trend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg · m (P trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). CONCLUSION Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.
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Affiliation(s)
- Justin C. Brown
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, PA
| | | | - Saya Segal
- Division of Female Pelvic Medicine and Reconstructive Surgery; University of Medicine and Dentistry of New Jersey, New Brunswick, NJ
| | - Christina S. Chu
- Divsion of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, PA
| | - Kathryn H. Schmitz
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, PA
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Harper C, Corlett C, Macdonald G, Worthington G, Porter D, Kelly D, Segal S, Pollard AJ, Atkinson S. PW03-032 – Periodic fevers in children. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952387 DOI: 10.1186/1546-0096-11-s1-a258] [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: 11/19/2022] Open
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Greer JA, Northington GM, Harvie HS, Segal S, Johnson JC, Arya LA. Functional Status and Postoperative Morbidity in Older Women with Prolapse. J Urol 2013; 190:948-52. [DOI: 10.1016/j.juro.2013.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 03/01/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Joy A. Greer
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Gina M. Northington
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Heidi S. Harvie
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Saya Segal
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Jerry C. Johnson
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
| | - Lily A. Arya
- Division of Urogynecology, Department of Obstetrics and Gynecology and Division of Geriatric Medicine, Department of Internal Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, and Departments of Obstetrics and Gynecology and Surgery, University of Medicine and Dentistry of New Jersey, New
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Abstract
The majority of women with pelvic organ prolapse and stress urinary incontinence report more than one symptom that affects urinary, bowel, or sexual function. Most research studies on outcomes following surgery for pelvic organ prolapse and stress incontinence focus on anatomic outcomes and relief of symptoms specific to prolapse and/or stress incontinence. Pelvic symptoms related to voiding function such as de novo urgency or incontinence, bowel function, and sexual function are clinically important outcomes but are infrequently reported. Deterioration of pelvic symptoms postoperatively is associated with decreased patient satisfaction, which underscores the importance of effectively assessing functional and anatomic treatment outcomes. Future studies of reconstructive pelvic surgery should routinely include multiple domain functional outcomes specifically addressing voiding, defecatory, and sexual function.
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Affiliation(s)
- Saya Segal
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 1000 Courtyard, Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Lily A. Arya
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 1000 Courtyard, Ravdin, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Ariana L. Smith
- Division of Urology, Department of Surgery, University of Pennsylvania Health System, 299 South 8th Street, Philadelphia, PA 19104, USA
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Saad F, Perez J, Segal S, Eastham J. 918 Prostate-specific antigen kinetics in patients with bone metastases from castration-resistant prostate cancer receiving zoledronic acid therapy. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s1569-9056(12)60915-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
OBJECTIVE To determine if women with urinary incontinence are able to recognize patterns of fluid intake associated with lower urinary tract symptoms. METHODS We performed a cross-sectional study of 256 consecutive women with urinary incontinence at an initial visit to a urogynecology practice. Data from the Questionnaire-Based Voiding Diary, a validated instrument that measures volume of fluid intake, fluid intake behavior, and lower urinary tract symptoms, were abstracted. Carbonated, caffeinated, and total fluid intake volumes were analyzed. Behaviors of excess consumption of caffeinated, carbonated, and total fluid intake as well as restriction of fluid intake were measured. Fluid intake volumes were divided into quartiles and correlated to fluid intake behavior and lower urinary tract symptoms. RESULTS Fluid intake behaviors of drinking excess carbonated and caffeinated beverages were significantly associated with the volume of carbonated (p<0.001) and caffeinated fluid intake (p<0.001). The behavior of drinking excess fluid was significantly associated with the total volume of fluid intake (p=0.019). A significant relationship between quartiles of total fluid intake and increasing number of daily voids (p<0.001) and quartiles of caffeinated fluid intake and increasing severity of urgency urinary incontinence (p=0.038) was noted. A direct statistical association between fluid intake behavior and lower urinary tract symptoms was not noted. CONCLUSIONS Women with urinary incontinence recognize their pattern of fluid intake and fluid intake behavior. The type and volume of fluid intake are significantly associated with symptoms of urinary frequency and urgency urinary incontinence.
