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Dar N, Wills A, Berg S, Gradecki SE, Cropley TG, Guffey D. Cutaneous mucormycosis with suspected dissemination in a patient with metastatic adrenocortical carcinoma. Med Mycol Case Rep 2024; 44:100646. [PMID: 38623179 PMCID: PMC11017034 DOI: 10.1016/j.mmcr.2024.100646] [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: 06/21/2023] [Revised: 03/23/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Mucormycosis is a frequently lethal fungal infection that most commonly affects patients with poorly controlled diabetes or other immunosuppressed states. We report the case of a suspected disseminated Rhizopus infection in a patient who was pursuing naturopathic treatment including mud baths for metastatic adrenocortical carcinoma. He was empirically treated with liposomal amphotericin B but opted to stop treatment following multiorgan failure. The patient passed away on the tenth day of his hospital admission.
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Affiliation(s)
- Nakul Dar
- School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA
| | - Abigail Wills
- Department of Dermatology, University of Virginia, Charlottesville, VA, 22908, USA
| | - Scott Berg
- Department of Dermatology, University of Virginia, Charlottesville, VA, 22908, USA
| | - Sarah E. Gradecki
- Department of Pathology, University of Virginia, Charlottesville, VA, 22908, USA
| | - Thomas G. Cropley
- Department of Dermatology, University of Virginia, Charlottesville, VA, 22908, USA
| | - Darren Guffey
- Department of Dermatology, University of Virginia, Charlottesville, VA, 22908, USA
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Byrnes KG, Berg S, Luu L, Borretta L, Flowers RH. Diffuse xanthomas in a patient with lipoprotein X hyperlipidemia. JAAD Case Rep 2023; 39:88-92. [PMID: 37664447 PMCID: PMC10468320 DOI: 10.1016/j.jdcr.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Affiliation(s)
- Katherine Grace Byrnes
- University of Virginia School of Medicine, Charlottesville, Virginia
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
| | - Scott Berg
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
| | - Lydia Luu
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
| | - Lisa Borretta
- Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Richard Hal Flowers
- Department of Dermatology, University of Virginia, Charlottesville, Virginia
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Törnudd M, Ramström S, Escobar Kvitting J, Alfredsson J, Berg S. NUMBERS AND FUNCTION OF PLATELETS ARE NOT REDUCED DURING CARDIOPULMONARY BYPASS, BUT BOTH ARE REDUCED AFTER ADMINISTRATION OF PROTAMINE. J Cardiothorac Vasc Anesth 2022. [DOI: 10.1053/j.jvca.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
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Panaccione R, Ferrante M, Feagan BG, Sandborn W, Panes J, Peyrin-Biroulet L, Colombel J, Schreiber S, Dubinsky M, Baert F, Hisamatsu T, Neimark E, Huang B, Liao X, Song A, Berg S, Duan W, Pang Y, Pivorunas V, Kligys K, Wallace K, D’Haens G. A37 EFFICACY AND SAFETY OF RISANKIZUMAB AS MAINTENANCE THERAPY IN PATIENTS WITH CROHN’S DISEASE: 52 WEEK RESULTS FROM THE PHASE 3 FORTIFY STUDY. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859234 DOI: 10.1093/jcag/gwab049.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Risankizumab (RZB), an anti-IL-23 p19 inhibitor, was well-tolerated and superior to placebo (PBO) in inducing clinical remission and endoscopic response in patients (pts) with moderate-to-severe Crohn’s disease (CD) in two phase 3 studies at 12 weeks. Aims FORTIFY (NCT03105102), was a 52-week (wk) phase 3 double-blind, re-randomized responder withdrawal study that evaluated the efficacy and safety of continuing RZB as subcutaneous (SC) maintenance therapy versus withdrawal to placebo in pts achieving induction response to RZB Methods Week 12 IV RZB responders were re-randomized 1:1:1 to: RZB SC 360mg (N=141), RZB 180mg (N=157), or PBO (withdrawal from IV RZB; N=164) every 8wks for 52wks. Co-primary endpoints were clinical remission (per CD Activity Index [CDAI] (US); or stool frequency/abdominal pain score [SF/APS] (OUS) and endoscopic response at wk52. Other clinical and endoscopic endpoints, inflammatory biomarkers, RZB serum levels, and safety were assessed over time. Results Rates of clinical remission (CDAI, SF/APS) and clinical response were similar for RZB and PBO groups through wk24, with rates lower for PBO thereafter. At wk52, clinical remission (CDAI, SF/APS) and endoscopic response rates were significantly higher with RZB 360mg than PBO ( P<0.01); RZB 180mg was superior to PBO for clinical remission per CDAI and endoscopic response ( P<0.01). Endoscopic remission and deep remission rates increased over time with 360mg, remained steady with 180mg, and decreased with PBO. Mean fecal calprotectin (FCP) and C-reactive protein (CRP) levels decreased with SC RZB, but increased with PBO, over 52wks. Exposure-adjusted event rates (per 100 pts-years) of serious adverse event (AE) were generally similar among groups (360mg, 21.0 E/100PY and 180mg, 19.5 E/100PY vs PBO, 19.3 E/100PY), as were AEs leading to drug discontinuation (4.8 E/100PY and 2.4 E/100PY vs 3.7 E/100PY), and serious infections (6.0 E/100PY and 3.0 E/100PY vs 5.0 E/100PY). Conclusions In pts with moderate-to-severe CD, a robust pharmacodynamic effect on the IL-23 pathway after 12wks RZB IV induction was maintained with RZB SC maintenance therapy. The durability of RZB was demonstrated with high rates of efficacy over the 52-wk study. RZB was superior to PBO for achieving clinical remission and endoscopic response at wk52. Results for the more stringent endpoints (endoscopic remission\deep remission) and persistent improvements in inflammatory biomarkers are consistent with a dose response relationship. Continued RZB SC maintenance treatment was generally safe and well-tolerated. Funding Agencies AbbVie
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Affiliation(s)
| | - M Ferrante
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium
| | | | - W Sandborn
- University of California San Diego, La Jolla, CA
| | - J Panes
- Institut d’Investigacions Biomediques August Pi i Sunyer, Barcelona, Catalunya, Spain
| | | | | | - S Schreiber
- Universitatsklinikum Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany
| | | | - F Baert
- AZ Delta vzw, Roeselare, West-Vlaanderen, Belgium
| | - T Hisamatsu
- Kyorin Daigaku Igakubu Daigakuin Igaku Kenkyuka, Mitaka, Tokyo, Japan
| | | | - B Huang
- AbbVie Inc, North Chicago, IL
| | - X Liao
- AbbVie Inc, North Chicago, IL
| | - A Song
- AbbVie Inc, North Chicago, IL
| | - S Berg
- AbbVie Inc, North Chicago, IL
| | - W Duan
- AbbVie Inc, North Chicago, IL
| | - Y Pang
- AbbVie Inc, North Chicago, IL
| | | | | | | | - G D’Haens
- Universiteit van Amsterdam, Amsterdam, Noord-Holland, Netherlands
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Sansone M, Studahl M, Berg S, Gisslén M, Sundell N. Severe multisystem inflammatory syndrome (MIS-C/A) after confirmed SARS-CoV-2 infection: a report of four adult cases. Infect Dis (Lond) 2022; 54:378-383. [PMID: 35034549 DOI: 10.1080/23744235.2021.2025422] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Multisystem inflammatory syndrome (MIS) triggered by a recent SARS-Cov-2 infection has been recognised worldwide. Although predominantly affecting children (MIS-C), similar presentations have been reported among adults (MIS-A). METHOD A retrospective case series describing four critically ill patients with MIS-C/A diagnosed between January and April 2021 at Sahlgrenska University Hospital, Gothenburg, Sweden. Clinical presentation, laboratory and radiological findings, treatment and outcome are reported. RESULTS Cases occurred in previously healthy patients with a history of laboratory-confirmed mild SARS-CoV-2 infection four to seven weeks earlier. The median age was 24 years (range 19-43) and 3/4 were male. All fulfilled suggested MIS-C/A criteria according to the US Centre for Disease Control and all required care at an intensive care unit. Treatment was initiated with intravenous immunoglobulin, interleukin-1-receptor antagonists, and pulse steroids in 3/4 cases which resulted in rapid clinical improvement. No severe complications were noticed in any case during a three-month follow-up period. CONCLUSION MIS-C/A should be considered, irrespective of age, in patients with fever, hyperinflammation and multiple organ system involvements emerging weeks after COVID-19. Previously suggested treatment regimens for MIS-C seem to be applicable also for MIS-A.
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Affiliation(s)
- M Sansone
- Department of Infectious Diseases, Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Studahl
- Department of Infectious Diseases, Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S Berg
- Department of Paediatrics at The Queen Silvia Children's Hospital, Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - M Gisslén
- Department of Infectious Diseases, Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N Sundell
- Department of Infectious Diseases, Region Vastra Gotaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Krepostman N, Collins M, Merchant K, De Sirkar S, Chan L, Allen S, Newman J, Patel D, Fareed J, Berg S, Darki A. Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19. Eur Heart J 2021. [PMCID: PMC8767580 DOI: 10.1093/eurheartj/ehab724.2492] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients with documented or suspected COVID-19 infection is the rapid identification of features associated with severe illness using readily available laboratory tests and clinical tools. The sequential organ failure assessment (SOFA) score is a validated tool to facilitate the identification of patients at risk of dying from sepsis. Purpose The aim of this study was to assess the discriminatory accuracy of the SOFA score in predicting clinical decompensation in patients hospitalized with COVID-19 infection. Methods We conducted a retrospective analysis at a three-hospital health system, comprised of one tertiary and two community hospitals, located in the Chicago metropolitan area. All patients had positive SARS-CoV-2 testing and were hospitalized for COVID-19 infection. The primary outcome was clinical decompensation, defined as the composite endpoint of death, ICU admission, or need for intubation. We utilized the most abnormal laboratory values observed during the admission to calculate the SOFA score. Receiver Operating Curves (ROC) were then constructed to determine the sensitivity and specificity of SOFA scores. Results Between March 1st and May 31st 2020, 1029 patients were included in our analysis with 367 patients meeting the study endpoint. The median SOFA score was 2.0 IQR (Q1, Q3 1,4) for the entire cohort. Patients who had in-hospital mortality had a median SOFA score of 4.0 (Q1,Q3 3,7). In patients that met the primary composite endpoint, the median SOFA score was 3.0, IQR (Q1, Q3 2,6). The ROC was 0.776 (95% CI 0.746–0.806, p<0.01). Conclusion The SOFA score demonstrates strong discriminatory accuracy for prediction of clinical decompensation in patients presenting with COVID-19 at our urban hospital system. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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Affiliation(s)
- N Krepostman
- Loyola University Medical Center, Maywood, United States of America
| | - M Collins
- Loyola University Medical Center, Maywood, United States of America
| | - K Merchant
- Loyola University Medical Center, Maywood, United States of America
| | - S De Sirkar
- Loyola University Medical Center, Maywood, United States of America
| | - L Chan
- Loyola University Medical Center, Maywood, United States of America
| | - S Allen
- Loyola University Medical Center, Maywood, United States of America
| | - J Newman
- Loyola University Medical Center, Maywood, United States of America
| | - D Patel
- Loyola University Medical Center, Maywood, United States of America
| | - J Fareed
- Loyola University Medical Center, Maywood, United States of America
| | - S Berg
- Loyola University Medical Center, Maywood, United States of America
| | - A Darki
- Loyola University Medical Center, Maywood, United States of America
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Krepostman N, Collins M, Merchant K, De Sirkar S, Chan L, Allen S, Newman J, Patel D, Fareed J, Berg S, Darki A. Predictors of clinical decompensation in patients presenting with COVID-19 in an urban hospital health system. Eur Heart J 2021. [PMCID: PMC8767592 DOI: 10.1093/eurheartj/ehab724.2473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a pandemic which has infected more than 128 million people and led to over 2.8 million deaths worldwide. Although the introduction of efficacious vaccines has led to overall declines in the incidence of SARS-CoV-2 infection, there has been a recent increase in infections once more due to the appearance of mutant strains with higher virulence. It therefore remains vital to identify predictors of poor outcomes in this patient population. Purpose The objective of our study was to identify predictors of prolonged hospitalization, intensive care unit (ICU) admission, intubation, and death in patients infected with SARS-CoV-2. Methods We conducted a retrospective analysis of all patients hospitalized with SARS-CoV-2 at our health system that includes one tertiary care center and two community hospitals located in the Chicago metropolitan area. The main outcome was a composite endpoint of hospitalization >28 days, ICU admission, intubation, and death. Explanatory variables associated with the primary outcome in the bivariate analysis (p<0.05) were included in the multivariable logistic regression model. Statistical analysis was performed using IBM SPSS 25.0. Results Between March 1, 2020 and May 31, 2020, 1029 patients hospitalized with SARS-CoV-2 were included in our analysis. Of these patients, 379 met the composite endpoint. Baseline demographics are described in Table 1. Of note, our cohort consisted of a predominantly minority patient population including 47% Hispanic, 17% African American, 16% Caucasian, and 16% other. In bivariate analysis, age, hypertension, tobacco and alcohol abuse, obesity, coronary artery disease, arrhythmias, valvular heart disease, dyslipidemia, hypertension, stroke, diabetes, documented thrombosis, troponin, CRP, ESR, ferritin, LDH, BNP, D-dimer >5x the upper limit of normal, lactate, and right ventricular outflow tract velocity time integral <9.5 were significant. After multivariable adjustment, explanatory variables associated with the composite endpoint included troponin (OR 2.36; 95% CI 1.08–5.17, p 0.03), D-dimer (OR 1.5; 95% CI 1.23–1.98, p<0.01, lactate (OR 1.58; 95% CI 1.28–1.95, p<0.01), and documented thrombosis (OR 3.56; 95% CI 1.30–8.70, p<.05). Race was not a predictor of poor outcomes in the bivariate or multivariate analysis (Table 2). Conclusions In a large urban cohort with a predominantly minority population, we identified several clinical predictors of poor outcomes. Of note, race was not a predictor of the primary endpoint in this study. While recent literature has demonstrated worse outcomes among racial minorities infected with SARS-CoV-2, our data suggests these variations are related to social determinants of health rather than biologic causes. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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Affiliation(s)
- N Krepostman
- Loyola University Medical Center, Maywood, United States of America
| | - M Collins
- Loyola University Medical Center, Maywood, United States of America
| | - K Merchant
- Loyola University Medical Center, Maywood, United States of America
| | - S De Sirkar
- Loyola University Medical Center, Maywood, United States of America
| | - L Chan
- Loyola University Medical Center, Maywood, United States of America
| | - S Allen
- Loyola University Medical Center, Maywood, United States of America
| | - J Newman
- Loyola University Medical Center, Maywood, United States of America
| | - D Patel
- Loyola University Medical Center, Maywood, United States of America
| | - J Fareed
- Loyola University Medical Center, Maywood, United States of America
| | - S Berg
- Loyola University Medical Center, Maywood, United States of America
| | - A Darki
- Loyola University Medical Center, Maywood, United States of America
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Juhlin D, Hammarskjöld F, Mernelius S, Taxbro K, Berg S. Microbiological colonization of peripheral venous catheters: a prospective observational study in a Swedish county hospital. Infect Prev Pract 2021; 3:100152. [PMID: 34458717 PMCID: PMC8379694 DOI: 10.1016/j.infpip.2021.100152] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/01/2021] [Indexed: 11/20/2022] Open
Abstract
Background Most peripheral venous catheters (PVCs) used in Scandinavia are fitted with an injection port, creating an open PVC system. This port is difficult to disinfect, which may lead to the introduction of micro-organisms upon use. Aim To investigate the prevalence of microbiological colonization of the injection port and internal lumen of ported PVCs with a minimum dwell time of 48 h at sample collection. Methods Adult patients admitted to different medical and surgical departments and the intensive care unit were invited to participate in this prospective observational study. With the PVC in situ, the injection port and internal lumen were swabbed and cultured separately. Demographic and clinical data were collected to compare patients with colonized and non-colonized PVCs. Findings In total, 300 PVCs from 300 patients were analysed. Of these, 33 patients (11.0%) had at least one positive culture. The colonization locations were as follows: port only, 26 (8.7%); internal lumen only, 5 (1.7%); and port and internal lumen, 2 (0.7%). The colonization rate was significantly higher in the injection port than in the internal lumen (P<0.0001). A ported PVC inserted in the hand incurred a significant risk of colonization (P=0.03). The odds ratio for colonization among patients in the infectious diseases department was 0.1 (95% confidence interval 0.1–1; P<0.06) compared with patients in the medical department. Conclusion This study showed that 11% of ported PVCs were colonized by micro-organisms, with the vast majority (8.7%) of colonization occurring in the injection port. Clinical trial registration ClinicalTrials.gov; ID NCT03351725.
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Affiliation(s)
- D. Juhlin
- Department of Anaesthesia and Intensive Care Medicine, Ryhov County Hospital, Jönköping, Sweden
| | - F. Hammarskjöld
- Department of Anaesthesia and Intensive Care Medicine, Ryhov County Hospital, Jönköping, Sweden
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - S. Mernelius
- Microbiology Laboratory, Department of Laboratory Services, Division of Medical Services, Ryhov County Hospital, Jönköping, Sweden
| | - K. Taxbro
- Department of Anaesthesia and Intensive Care Medicine, Ryhov County Hospital, Jönköping, Sweden
| | - S. Berg
- Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Linköping University Hospital, Linköping, Sweden
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Corresponding author. Address: Department of Cardiothoracic Surgery, University Hospital, SE-581 85 Linköping, Sweden.