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Affiliation(s)
- Saya Segal
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Arya LA, Heidi H, Cory L, Segal S, Northington GM. Construct validity of a questionnaire to measure the type of fluid intake and type of urinary incontinence. Neurourol Urodyn 2011; 30:1597-602. [PMID: 21462242 DOI: 10.1002/nau.21091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 02/08/2011] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the reproducibility and construct validity of the Questionnaire Based Voiding Diary (QVD) for measuring the type and volume of fluid intake and the type of urinary incontinence. METHODS 250 women completed the QVD, a 48-hour bladder diary and underwent complete urogynecologic evaluation to determine a final clinical diagnosis. The questionnaire was re-administered after a 2-week period with no change in treatment, and 2-3 months later following treatment of urinary symptoms. RESULTS The reproducibility of the fluid intake, output, fluid intake behavior and urinary symptom subscales of the QVD was 0.68-0.92. Correlation of the fluid intake scale of the QVD with the 48-hour voiding diary for determining the type and volume of fluid intake was high (r = 0.65-0.83, P < 0.01). High correlations were noted between the fluid intake behavior scale and urinary frequency (r = 0.82, P < .01), urgency (r = 0.77, P < .01) and urge incontinence (r = 0.71, P < .01). The median total fluid intake and mean urinary symptom score was significantly lower in responders (2074 mL, 10.2 ± 3.3) than non-responders (2347 mL, 18.5 ± 4.6). As compared to the final clinical diagnosis, the sensitivity, specificity and positive likelihood ratio of the QVD for the diagnosis of predominant stress urinary incontinence are 86%, 66% and 2.6 and for predominant urge incontinence 82%, 79% and 4.0 respectively. CONCLUSION The QVD provides clinically meaningful information on the type and volume of fluid intake and the type of urinary incontinence at the initial office visit.
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Affiliation(s)
- Lily A Arya
- Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Tsai MC, Gulyaeva L, Segal S, Maxwell E, Mittal K. Postoperative Diagnosis of an Unsuspected Ruptured Appendiceal Mucinous Cystadenoma in a Perimenopausal Woman. J Gynecol Surg 2010. [DOI: 10.1089/gyn.2009.0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ming C. Tsai
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY
| | - Luba Gulyaeva
- New York University School of Medicine, New York, NY
| | - Saya Segal
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY
| | - Elizabeth Maxwell
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY
| | - Khushbakhat Mittal
- Department of Pathology, New York University School of Medicine, New York, NY
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Segal S, Mercado R, Rivnay B. Ectopic pregnancy early diagnosis markers. Minerva Ginecol 2010; 62:49-62. [PMID: 20186114] [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: 05/28/2023]
Abstract
Ectopic pregnancy (EP) is a high-risk medical condition with an incidence of 1.9% in reported pregnancies, and has proven to be the most common cause of pregnancy-related deaths in the first trimester. The clinical symptoms can mimic non-EP conditions, thus creating a challenge for developing diagnostic criteria and new diagnostic tools. Early diagnosis of ectopic pregnancy is essential in order to minimize the morbidity and to assess the need for urgent surgical intervention. Currently, ultrasound and serum biomarkers are used by clinicians for early detection and diagnosis. This review summarizes and comments on the available literature on the various markers including their utility and their statistical parameters.
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Affiliation(s)
- S Segal
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Lincoln Medical Center, Weill Medical College of Cornell University, New York, NY, USA.
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Chapman SJ, Khor CC, Vannberg FO, Rautanen A, Segal S, Moore CE, Davies RJO, Day NP, Peshu N, Crook DW, Berkley JA, Williams TN, Scott JA, Hill AVS. NFKBIZ polymorphisms and susceptibility to pneumococcal disease in European and African populations. Genes Immun 2009; 11:319-25. [PMID: 19798075 DOI: 10.1038/gene.2009.76] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The proinflammatory transcription factor nuclear factor-kappaB (NF-kappaB) has a central role in host defence against pneumococcal disease. Both rare mutations and common polymorphisms in the NFKBIA gene encoding the NF-kappaB inhibitor, IkappaB-alpha, associate with susceptibility to bacterial disease, but the possible role of polymorphisms within the related IkappaB-zeta gene NFKBIZ in the development of invasive pneumococcal disease (IPD) has not been reported previously. To investigate this further, we examined the frequencies of 22 single-nucleotide polymorphisms spanning NFKBIZ in two case-control studies, comprising UK Caucasian (n=1008) and Kenyan (n=723) individuals. Nine polymorphisms within a single UK linkage disequilibrium (LD) block and all four polymorphisms within the equivalent, shorter Kenyan LD block displayed either a significant association with IPD or a trend towards association. For each polymorphism, heterozygosity was associated with protection from IPD when compared with the combined homozygous states (for example, for rs600718, Mantel-Haenszel 2 x 2 chi(2)=7.576, P=0.006, odds ratio (OR)=0.67, 95% confidence interval (95% CI) for OR: 0.51-0.88; for rs616597, Mantel-Haenszel 2 x 2 chi(2)=8.715, P=0.003, OR=0.65, 95% CI: 0.49-0.86). We conclude that multiple NFKBIZ polymorphisms associate with susceptibility to IPD in humans. The study of multiple populations may aid in fine mapping of associations within extensive regions of strong LD ('transethnic mapping').