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Ruspini LC, Øren PE, Berg S, Masalmeh S, Bultreys T, Taberner C, Sorop T, Marcelis F, Appel M, Freeman J, Wilson OB. Multiscale Digital Rock Analysis for Complex Rocks. Transp Porous Media 2021. [DOI: 10.1007/s11242-021-01667-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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David KA, Sundaram S, Kim S, Vaca R, Lin Y, Singer S, Malecek M, Carter J, Zayac A, Kim MS, Reddy N, Ney D, Habib A, Strouse C, Graber J, Bachanova V, Salman S, Vendiola JA, Hossain N, Tsang M, Major A, Bond DB, Agrawal P, Mier‐Hicks A, Torka P, Rajakumar P, Venugopal P, Berg S, Glantz M, Goldlust S, Kumar P, Ollila T, Cai J, Spurgeon S, Sieg A, Cleveland J, Epperla N, Karmali R, Naik S, Martin P, Smith SM, Rubenstein J, Kahl B, Evens AM. OLDER PATIENTS WITH PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL): REAL WORLD (RW) OUTCOMES OF POST‐INDUCTION THERAPY IN THE MODERN ERA. Hematol Oncol 2021. [DOI: 10.1002/hon.69_2880] [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: 11/10/2022]
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Grivas P, Khaki AR, Wise-Draper TM, French B, Hennessy C, Hsu CY, Shyr Y, Li X, Choueiri TK, Painter CA, Peters S, Rini BI, Thompson MA, Mishra S, Rivera DR, Acoba JD, Abidi MZ, Bakouny Z, Bashir B, Bekaii-Saab T, Berg S, Bernicker EH, Bilen MA, Bindal P, Bishnoi R, Bouganim N, Bowles DW, Cabal A, Caimi PF, Chism DD, Crowell J, Curran C, Desai A, Dixon B, Doroshow DB, Durbin EB, Elkrief A, Farmakiotis D, Fazio A, Fecher LA, Flora DB, Friese CR, Fu J, Gadgeel SM, Galsky MD, Gill DM, Glover MJ, Goyal S, Grover P, Gulati S, Gupta S, Halabi S, Halfdanarson TR, Halmos B, Hausrath DJ, Hawley JE, Hsu E, Huynh-Le M, Hwang C, Jani C, Jayaraj A, Johnson DB, Kasi A, Khan H, Koshkin VS, Kuderer NM, Kwon DH, Lammers PE, Li A, Loaiza-Bonilla A, Low CA, Lustberg MB, Lyman GH, McKay RR, McNair C, Menon H, Mesa RA, Mico V, Mundt D, Nagaraj G, Nakasone ES, Nakayama J, Nizam A, Nock NL, Park C, Patel JM, Patel KG, Peddi P, Pennell NA, Piper-Vallillo AJ, Puc M, Ravindranathan D, Reeves ME, Reuben DY, Rosenstein L, Rosovsky RP, Rubinstein SM, Salazar M, Schmidt AL, Schwartz GK, Shah MR, Shah SA, Shah C, Shaya JA, Singh SRK, Smits M, Stockerl-Goldstein KE, Stover DG, Streckfuss M, Subbiah S, Tachiki L, Tadesse E, Thakkar A, Tucker MD, Verma AK, Vinh DC, Weiss M, Wu JT, Wulff-Burchfield E, Xie Z, Yu PP, Zhang T, Zhou AY, Zhu H, Zubiri L, Shah DP, Warner JL, Lopes G. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol 2021; 32:787-800. [PMID: 33746047 PMCID: PMC7972830 DOI: 10.1016/j.annonc.2021.02.024] [Citation(s) in RCA: 202] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/18/2021] [Accepted: 02/28/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patients with cancer may be at high risk of adverse outcomes from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed a cohort of patients with cancer and coronavirus 2019 (COVID-19) reported to the COVID-19 and Cancer Consortium (CCC19) to identify prognostic clinical factors, including laboratory measurements and anticancer therapies. PATIENTS AND METHODS Patients with active or historical cancer and a laboratory-confirmed SARS-CoV-2 diagnosis recorded between 17 March and 18 November 2020 were included. The primary outcome was COVID-19 severity measured on an ordinal scale (uncomplicated, hospitalized, admitted to intensive care unit, mechanically ventilated, died within 30 days). Multivariable regression models included demographics, cancer status, anticancer therapy and timing, COVID-19-directed therapies, and laboratory measurements (among hospitalized patients). RESULTS A total of 4966 patients were included (median age 66 years, 51% female, 50% non-Hispanic white); 2872 (58%) were hospitalized and 695 (14%) died; 61% had cancer that was present, diagnosed, or treated within the year prior to COVID-19 diagnosis. Older age, male sex, obesity, cardiovascular and pulmonary comorbidities, renal disease, diabetes mellitus, non-Hispanic black race, Hispanic ethnicity, worse Eastern Cooperative Oncology Group performance status, recent cytotoxic chemotherapy, and hematologic malignancy were associated with higher COVID-19 severity. Among hospitalized patients, low or high absolute lymphocyte count; high absolute neutrophil count; low platelet count; abnormal creatinine; troponin; lactate dehydrogenase; and C-reactive protein were associated with higher COVID-19 severity. Patients diagnosed early in the COVID-19 pandemic (January-April 2020) had worse outcomes than those diagnosed later. Specific anticancer therapies (e.g. R-CHOP, platinum combined with etoposide, and DNA methyltransferase inhibitors) were associated with high 30-day all-cause mortality. CONCLUSIONS Clinical factors (e.g. older age, hematological malignancy, recent chemotherapy) and laboratory measurements were associated with poor outcomes among patients with cancer and COVID-19. Although further studies are needed, caution may be required in utilizing particular anticancer therapies. CLINICAL TRIAL IDENTIFIER NCT04354701.
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Affiliation(s)
- P Grivas
- University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA.
| | - A R Khaki
- University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA; Stanford University, Stanford, USA
| | | | - B French
- Vanderbilt University Medical Center, Nashville, USA
| | - C Hennessy
- Vanderbilt University Medical Center, Nashville, USA
| | - C-Y Hsu
- Vanderbilt University Medical Center, Nashville, USA
| | - Y Shyr
- Vanderbilt University Medical Center, Nashville, USA
| | - X Li
- Vanderbilt University School of Medicine, Nashville, USA
| | | | - C A Painter
- Broad Institute, Cancer Program, Cambridge, USA
| | - S Peters
- Lausanne University, Lausanne, Switzerland
| | - B I Rini
- Vanderbilt University Medical Center, Nashville, USA
| | | | - S Mishra
- Vanderbilt University Medical Center, Nashville, USA
| | - D R Rivera
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, USA
| | - J D Acoba
- University of Hawaii Cancer Center, Honolulu, USA
| | - M Z Abidi
- University of Colorado School of Medicine, Aurora, USA
| | - Z Bakouny
- Dana-Farber Cancer Institute, Boston, USA
| | - B Bashir
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA
| | | | - S Berg
- Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, USA
| | | | - M A Bilen
- Winship Cancer Institute of Emory University, Atlanta, USA
| | - P Bindal
- Beth Israel Deaconess Medical Center, Boston, USA
| | - R Bishnoi
- University of Florida, Gainesville, USA
| | - N Bouganim
- McGill University Health Centre, Montréal, Canada
| | - D W Bowles
- University of Colorado School of Medicine, Aurora, USA
| | - A Cabal
- University of California San Diego, Moores Cancer Center, La Jolla, USA
| | - P F Caimi
- University Hospitals Seidman Cancer Center, Cleveland, USA; Case Western Reserve University, Cleveland, USA
| | - D D Chism
- Thompson Cancer Survival Center, Knoxville, USA
| | - J Crowell
- St. Elizabeth Healthcare, Edgewood, USA
| | - C Curran
- Dana-Farber Cancer Institute, Boston, USA
| | - A Desai
- Mayo Clinic Cancer Center, Rochester, USA
| | - B Dixon
- St. Elizabeth Healthcare, Edgewood, USA
| | - D B Doroshow
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - E B Durbin
- Markey Cancer Center, University of Kentucky, Lexington, USA
| | - A Elkrief
- McGill University Health Centre, Montréal, Canada
| | - D Farmakiotis
- The Warren Alpert Medical School of Brown University, Providence, USA
| | - A Fazio
- Tufts Medical Center Cancer Center, Boston and Stoneham, USA
| | - L A Fecher
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - D B Flora
- St. Elizabeth Healthcare, Edgewood, USA
| | - C R Friese
- University of Michigan Rogel Cancer Center, Ann Arbor, USA
| | - J Fu
- Tufts Medical Center Cancer Center, Boston and Stoneham, USA
| | - S M Gadgeel
- Henry Ford Cancer Institute/Henry Ford Health System, Detroit, USA
| | - M D Galsky
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - D M Gill
- Intermountain Healthcare, Salt Lake City, USA
| | | | - S Goyal
- George Washington University, Washington DC, USA
| | - P Grover
- University of Cincinnati Cancer Center, Cincinnati, USA
| | - S Gulati
- University of Cincinnati Cancer Center, Cincinnati, USA
| | - S Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, USA
| | | | | | - B Halmos
- Albert Einstein Cancer Center/Montefiore Medical Center, Bronx, USA
| | - D J Hausrath
- Vanderbilt University School of Medicine, Nashville, USA
| | - J E Hawley
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, USA
| | - E Hsu
- Hartford HealthCare, Hartford, USA; University of Connecticut, Farmington, USA
| | - M Huynh-Le
- George Washington University, Washington DC, USA
| | - C Hwang
- Henry Ford Cancer Institute/Henry Ford Health System, Detroit, USA
| | - C Jani
- Mount Auburn Hospital, Cambridge, USA
| | | | - D B Johnson
- Vanderbilt University Medical Center, Nashville, USA
| | - A Kasi
- University of Kansas Medical Center, Kansas City, USA
| | - H Khan
- The Warren Alpert Medical School of Brown University, Providence, USA
| | - V S Koshkin
- University of California, San Francisco, San Francisco, USA
| | - N M Kuderer
- Advanced Cancer Research Group, LLC, Kirkland, USA
| | - D H Kwon
- University of California, San Francisco, San Francisco, USA
| | | | - A Li
- Baylor College of Medicine, Houston, USA
| | | | - C A Low
- Intermountain Healthcare, Salt Lake City, USA
| | | | - G H Lyman
- University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA
| | - R R McKay
- University of California San Diego, Moores Cancer Center, La Jolla, USA
| | - C McNair
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA
| | - H Menon
- Penn State Health/Penn State Cancer Institute/St. Joseph Cancer Center, Hershey, USA
| | - R A Mesa
- Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, USA
| | - V Mico
- Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, USA
| | - D Mundt
- Advocate Aurora Health, Milwaukee, USA
| | - G Nagaraj
- Loma Linda University Cancer Center, Loma Linda, USA
| | - E S Nakasone
- University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA
| | - J Nakayama
- Case Western Reserve University, Cleveland, USA; University Hospitals Cleveland Medical Center, Cleveland, USA
| | - A Nizam
- Cleveland Clinic Taussig Cancer Institute, Cleveland, USA
| | - N L Nock
- University Hospitals Seidman Cancer Center, Cleveland, USA; Case Western Reserve University, Cleveland, USA
| | - C Park
- University of Cincinnati Cancer Center, Cincinnati, USA
| | - J M Patel
- Beth Israel Deaconess Medical Center, Boston, USA
| | - K G Patel
- University of California Davis Comprehensive Cancer Center, Sacramento, USA
| | - P Peddi
- Willis-Knighton Cancer Center, Shreveport, USA
| | - N A Pennell
- Cleveland Clinic Taussig Cancer Institute, Cleveland, USA
| | | | - M Puc
- Virtua Health, Marlton, USA
| | | | - M E Reeves
- Loma Linda University Cancer Center, Loma Linda, USA
| | - D Y Reuben
- Medical University of South Carolina, Charleston, USA
| | | | - R P Rosovsky
- Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | - M Salazar
- Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, USA
| | | | - G K Schwartz
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, USA
| | - M R Shah
- Rutgers Cancer Institute of New Jersey, New Brunswick, USA
| | - S A Shah
- Stanford University, Stanford, USA
| | - C Shah
- University of Florida, Gainesville, USA
| | - J A Shaya
- University of California San Diego, Moores Cancer Center, La Jolla, USA
| | - S R K Singh
- Henry Ford Cancer Institute/Henry Ford Health System, Detroit, USA
| | - M Smits
- ThedaCare Regional Cancer Center, Appleton, USA
| | | | - D G Stover
- The Ohio State University, Columbus, USA
| | | | - S Subbiah
- Stanley S. Scott Cancer Center, LSU Health Sciences Center, New Orleans, USA
| | - L Tachiki
- University of Washington/Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, USA
| | - E Tadesse
- Advocate Aurora Health, Milwaukee, USA
| | - A Thakkar
- Albert Einstein Cancer Center/Montefiore Medical Center, Bronx, USA
| | - M D Tucker
- Vanderbilt University Medical Center, Nashville, USA
| | - A K Verma
- Albert Einstein Cancer Center/Montefiore Medical Center, Bronx, USA
| | - D C Vinh
- McGill University Health Centre, Montréal, Canada
| | - M Weiss
- ThedaCare Regional Cancer Center, Appleton, USA
| | - J T Wu
- Stanford University, Stanford, USA
| | | | - Z Xie
- Mayo Clinic Cancer Center, Rochester, USA
| | - P P Yu
- Hartford HealthCare, Hartford, USA
| | - T Zhang
- Duke University, Durham, USA
| | - A Y Zhou
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, USA
| | - H Zhu
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
| | - L Zubiri
- Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - D P Shah
- Mays Cancer Center at UT Health San Antonio MD Anderson, San Antonio, USA
| | - J L Warner
- Vanderbilt University Medical Center, Nashville, USA
| | - GdL Lopes
- University of Miami/Sylvester Comprehensive Cancer Center, Miami, USA
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12
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Eldhagen P, Berg S, Lund LH, Sörensson P, Suhr OB, Westermark P. Transthyretin amyloid deposits in lumbar spinal stenosis and assessment of signs of systemic amyloidosis. J Intern Med 2021; 289:895-905. [PMID: 33274477 PMCID: PMC8248398 DOI: 10.1111/joim.13222] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Wild-type transthyretin (ATTRwt) amyloidosis is the most common systemic amyloidosis in Western countries and manifests mainly as progressive restrictive cardiomyopathy. OBJECTIVE To study the prevalence of ATTR deposits in ligament tissue in patients undergoing surgery for lumbar spinal stenosis and to assess whether these deposits are associated with cardiac amyloidosis. MATERIALS AND METHODS A total of 250 patients, aged 50-89 (57% women), none with known cardiovascular disease, were included. Ligaments were investigated microscopically for amyloid. ATTR type was determined by immunohistochemistry and fibril type by Western blot. The amount of amyloid was graded 0-4. All patients with grade 3-4 ATTR deposits were offered cardiac investigation including ECG, cardiac ultrasound, plasma NT-proBNP and cardiac magnetic resonance (CMR), including modern tissue characterization. RESULTS Amyloid was identified in 221 of the samples (88.4%). ATTR appeared in 93 samples (37%) of whom 42 (17 women and 25 men) were graded 3-4; all had fibril type A (mixture of full-length TTR and fragmented TTR). Twenty-nine of 42 patients with grade 3-4 ATTR deposits accepted cardiovascular investigations; none of them had definite signs of cardiac amyloidosis, but five men had a history of carpal tunnel syndrome. CONCLUSIONS The prevalence of ATTR deposits in ligamentum flavum in patients with lumbar spinal stenosis was high but not associated with manifest ATTR cardiac amyloidosis. However, the findings of fibril type A, the prevalence of previous carpal tunnel syndrome and ATTR amyloid in surrounding adipose and vascular tissue indicate that amyloid deposits in ligamentum flavum may be an early manifestation of systemic ATTR disease.
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Affiliation(s)
- P Eldhagen
- From the, Department of Medicine, Karolinska Institute, Karolinska University Hospital, Solna, Sweden
| | - S Berg
- Stockholm Spine Centre, Löwenströmska Hospital, Upplands Väsby, Sweden
| | - L H Lund
- From the, Department of Medicine, Karolinska Institute, Karolinska University Hospital, Solna, Sweden
| | - P Sörensson
- From the, Department of Medicine, Karolinska Institute, Karolinska University Hospital, Solna, Sweden
| | - O B Suhr
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - P Westermark
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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13
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Lakhoo K, Davies J, Chakraborty S, Berg S, Tennyson R, Fowler D, Manek S, Verrill C, Lane S. Correction to: Development of a new reproductive tissue cryopreservation clinical service for children: the Oxford programme. Pediatr Surg Int 2020; 36:537. [PMID: 32030460 PMCID: PMC7645559 DOI: 10.1007/s00383-020-04624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the published version, the Acknowledgements section was missing a funding note of co-author Dr C Verrill. The corrected version should read as follows.