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Affiliation(s)
- S J Chapman
- Immunity and Inflammation, The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
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Segal S, Glatstein I, Pang S, Go K, Carson R, Ezcurra R. Comparison of outcomes between controlled ovarian stimulation with GnRH-agonist vs GnRH-antagonist for in vitro fertilization cycles in women with polycystic ovarian syndrome. Fertil Steril 2008. [DOI: 10.1016/j.fertnstert.2008.07.565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dubroff JG, Ficicioglu C, Segal S, Wintering NA, Alavi A, Newberg AB. FDG-PET findings in patients with galactosaemia. J Inherit Metab Dis 2008; 31:533-9. [PMID: 18500575 DOI: 10.1007/s10545-008-0806-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [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: 11/07/2007] [Revised: 02/12/2008] [Accepted: 02/14/2008] [Indexed: 10/22/2022]
Abstract
Despite treatment with a galactose-restricted diet, many galactosaemia patients develop lifelong cognitive impairment, speech abnormalities and a gamut of neurological problems including cognitive impairment and tremors. No study has explored changes in cerebral glucose metabolism in patients with galactosaemia. Five patients with galactosaemia had ages ranging from 20 to 40 years (mean age 28 years) and eight similarly aged controls received brain [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) scans. PET scans were analysed using a previously validated template methodology of regions of interest (ROIs). Count ratios for each anatomical ROI were compared between the galactosaemic patients and the healthy controls. Statistical parametric mapping (SPM) software was also used to further analyse the data. ROI analysis showed that galactosaemic patients had significant bilateral decreases in cerebral glucose metabolism in the superior temporal gyrus, medial occipital lobe, parietal lobe, cerebellum, calcarine cortex, superior frontal cortex, and superior parietal cortex when compared with controls. Significant increases were seen in the cingulate gyrus and temporal poles, bilaterally. SPM analysis revealed foci of decreased glucose metabolism in the caudate, cerebellum, precentral gyrus and cerebellar tonsils of galactosaemic patients. SPM also showed increased glucose metabolism in the subcallosal gyrus and claustrum. The results show significant abnormalities in cerebral function in patients with galactosaemia, particularly with widespread decreases in cortical metabolism. These abnormalities appear to be in brain regions that may be associated with the neuropsychological deficits in these patients. PET brain scans may be of value in galactosaemia patients to evaluate for dysfunction.
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Affiliation(s)
- J G Dubroff
- Division of Nuclear Medicine, Department of Radiology, The University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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Fedida-Metula S, Sion-Vardy N, Suzlovich Z, Osyntsov L, Segal S, Fishman D. Expression pattern of IL-1 beta in malignant and benign prostate tissues coincides with its inhibitory effects on carcinoma cells. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)71805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Devanand DP, Pradhaban G, Liu X, Khandji A, De Santi S, Segal S, Rusinek H, Pelton GH, Honig LS, Mayeux R, Stern Y, Tabert MH, de Leon MJ. Hippocampal and entorhinal atrophy in mild cognitive impairment: prediction of Alzheimer disease. Neurology 2007; 68:828-36. [PMID: 17353470 DOI: 10.1212/01.wnl.0000256697.20968.d7] [Citation(s) in RCA: 478] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the utility of MRI hippocampal and entorhinal cortex atrophy in predicting conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD). METHODS Baseline brain MRI was performed in 139 patients with MCI, broadly defined, and 63 healthy controls followed for an average of 5 years (range 1 to 9 years). RESULTS Hippocampal and entorhinal cortex volumes were each largest in controls, intermediate in MCI nonconverters, and smallest in MCI converters to AD (37 of 139 patients converted to AD). In separate Cox proportional hazards models, covarying for intracranial volume, smaller hippocampal volume (risk ratio [RR] 3.62, 95% CI 1.93 to 6.80, p < 0.0001), and entorhinal cortex volume (RR 2.43, 95% CI 1.56 