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Affiliation(s)
- K. Lakhoo
- Department of Paediatric Surgery, University of Oxford and Oxford University Hospitals, Oxford, UK ,Nuffield Department of Surgery, Oxford University and Oxford University Hospitals, Headley Way, Oxford, OX39DA UK
| | - J. Davies
- Oxford Tissue Bank, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Chakraborty
- Department of Paediatric Radiology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Berg
- Department of Paediatric Anaesthesia, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - R. Tennyson
- Department of Psychology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - D. Fowler
- Department of Cellular Pathology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Manek
- Department of Cellular Pathology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - C. Verrill
- Department of Cellular Pathology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Lane
- Department of Paediatrics and Child Health, University of Oxford and Oxford University Hospitals, Oxford, UK
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14
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Larsson K, Möller T, Berg S, Berntsson I, Eklund E, Hald B, Jacobsson KG, Langseth W, MacDonald S, Majerus P, Mann P, Rasmussen G, Wood G. Liquid Chromatographic Determination of Ochratoxin A in Barley, Wheat Bran, and Rye by the AOAC/IUPAC/NMKL Method: NMKL Collaborative Study1. J AOAC Int 2020. [DOI: 10.1093/jaoac/79.5.1102] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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
In an inter laboratory study of the AOAC/lnternational Union of Pure and Applied Chemistry (IUPAC)/ Nordic Committee on Food Analysis (NMKL) liquid chromatographic method for ochratoxin A (OTA), 3 spiked samples each of wheat bran and rye and 3 naturally contaminated barley samples with expected OTA contents between 2 and 9 μg/kg were analyzed by 12 European laboratories. Mean recoveries ranged from 64 to 72%. Within-laboratory standard deviations were 21,17, and 12% for wheat bran, rye, and barley, respectively. Corresponding between-laboratory standard deviations were 23-28,20-28, and 18-31%. Horwitz ratio values ranged from 0.50 to 0.77. The method was accepted as an official NMKL method for determining OTA at ≥2 μg/kg in cereals and cereal products.
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Affiliation(s)
- Kjell Larsson
- Lantmönnen Foderutveckling AB, Box 30192, S-104 25 Stockholm, Sweden
| | - Tord Möller
- Lantmönnen Foderutveckling AB, Box 30192, S-104 25 Stockholm, Sweden
| | - S Berg
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - I Berntsson
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - E Eklund
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - B Hald
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - K-G Jacobsson
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - W Langseth
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - S MacDonald
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - P Majerus
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - P Mann
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - G Rasmussen
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
| | - G Wood
- National Food Administration, Box 622, S-751 26 Uppsala, Sweden
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15
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Flanigan RC, Dornbier R, Quek ML, Woods M, Gorbonos A, Gupta G, Harkenrider MM, Solanki A, Badami A, Henry E, Berg S, Bova D, Barkan GA, Picken MM. Penile Paget's Disease: A Case Report and Review of the Literature. Arch Nephrol Urol 2020; 3:90-96. [PMID: 36714463 PMCID: PMC9884174 DOI: 10.26502/anu.2644-2833025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Extramammary Paget's Disease (EMPD) is a rare cutaneous, slow growing, intraepithelial adenocarcinoma that can be either primary (intraepithelial arising within the epidermis) or secondary (intraepithelial spread of a visceral carcinoma). Here we present the case of a 63-year-old male with EMPD of the glans penis stemming from underlying urothelial carcinoma. Our treatment decision elected for management with chemotherapy and local treatment with radiation therapy. Subsequent, review of the literature demonstrated a rare disease with a variety of underlying malignancies causing this secondary pathology. Caregivers should be aware of the association of Paget's disease and urothelial cancer and should have a high index of suspicion that erythematous penile lesions may represent Paget's disease and that penile biopsies should be performed early in this setting.
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Affiliation(s)
- R C Flanigan
- The Departments of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - R Dornbier
- The Departments of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - M L Quek
- The Departments of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - M Woods
- The Departments of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - A Gorbonos
- The Departments of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - G Gupta
- The Departments of Urology, Loyola University Medical Center, Maywood, IL, USA
| | - M M Harkenrider
- Radiation Oncology, Loyola University Medical Center, Maywood, IL, USA
| | - A Solanki
- Radiation Oncology, Loyola University Medical Center, Maywood, IL, USA
| | - A Badami
- Medical Oncology, Loyola University Medical Center, Maywood, IL, USA
| | - E Henry
- Medical Oncology, Loyola University Medical Center, Maywood, IL, USA
| | - S Berg
- Medical Oncology, Loyola University Medical Center, Maywood, IL, USA
| | - D Bova
- Radiology, Loyola University Medical Center, Maywood, IL, USA
| | - G A Barkan
- Pathology, Loyola University Medical Center, Maywood, IL, USA
| | - M M Picken
- Pathology, Loyola University Medical Center, Maywood, IL, USA
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16
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Jackson S, Stanley N, Berg S, Oulton C. A short device-based questionnaire 'sleephubs check-up' to engage the general population in understanding more about their sleep. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Lakhoo K, Davies J, Chakraborty S, Berg S, Tennyson R, Fowler D, Manek S, Verrill C, Lane S. Development of a new reproductive tissue cryopreservation clinical service for children: the Oxford programme. Pediatr Surg Int 2019; 35:1271-1278. [PMID: 31267143 PMCID: PMC6800834 DOI: 10.1007/s00383-019-04503-3] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2019] [Indexed: 12/04/2022]
Abstract
PURPOSE This article describes the development of a new reproductive tissue cryopreservation clinical service for children at high risk of infertility in the NHS during times of severe financial constraints in the health service. METHOD A development plan with two phases was drawn up. Phase 1 restricted the service to childhood cancer patients referred to the Oxford Paediatric Oncology and Haematology Principle Treatment Centre. It was estimated that there would be 10 patients/year and used existing staff and facilities from paediatric oncology, surgery, anaesthetics radiology, pathology, psychology, teenage-young adult gynaecology, and an existing Human Tissue Authority tissue bank with a licence for storage of tissue under a Human Sector Licence. Phase 2 extended the service to include children and young adults across England, Wales and Ireland-patients from Scotland having access to a research programme in Edinburgh. The main challenge in phase 2 being resources and the need for patients to be able to be treated as close to home as safely as possible. RESULTS The Oxford team developed information resources and eligibility criteria based on published best practice, referral and treatment pathways, multidisciplinary team meetings, a network of third party sites, and a dedicated case management and database. As the programme expanded, the Oxford team was able to justify to management the need for a dedicated theatre list. Patient feedback through questionnaires, qualitative work conducted as part of a Ph.D. thesis as well as direct patient stories and interviews in TV, and radio features underpins the positive impact the programme has on patients and their families. CONCLUSION The Oxford Reproductive Cryopreservation programme delivers fertility preservation treatment to children and young adults at high risk of infertility safely, effectively and as close to home as possible. The onward view is to apply for national funding for this programme for recognition and sustainability.
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Affiliation(s)
- K. Lakhoo
- Department of Paediatric Surgery, University of Oxford and Oxford University Hospitals, Oxford, UK ,Nuffield Department of Surgery, Oxford University and Oxford University Hospitals, Headley Way, Oxford, OX39DA UK
| | - J. Davies
- Oxford Tissue Bank, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Chakraborty
- Department of Paediatric Radiology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Berg
- Department of Paediatric Anaesthesia, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - R. Tennyson
- Department of Psychology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - D. Fowler
- Department of Cellular Pathology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Manek
- Department of Cellular Pathology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - C. Verrill
- Department of Cellular Pathology, University of Oxford and Oxford University Hospitals, Oxford, UK
| | - S. Lane
- Department of Paediatrics and Child Health, University of Oxford and Oxford University Hospitals, Oxford, UK
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18
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Olsson A, Alfredsson J, Thelander M, Svedjeholm R, Berglund JS, Berg S. Activated platelet aggregation is transiently impaired also by a reduced dose of protamine. SCAND CARDIOVASC J 2019; 53:355-360. [PMID: 31476919 DOI: 10.1080/14017431.2019.1659396] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: Protamine reduces platelet aggregation after cardiopulmonary bypass (CPB). We studied the inhibitory effect of a reduced protamine dose, the duration of impaired platelet function and the possible correlation to postoperative bleeding. Design: Platelet function was assessed by impedance aggregometry in 30 patients undergoing cardiac surgery with CPB at baseline, before protamine administration, after 70% and 100% of the calculated protamine dose, after 20 minutes and at arrival to the intensive care unit. Adenosine diphosphate (ADP), thrombin receptor activating peptide-6 (TRAP), arachidonic acid (AA) and collagen (COL) were used as activators. Blood loss was measured during operation and three hours after surgery. Results are presented as median (25th-75th percentile). Results: Platelet aggregation decreased markedly after the initial dose of protamine (70%) with all activators; ADP 89 (71-110) to 54 (35-78), TRAP 143 (116-167) to 109 (77-136), both p < .01; AA 25 (16-49) to 17 (12-24) and COL 92 (47-103) to 60 (38-81) U, both p < .05. No further decrease was seen after 100% protamine. The effect was transient and after twenty minutes platelet aggregation had started to recover; ADP 76 (54-106), TRAP 138 (95-158), AA 20 (10-35), COL 70 (51-93) U. Blood loss during operation correlated to aggregometry measured at baseline and after protaminization. Conclusions: Protamine after CPB induces a marked decrease in platelet aggregation already at a protamine-heparin ratio of 0.7:1. The impairment seems to be transient and recovery had started after 20 minutes.