to 3.79, p < 0.0001) each predicted time to conversion to AD. Similar results were obtained for hippocampal and entorhinal cortex volume in patients with MCI with Mini-Mental State Examination (MMSE) scores > or = 27 out of 30 (21% converted to AD) and in the subset of patients with amnestic MCI (35% converted to AD). In the total patient sample, when both hippocampal and entorhinal volume were entered into an age-stratified Cox model with sex, MMSE, education, and intracranial volume, smaller hippocampal volume (RR 2.21, 95% CI 1.14 to 4.29, p < 0.02) and entorhinal cortex volume (RR 2.48, 95% CI 1.54 to 3.97, p < 0.0002) predicted time to conversion to AD. Similar results were obtained in a Cox model that also included Selective Reminding Test (SRT) delayed recall and Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol as predictors. Based on logistic regression models in the 3-year follow-up sample, for a fixed specificity of 80%, the sensitivities for MCI conversion to AD were as follows: age 43.3%, MMSE 43.3%, age + MMSE 63.7%, age + MMSE + SRT delayed recall + WAIS-R Digit Symbol 80.6% (79.6% correctly classified), hippocampus + entorhinal cortex 66.7%, age + MMSE + hippocampus + entorhinal cortex 76.7% (85% correctly classified), age + MMSE + SRT delayed recall + WAIS-R Digit Symbol + hippocampus + entorhinal cortex 83.3% (86.8% correctly classified). CONCLUSIONS Smaller hippocampal and entorhinal cortex volumes each contribute to the prediction of conversion to Alzheimer disease. Age and cognitive variables also contribute to prediction, and the added value of hippocampal and entorhinal cortex volumes is small. Nonetheless, combining these MRI volumes with age and cognitive measures leads to high levels of predictive accuracy that may have potential clinical application.
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Affiliation(s)
- D P Devanand
- Department of Biological Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
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Fedida S, Fishman D, Suzlovich Z, Argov S, Friger M, Oren L, Segal S, Sion-Vardy N. Impaired access of lymphocytes to neoplastic prostate tissue is associated with neoangiogenesis in the tumour site. Br J Cancer 2007; 96:980-5. [PMID: 17325703 PMCID: PMC2360109 DOI: 10.1038/sj.bjc.6603650] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Recent reports demonstrated that neovasculature of certain murine tumours inhibits migration of lymphocytes to malignant tissues. We examined the possible existence of this phenomenon in human prostate adenocarcinoma by relating extent, patterns and composition of leucocyte infiltrates in adenocarcinoma specimens (N=28) to microvessel density and percentages of these vessels expressing adhesion molecules CD54, CD106 and CD62E. Specimens of nodular hyperplasia (N=30) were used as a control for nonmalignant prostate. Increased microvessel density was detected in foci of adenocarcinoma, as compared with adjacent benign areas (P=0.004) or hyperplastic specimens (P=0.001). Only CD54 was detected on prostate vasculature; percentages of CD54-expressing vessels in adenocarcinoma lesions and adjacent areas were higher than in hyperplasia (P=0.041 and P=0.014, respectively). Infiltrating leucocytes were either scattered diffusely in tissue or organised into clusters mainly composed of CD4-positive lymphocytes; smaller percentage of tissue was occupied by clustered infiltrates in adenocarcinoma foci (mean=0.7; median=0; range=0-5) than in adjacent tissue (mean=2.5; median=1; range=0-15; P=.021) and hyperplasia (mean=1.9; median=2; range=0-5; P=.006). In adenocarcinoma foci, microvessel density tended to negatively correlate with percentage of tissue occupied by an overall leucocyte infiltrate (mean=8.6; median=7.5; range=30) and negatively correlated with percentage of tissue occupied by clustered infiltrate (P=0.045). Percentage of CD54-expressing vessels positively correlated with percentage of tissue occupied by an overall (mean=12; median=10; range=30; P=0.01) and clustered (P=0.023) infiltrate in hyperplasia, whereas in carcinoma-adjacent benign areas, correlation was detected only for clustered infiltrates (P=0.02). The results indicate that impaired access of lymphocytes to malignant lesions is associated with increased numbers of newly formed blood vessels, whereas vascular CD54 likely contributes to extravasation of lymphocytes only in benign prostate tissue.
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Affiliation(s)
- S Fedida
- Department of Microbiology and Immunology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Department of Morphology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
| | - D Fishman
- Department of Microbiology and Immunology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Department of Morphology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Department of Microbiology and Immunology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel. E-mail:
| | - Z Suzlovich
- Institute of Pathology, Soroka University Medical Center, Beer-Sheva, Israel
| | - S Argov
- Department of Morphology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Institute of Pathology, Soroka University Medical Center, Beer-Sheva, Israel
| | - M Friger
- Department of Morphology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
| | - L Oren
- Department of Behavior Sciences, College of Judea and Samaria, POB 3, Ariel, Israel
| | - S Segal
- Department of Microbiology and Immunology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Department of Morphology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
| | - N Sion-Vardy
- Department of Morphology, Faculty of Health Sciences, Ben-Gurion University Cancer Research Center, Ben-Gurion University of the Negev POB 653, Beer-Sheva 84105, Israel
- Institute of Pathology, Soroka University Medical Center, Beer-Sheva, Israel
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Segal S, Glatstein I, Lyman C, McShane P, Ezcurra D, Mendel A. P-765. Fertil Steril 2006. [DOI: 10.1016/j.fertnstert.2006.07.1151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Smith MR, Chu F, Forrest J, Malkowicz SB, Price D, Sieber P, Barnette KG, Segal S, Steiner MS. Toremifene citrate increases bone mineral density in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4553 Background: In men with prostate cancer, androgen deprivation therapy by either surgical orchiectomy or treatment with a gonadotropin releasing hormone agonist decreases bone mineral density (BMD) and increases clinical fracture risk. In postmenopausal women, selective estrogen receptor modulators (SERMs) increase BMD and decrease fracture incidence. We conducted a multicenter randomized controlled trial to evaluate the efficacy of the SERM toremifene citrate in men with prostate cancer. Methods: In a 24-month prospective study, 1392 men with prostate cancer who have been treated with ADT for at least 6 months and are at increased risk of fracture based on either being older than 70 years of age or having evidence of osteopenia by baseline dual energy X-ray absorptiometry (DEXA) scan were assigned randomly (1:1) to receive either toremifene citrate 80mg or placebo (by mouth daily). The primary study endpoint is proportion of men with one or more fracture at 24 months. Secondary endpoints include changes in BMD of the hip and spine. Here we report the results of a planned interim analysis of 12-month changes in BMD for the first 200 subjects. Results: As summarized in the table below, toremifene citrate significantly increased BMD of the lumbar spine, total hip, and femoral neck compared to placebo. Conclusions: In men receiving ADT for prostate cancer, toremifene citrate significantly increased BMD of the hip and spine. In randomized controlled trials of SERMs in postmenopausal women, similar BMD improvements translated into statistically and clinically significant decreases in fractures risk. These interim results of BMD effects suggest toremifene citrate has the potential to provide a fracture reduction benefit in men with prostate cancer, the hypothesis being tested in the ongoing study. [Table: see text] [Table: see text]
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Affiliation(s)
- M. R. Smith
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - F. Chu
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - J. Forrest
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - S. B. Malkowicz
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - D. Price
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - P. Sieber
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - K. G. Barnette
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - S. Segal
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
| | - M. S. Steiner
- Massachusetts General Hospital, Boston, MA; San Bernadino Urology Associates, San Bernadino, CA; Urology Specialists of Oklahoma, Tulsa, OK; University of Pennsylvania, Philadelphia, PA; Regional Urology, Shreveport, LA; Urology Associates of Lancaster, Lancaster, PA; GTx, Inc., Memphis, TN
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Eviatar E, Katzenell U, Segal S, Shlamkovitch N, Kalmovich LM, Kessler A, Vaiman M. The endoscopic Draf II frontal sinusotomy: non-navigated approach. Rhinology 2006; 44:108-13. [PMID: 16792168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Endoscopic endonasal Draf II frontal sinusotomy is indicated for a variety of pathologies such as mucocele and non-responsive chronic frontal sinusitis. However, this approach is challenged and controversial. The objectives were to evaluate the advantages, disadvantages, indications, and rate of complications of this approach, without the use of a navigation system. METHODS The files and computed tomography (CT) scans of 25 patients who underwent endoscopic endonasal Draf II sinusotomy at Assaf Harofeh Medical Center between 1999 and 2002 were reviewed. RESULTS Thirty-one frontal sinuses were operated on and follow-up was between 18 and 62 months (average 30.3). Twenty-two sinuses (71%) had previous surgery. The Draf II procedure was used in 3.7% of all cases during the survey period. The most frequent indication for surgery was inflammation (48%) followed by mucocele (28%). In all but 2 sinuses (93%), the frontal floor between the lamina papyracea and the middle concha was drilled out. Twenty-four patients (96%) were successfully ventilated. No major complications were noted. CONCLUSIONS The Draf II approach can be used safely and successfully without a navigation system, including cases of revision endoscopic sinus surgery. Correct interpretation of the surgical field and a CT scan are crucial for success. Careful patient selection is essential for this procedure.