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Affiliation(s)
- A Olsson
- Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardio-Thoracic Surgery, Blekinge Hospital, Karlskrona, Sweden
| | - J Alfredsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardiology, Linköping University, Linköping, Sweden
| | - M Thelander
- Department of Cardio-Thoracic Surgery, Blekinge Hospital, Karlskrona, Sweden
| | - R Svedjeholm
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardio-Thoracic and Vascular Surgery, Linköping University, Linköping, Sweden
| | - J Sanmartin Berglund
- Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden
| | - S Berg
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Cardiovascular Anesthesia and Intensive Care, Linköping University, Linköping, Sweden
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19
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Unsal E, Rücker M, Berg S, Bartels W, Bonnin A. Imaging of compositional gradients during in situ emulsification using X-ray micro-tomography. J Colloid Interface Sci 2019; 550:159-169. [DOI: 10.1016/j.jcis.2019.04.068] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/21/2019] [Accepted: 04/22/2019] [Indexed: 10/27/2022]
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20
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Jagadeesh D, Tsai D, Wei W, Wagner-Johnston N, Xie E, Berg S, Smith S, Koff J, Barot S, Hwang D, Kim S, Venugopal P, Fenske T, Sriram D, David K, Santapuram P, Reddy N, Dharnidharka V, Evens A. POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER (PTLD) AFTER SOLID ORGAN TRANSPLANT (SOT): SURVIVAL AND PROGNOSTICATION AMONG 570 PATIENTS (PTS) TREATED IN THE MODERN ERA. Hematol Oncol 2019. [DOI: 10.1002/hon.116_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: 11/07/2022]
Affiliation(s)
- D. Jagadeesh
- Hematology and Medical Oncology; Cleveland Clinic; Cleveland United States
| | - D. Tsai
- Hematology/Oncology; University of Pennsylvania; Philadelphia United States
| | - W. Wei
- Hematology and Medical Oncology; Cleveland Clinic; Cleveland United States
| | - N. Wagner-Johnston
- Hematology and Oncology; Johns Hopkins Medical Institution; Baltimore United States
| | - E. Xie
- Hematology and Oncology; Johns Hopkins Medical Institution; Baltimore United States
| | - S. Berg
- Hematology and Oncology; Loyola University Medical Center; Melrose Park United States
| | - S.E. Smith
- Hematology and Oncology; Loyola University Medical Center; Melrose Park United States
| | - J.L. Koff
- Hematology and Medical Oncology; Emory University; Atlanta United States
| | - S. Barot
- Hematology and Medical Oncology; Cleveland Clinic; Cleveland United States
| | - D. Hwang
- Hematology and Oncology; Loyola University Medical Center; Melrose Park United States
| | - S. Kim
- Hematology and Oncology; Rush University Medical Center; Chicago United States
| | - P. Venugopal
- Hematology and Oncology; Rush University Medical Center; Chicago United States
| | - T. Fenske
- Hematology and Oncology; Medical College of Wisconsin; Milwaukee United States
| | - D. Sriram
- Hematology and Oncology; Medical College of Wisconsin; Milwaukee United States
| | - K. David
- Hematology and Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - P. Santapuram
- Department of Medicine; Vanderbilt University Medical Center; Nashville United States
| | - N. Reddy
- Department of Medicine; Vanderbilt University Medical Center; Nashville United States
| | - V. Dharnidharka
- Pediatric Nephrology; Hypertension and Pheresis, Washington University School of Medicine & St. Louis Children's Hospital; St. Louis United States
| | - A.M. Evens
- Hematology and Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
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Sparud-Lundin C, Berg S, Fasth A, Karlsson A, Wekell P. From uncertainty to gradually managing and awaiting recovery of a periodic condition- a qualitative study of parents´ experiences of PFAPA syndrome. BMC Pediatr 2019; 19:99. [PMID: 30961562 PMCID: PMC6454720 DOI: 10.1186/s12887-019-1458-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 03/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is unknown. Although an uncommon condition, it is considered to be the most common autoinflammatory disease among children in many parts of the world. The knowledge of the consequences of the recurrent fever episodes for the child and its family are limited. This study explores the experiences of parents regarding the impact of the disease on the child's general well-being, the family's situation and how the family handles the associated challenges. METHODS A qualitative approach was used, applying a modified version of Grounded theory for design, data collection and analysis. Data was collected from two different sources: communication between parents of children with PFAPA in a closed Facebook group and face-to face interviews with one of the parents of children diagnosed with PFAPA (6 mothers and 2 fathers). RESULTS Parents described a lengthy process of how everyday life becomes affected by their child's recurrent fever episodes. This process is depicted in the following Grounded Theory core category: From uncertainty to gradually managing and awaiting recovery. The categories Uncertainty, Assurance, Gradually managing and Recovery describe the experienced illness trajectory. The illness representation illustrates the experiences/impacts of the periodic condition in the subcategories: Harmlessness-Severity, Disclosure of diagnosis, Impact on daily life and Regularity-Unpredictability. The children's well-being was highly affected by the symptoms during episodes. Parents experienced increased stress with constant fatigue, social constraints of family life and restricted career opportunities. Nevertheless, hope of recovery was constantly present. CONCLUSIONS PFAPA is associated with a considerable burden on the child and the parents in daily life. Obtaining a diagnosis enables parents to move from a state of uncertainty towards a sense of coherence while awaiting recovery. Because of limited general knowledge of the condition and its impact on daily life, health care professionals need to become aware of the parents' efforts to mitigate the consequences of the recurrent episodes for the child and for the family as a whole.
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Affiliation(s)
- C Sparud-Lundin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-, 405 30, Gothenburg, Sweden.
| | - S Berg
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Fasth
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Karlsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P Wekell
- Department of Pediatrics, NU-Hospital Group, Uddevalla, Sweden.,Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
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Højskov I, Moons P, Egerod I, Olsen P, Thygesen L, Hansen N, Cour S, Bech K, Borregaard B, Gluud C, Winkel P, Lindschou J, Berg S. Early physical and psycho-educational rehabilitation in patients with coronary artery bypass grafting: A randomized controlled trial. J Rehabil Med 2019; 51:136-143. [DOI: 10.2340/16501977-2499] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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McElroy WN, Berg S, Crockett TB, Tuttle RJ. Measurement of Neutron Flux Spectra by a Multiple Foil Activation Iterative Method and Comparison with Reactor Physics Calculations and Spectrometer Measurements. NUCL SCI ENG 2017. [DOI: 10.13182/nse69-a18853] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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]
Affiliation(s)
- W. N. McElroy
- Battelle Memorial Institute, Pacific Northwest Laboratory, Richland, Washington 99352
| | - S. Berg
- Atomics International, A Division of North American Rockwell Corporation Canoga Park, California 91303
| | - T. B. Crockett
- Atomics International, A Division of North American Rockwell Corporation Canoga Park, California 91303
| | - R. J. Tuttle
- Atomics International, A Division of North American Rockwell Corporation Canoga Park, California 91303
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Affiliation(s)
- W. N. McElroy
- Atomics International, A Division of North American Aviation, Inc., Canoga Park, California
| | - S. Berg
- Atomics International, A Division of North American Aviation, Inc., Canoga Park, California
| | - G. Gigas
- Atomics International, A Division of North American Aviation, Inc., Canoga Park, California
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Hornung D, Biktashev VN, Otani NF, Shajahan TK, Baig T, Berg S, Han S, Krinsky VI, Luther S. Mechanisms of vortices termination in the cardiac muscle. R Soc Open Sci 2017; 4:170024. [PMID: 28405398 PMCID: PMC5383855 DOI: 10.1098/rsos.170024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/14/2017] [Indexed: 06/07/2023]
Abstract
We propose a solution to a long-standing problem: how to terminate multiple vortices in the heart, when the locations of their cores and their critical time windows are unknown. We scan the phases of all pinned vortices in parallel with electric field pulses (E-pulses). We specify a condition on pacing parameters that guarantees termination of one vortex. For more than one vortex with significantly different frequencies, the success of scanning depends on chance, and all vortices are terminated with a success rate of less than one. We found that a similar mechanism terminates also a free (not pinned) vortex. A series of about 500 experiments with termination of ventricular fibrillation by E-pulses in pig isolated hearts is evidence that pinned vortices, hidden from direct observation, are significant in fibrillation. These results form a physical basis needed for the creation of new effective low energy defibrillation methods based on the termination of vortices underlying fibrillation.
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Affiliation(s)
- D. Hornung
- Max Planck Institute DS, BMPG, Gottingen, Germany
| | | | - N. F. Otani
- Rochester Institute of Technology, Rochester, NY, USA
| | - T. K. Shajahan
- National Institute of Technology Karnataka, Bangalore, India
| | - T. Baig
- Max Planck Institute DS, BMPG, Gottingen, Germany
- Institute for Nonlinear Dynamics, Georg-August-Universität Göttingen, Am Faßberg 17, 37077 Göttingen
| | - S. Berg
- Max Planck Institute DS, BMPG, Gottingen, Germany
- Institute for Nonlinear Dynamics, Georg-August-Universität Göttingen, Am Faßberg 17, 37077 Göttingen
| | - S. Han
- Rochester Institute of Technology, Rochester, NY, USA
| | - V. I. Krinsky
- Max Planck Institute DS, BMPG, Gottingen, Germany
- INLN, CNRS, Valbonne, France
| | - S. Luther
- Max Planck Institute DS, BMPG, Gottingen, Germany
- Institute for Nonlinear Dynamics, Georg-August-Universität Göttingen, Am Faßberg 17, 37077 Göttingen
- Department of Pharmacology, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
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Ameni G, Tafess K, Zewde A, Eguale T, Tilahun M, Hailu T, Sirak A, Salguero FJ, Berg S, Aseffa A, Hewinson RG, Vordermeier HM. Vaccination of calves with Mycobacterium bovis Bacillus Calmette-Guerin reduces the frequency and severity of lesions of bovine tuberculosis under a natural transmission setting in Ethiopia. Transbound Emerg Dis 2017; 65:96-104. [PMID: 28168855 PMCID: PMC5811905 DOI: 10.1111/tbed.12618] [Citation(s) in RCA: 23] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Indexed: 11/29/2022]
Abstract
Bovine tuberculosis (bTB) is highly prevalent in intensive dairy farms of the urban "milk-sheds" in Ethiopia, and vaccination could be a cost-effective disease control strategy. In the present study, the efficacy of Bacillus Calmette-Guerin (BCG) to protect against bTB was assessed in Holstein-Friesian calves in a natural transmission setting. Twenty-three 2-week-old calves were subcutaneously vaccinated with BCG Danish SSI strain 1331, and matched 26 calves were injected with placebo. Six weeks later, calves were introduced into a herd of M. bovis-infected animals (reactors) and kept in contact with them for 1 year. In vitro and in vivo immunological tests were performed to assess immune responses post-vaccination and during exposure. Successful vaccine uptake was confirmed by tuberculin skin test and IFN-γ responses in vaccinated calves. The kinetics of IFN-γ responses to early secretory antigen target 6 and culture filtrate protein 10 (ESAT6 and CFP10, respectively) and tuberculin skin test responses post-exposure suggested that the animals were infected early after being placed in contact with the infected herd as immunological signs of infection were measurable between 2 and 4 months post-initial exposure. Protection was determined by comparing gross and microscopic pathology and bacteriological burden between vaccinated and control calves. BCG vaccination reduced the proportions of tissues with visible pathology in vaccinates compared to control calves by 49% (p < .001) with 56%, 43%, 72%, and 38% reductions in the proportion of lesioned tisues in head, thoracic, abdominal lymph nodes, and lungs, respectively (p-values .029-.0001). In addition, the lesions were less severe grossly and microscopically in vaccinated calves than in non-vaccinated calves (p < .05). The reduction in the overall incidence rates of bTB was 23%, 28%, and 33% on the basis of the absence of gross pathology, M. bovis culture positivity, and histopathology, respectively, in vaccinated animals. In conclusion, BCG vaccination reduced the frequency and severity of the pathology of bTB significantly, which is likely to reduce onwards transmission of the disease.
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Affiliation(s)
- G Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - K Tafess
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - A Zewde
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - T Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - M Tilahun
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - T Hailu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - A Sirak
- National Animal Health Diagnostic and Investigation Centre, Sebeta, Ethiopia
| | - F J Salguero
- School of Veterinary Medicine, University of Surrey, Surrey, UK
| | - S Berg
- Animal and Plant Health Agency, New Haw, Surrey, UK
| | - A Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - R G Hewinson
- Animal and Plant Health Agency, New Haw, Surrey, UK
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Lelu S, Afadzi M, Berg S, Aslund AKO, Torp SH, Sattler W, de L Davies C. Primary Porcine Brain Endothelial Cells as In Vitro Model to Study Effects of Ultrasound and Microbubbles on Blood-Brain Barrier Function. IEEE Trans Ultrason Ferroelectr Freq Control 2017; 64:281-290. [PMID: 27529871 DOI: 10.1109/tuffc.2016.2597004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Focused ultrasound (FUS) in the presence of microbubbles transiently and reversibly opens the blood-brain barrier (BBB) in rodents and humans, thereby providing a time window for increased drug delivery into brain tissue. To get insight into the underlying mechanisms that govern ultrasound (US)-mediated opening of the BBB, in vitro models are a useful alternative. In this paper, we have utilized an in vitro BBB model that consists of primary porcine brain endothelial cells (PBECs). PBEC monolayers are grown on permeable membranes, which allow assessment of key features of BBB function as well as US treatment. This experimental model is characterized by low permeability for both small molecules and proteins, has a high transendothelial electrical resistance, and expresses tight junctions and efflux pumps. Here, we compare the effects of inertial and stable cavitation in the presence of SonoVue microbubbles on PBEC monolayers' electrical resistance and permeability properties. Our results point out the fragility of PBEC monolayers, which enhances results variability. In particular, we show that handling of the inserts, such as medium change and transfer to the US setup, modifies the cellular response, and immunostaining of the monolayers introduces damage and cell detachment within the US-exposed monolayers. Our results indicate that stable cavitation might have a more pronounced impact on cell permeability as compared with inertial cavitation in vitro. This paper might contribute to further development of experimental setups that are suitable to characterize the impact of FUS and microbubbles on BBB properties in vitro.
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Berg BI, Mueller AA, Augello M, Berg S, Jaquiéry C. Imaging in Patients with Bisphosphonate-Associated Osteonecrosis of the Jaws (MRONJ). Dent J (Basel) 2016; 4:E29. [PMID: 29563471 PMCID: PMC5806936 DOI: 10.3390/dj4030029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 08/11/2016] [Accepted: 08/17/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Bisphosphonate-associated osteonecrosis of the jaws (MRONJ/BP-ONJ/BRONJ) is a commonly seen disease. During recent decades, major advances in diagnostics have occurred. Once the clinical picture shows typical MRONJ features, imaging is necessary to determine the size of the lesion. Exposed bone is not always painful, therefore a thorough clinical examination and radiological imaging are essential when MRONJ is suspected. METHODS In this paper we will present the latest clinical update on the imaging options in regard to MRONJ: X-ray/Panoramic Radiograph, Cone Beam Computed Tomography (CBCT) and Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Nuclear Imaging, Fluorescence-Guided Bone Resection. CONCLUSION Which image modality is chosen depends not only on the surgeon's/practitioner's preference but also on the available imaging modalities. A three-dimensional imaging modality is desirable, and in severe cases necessary, for extended resections and planning of reconstruction.
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Affiliation(s)
- Britt-Isabelle Berg
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, 4056 Basel, Switzerland.
- Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY 10032, USA.
| | - Andreas A Mueller
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, 4056 Basel, Switzerland.
| | - Marcello Augello
- Clinic of Cranio-Maxillofacial Surgery, Kantonsspital Aarau, 5001 Aarau, Switzerland.
| | - Scott Berg
- Private Practice, 25524 Itzehoe, Germany.
| | - Claude Jaquiéry
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, 4056 Basel, Switzerland.
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Zilg B, Alkass K, Berg S, Druid H. Interpretation of postmortem vitreous concentrations of sodium and chloride. Forensic Sci Int 2016; 263:107-113. [DOI: 10.1016/j.forsciint.2016.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/04/2016] [Indexed: 01/18/2023]
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Berg S, Wekell P, Óskarsdóttir S, Martinell J, Rupröder R, Fridh E, Karlsson A, Backteman T, Fasth A. Pediatric chronic non-bacterial osteomyelitis in Goteborg, Sweden. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599932 DOI: 10.1186/1546-0096-13-s1-p180] [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: 11/10/2022] Open
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31
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Hilfer R, Armstrong RT, Berg S, Georgiadis A, Ott H. Capillary saturation and desaturation. Phys Rev E Stat Nonlin Soft Matter Phys 2015; 92:063023. [PMID: 26764820 DOI: 10.1103/physreve.92.063023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Indexed: 06/05/2023]
Abstract
Capillary desaturation experiments produce disconnected (trapped) ganglia of mesoscopic sizes intermediate between pore size and system size. Experimental evidence for interactions between these mesoscale clusters during desaturation is analyzed and discussed within the established microscopic and macroscopic laws of Newton, Young-Laplace, and Darcy. A theoretical expression for capillary number correlations is introduced that seems to have remained unnoticed. It expresses capillary desaturation curves in terms of stationary capillary pressures and relative permeabilities. The theoretical expression shows that the plateau saturation in capillary desaturation curves may in general differ from the residual nonwetting saturation defined through the saturation limit of the main hysteresis loop. Hysteresis effects as well as the difference between wetting and nonwetting fluids are introduced into the analysis of capillary desaturation experiments. The article examines experiments with different desaturation protocols and discusses the existence of a mesoscopic length scale intermediate between pore scale and sample scale. The theoretical expression is derived entirely within the existing traditional theory of two-phase flow in porous media and compared to a recent experiment.