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Affiliation(s)
- E Eviatar
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
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Affiliation(s)
- S Segal
- Clinical Endocrinology Branch, National Institute of Arthritis and Metabolic Diseases, Bethesda, Md
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Li Y, Li J, Segal S, Wegiel J, De Santi S, Zhan J, de Leon MJ. Hippocampal cerebrospinal fluid spaces on MR imaging: Relationship to aging and Alzheimer disease. AJNR Am J Neuroradiol 2006; 27:912-8. [PMID: 16611790 PMCID: PMC8133961] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Accepted: 08/29/2005] [Indexed: 05/08/2023]
Abstract
BACKGROUND AND PURPOSE Perihippocampal fissures (PHFs) and hippocampal sulcus residual cavities (HSCs) are common findings in the MR imaging examination of the hippocampus in aging and Alzheimer disease (AD); however, little is known about how to distinguish them or their relative clinical relevance. We hypothesized that prominence of the HSC, unlike PHF, is not significantly influenced by the hippocampal atrophy related to aging or AD. METHODS We studied and evaluated these hippocampal CSF spaces on MR imaging scans from 130 normal control (NC) subjects (20-90 years of age) and 27 AD patients. RESULTS HSC is poorly correlated with age and is not related to the magnitude of hippocampal atrophy. There is no significant difference of HSCs between AD and age-matched NCs, but in the extremely high HSCs group (top 20%), 91% of cases are NC. PHFs, on the other hand, are strongly correlated with age and are valuable in the diagnosis of AD. Location and communication with ambient cistern is the key to distinguish HSC from PHF. CONCLUSION Identifying hippocampal atrophy (enlarged PHF) may be particularly challenging in the presence of HSC. Distinguishing among the CSF spaces in hippocampus may help in the radiologic evaluation of hippocampal atrophy. Patients with extremely high HSCs (>8.4) can be excluded from AD risk with 93% specificity.
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Affiliation(s)
- Y Li
- Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA
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de Leon MJ, DeSanti S, Zinkowski R, Mehta PD, Pratico D, Segal S, Rusinek H, Li J, Tsui W, Saint Louis LA, Clark CM, Tarshish C, Li Y, Lair L, Javier E, Rich K, Lesbre P, Mosconi L, Reisberg B, Sadowski M, DeBernadis JF, Kerkman DJ, Hampel H, Wahlund LO, Davies P. Longitudinal CSF and MRI biomarkers improve the diagnosis of mild cognitive impairment. Neurobiol Aging 2006; 27:394-401. [PMID: 16125823 DOI: 10.1016/j.neurobiolaging.2005.07.003] [Citation(s) in RCA: 171] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Revised: 05/28/2005] [Accepted: 07/01/2005] [Indexed: 11/28/2022]
Abstract
The diagnosis of Alzheimer's disease (AD) in patients with mild cognitive impairment (MCI) is limited because it is based on non-specific behavioral and neuroimaging findings. The lesions of Alzheimer's disease: amyloid beta (Abeta) deposits, tau pathology and cellular oxidative damage, affect the hippocampus in the earlier stages causing memory impairment. In a 2-year longitudinal study of MCI patients and normal controls, we examined the hypothesis that cerebrospinal fluid (CSF) markers for these pathological features improve the diagnostic accuracy over memory and magnetic resonance imaging (MRI)-hippocampal volume evaluations. Relative to control, MCI patients showed decreased memory and hippocampal volumes and elevated CSF levels of hyperphosphorylated tau and isoprostane. These two CSF measures consistently improved the diagnostic accuracy over the memory measures and the isoprostane measure incremented the accuracy of the hippocampal volume achieving overall diagnostic accuracies of about 90%. Among MCI patients, over 2 years, longitudinal hippocampal volume losses were closely associated with increasing hyperphosphorylated tau and decreasing amyloid beta-42 levels. These results demonstrate that CSF biomarkers for AD contribute to the characterization of MCI.
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Affiliation(s)
- M J de Leon
- Department of Psychiatry, New York University School of Medicine New York, Center for Brain Health of the Silberstein Institute, NY 10016, USA.
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Affiliation(s)
- S Segal
- Dept of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK.
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