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Affiliation(s)
- R Hilfer
- ICP, Universität Stuttgart, 70569 Stuttgart, Germany
| | - R T Armstrong
- School of Petroleum Engineering, University of New South Wales, NSW, 2052 Sydney, Australia
| | - S Berg
- Shell Global Solutions International B.V., 2288 GS Rijswijk, Netherlands
| | - A Georgiadis
- Shell Global Solutions International B.V., 2288 GS Rijswijk, Netherlands
| | - H Ott
- Shell Global Solutions International B.V., 2288 GS Rijswijk, Netherlands
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Wekell P, Björnsdottir H, Björkman L, Sundqvist M, Christenson K, Osla V, Berg S, Fasth A, Welin A, Bylund J, Karlsson A. Challenging the opinion that SAPHO syndrome is associated with low intracellular ROS production in neutrophils. Pediatr Rheumatol Online J 2015. [PMCID: PMC4596968 DOI: 10.1186/1546-0096-13-s1-p16] [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: 11/10/2022] Open
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Berg S, Björnsdottir H, Sundqvist M, Wekell P, Christenson K, Osla V, Welin A, Bylund J, Karlsson A. MPO deficiency confers impaired processing of neutrophil reactive oxygen species in a patient with severe CRMO. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599949 DOI: 10.1186/1546-0096-13-s1-p191] [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: 12/03/2022] Open
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Kammoun M, Berg S, Ardebili H. Flexible thin-film battery based on graphene-oxide embedded in solid polymer electrolyte. Nanoscale 2015; 7:17516-22. [PMID: 26444436 DOI: 10.1039/c5nr04339e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Enhanced safety of flexible batteries is an imperative objective due to the intimate interaction of such devices with human organs such as flexible batteries that are integrated with touch-screens or embedded in clothing or space suits. In this study, the fabrication and testing of a high performance thin-film Li-ion battery (LIB) is reported that is both flexible and relatively safer compared to the conventional electrolyte based batteries. The concept is facilitated by the use of solid polymer nanocomposite electrolyte, specifically, composed of polyethylene oxide (PEO) matrix and 1 wt% graphene oxide (GO) nanosheets. The flexible LIB exhibits a high maximum operating voltage of 4.9 V, high capacity of 0.13 mA h cm(-2) and an energy density of 4.8 mW h cm(-3). The battery is encapsulated using a simple lamination method that is economical and scalable. The laminated battery shows robust mechanical flexibility over 6000 bending cycles and excellent electrochemical performance in both flat and bent configurations. Finite element analysis (FEA) of the LIB provides critical insights into the evolution of mechanical stresses during lamination and bending.
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Affiliation(s)
- M Kammoun
- Department of Mechanical Engineering University of Houston, Houston, TX 77204-4006, USA.
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Zilg B, Bernard S, Alkass K, Berg S, Druid H. A new model for the estimation of time of death from vitreous potassium levels corrected for age and temperature. Forensic Sci Int 2015; 254:158-66. [PMID: 26232848 DOI: 10.1016/j.forsciint.2015.07.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [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] [Revised: 06/10/2015] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
Abstract
Analysis of potassium concentration in the vitreous fluid of the eye is frequently used by forensic pathologists to estimate the postmortem interval (PMI), particularly when other methods commonly used in the early phase of an investigation can no longer be applied. The postmortem rise in vitreous potassium has been recognized for several decades and is readily explained by a diffusion of potassium from surrounding cells into the vitreous fluid. However, there is no consensus regarding the mathematical equation that best describes this increase. The existing models assume a linear increase, but different slopes and starting points have been proposed. In this study, vitreous potassium levels, and a number of factors that may influence these levels, were examined in 462 cases with known postmortem intervals that ranged from 2h to 17 days. We found that the postmortem rise in potassium followed a non-linear curve and that decedent age and ambient temperature influenced the variability by 16% and 5%, respectively. A long duration of agony and a high alcohol level at the time of death contributed less than 1% variability, and evaluation of additional possible factors revealed no detectable impact on the rise of vitreous potassium. Two equations were subsequently generated, one that represents the best fit of the potassium concentrations alone, and a second that represents potassium concentrations with correction for decedent age and/or ambient temperature. The former was associated with narrow confidence intervals in the early postmortem phase, but the intervals gradually increased with longer PMIs. For the latter equation, the confidence intervals were reduced at all PMIs. Therefore, the model that best describes the observed postmortem rise in vitreous potassium levels includes potassium concentration, decedent age, and ambient temperature. Furthermore, the precision of these equations, particularly for long PMIs, is expected to gradually improve by adjusting the constants as more reference data are added over time. A web application that facilitates this calculation process and allows for such future modifications has been developed.
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Affiliation(s)
- B Zilg
- Department of Forensic Medicine, Karolinska Institutet, Retzius v. 3, SE-171 77 Stockholm, Sweden.
| | - S Bernard
- CNRS UMR5208, Institut Camille Jordan, Université Claude Bernard Lyon 1, 69622 Villeurbanne, France
| | - K Alkass
- Department of Forensic Medicine, Karolinska Institutet, Retzius v. 3, SE-171 77 Stockholm, Sweden
| | - S Berg
- Department of Medicine and Health, Linköping University, University Hospital, SE-581 85, Linköping, Sweden
| | - H Druid
- Department of Forensic Medicine, Karolinska Institutet, Retzius v. 3, SE-171 77 Stockholm, Sweden
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Jacobsen L, Berg S, Baktoft H, Skov C. Behavioural strategy of large perch Perca fluviatilis varies between a mesotrophic and a hypereutrophic lake. J Fish Biol 2015; 86:1016-29. [PMID: 25644471 DOI: 10.1111/jfb.12613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 11/20/2014] [Indexed: 05/26/2023]
Abstract
Behaviour of large perch Perca fluviatilis was studied in two lakes differing in environmental state i.e. mesotrophic v. hypereutrophic. A total of 20 adult perch P. fluviatilis (29-42 cm total length) in each lake were tagged with radio-transmitters, tracked and located eight times a day during six 24 h tracking periods over a year, enabling detection of differences in diel activity patterns and habitat use during summer and winter under two different environmental regimes. During summer, P. fluviatilis in the mesotrophic lake showed a distinct crepuscular activity pattern and a change from pelagic residency during daytime towards the littoral zone at night. In contrast, P. fluviatilis in the hypereutrophic lake were active during the entire diel cycle and were spread throughout the lake also during dark. During winter, crepuscular patterns of activity were seen in both lakes. Condition factor of large P. fluviatilis did not differ between the two lakes. Thus, it is suggested that P. fluviatilis in the hypereutrophic turbid lake adopted an alternative behaviour for successful foraging, being uniformly active throughout the diel cycle.
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Affiliation(s)
- L Jacobsen
- Technical University of Denmark, National Institute of Aquatic Resources (DTU-Aqua), Vejlsøvej 39, 8600 Silkeborg, Denmark
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Berg S, Zwisler A, Koch M, Svendsen J, Christensen A, Pedersen P, Thygesen L. Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes: Findings from the COPE-ICD randomized controlled trial. J Rehabil Med 2015; 47:267-72. [DOI: 10.2340/16501977-1920] [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: 11/16/2022] Open
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Abstract
The purpose of the present study was to compare the primary bending stiffness characteristics of 5 different ankle arthrodesis fixation techniques: 3 compression screws, an anterior locking plate, a lateral locking plate, an anterior locking plate with a compression screw, and a lateral locking plate with a compression screw. A total of 25 full-scale anatomic models consisting of fourth-generation composite tibiae and tali were tested using an Instron 4505 Universal Testing System. We hypothesized that the use of a compression screw with a locking plate would add considerable stiffness to the fixation construct compared with the use of a locking plate alone. The data have shown that an anterior or lateral plate with a compression screw provides significantly greater stiffness than both a plate and 3 compression screws used individually. No significant difference was seen between the anterior plate with a compression screw and the lateral plate with a compression screw. No significant differences were found among the use of an anterior plate, a lateral plate, or 3 compression screws. We have concluded that when using a locking plate in an anterior or lateral configuration, the addition of a compression screw will considerably increase the primary bending stiffness of ankle arthrodesis.
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Affiliation(s)
| | - Scott Berg
- Postgraduate Year III Resident, Franciscan Health System, Federal Way, WA.
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Classen CF, William D, Linnebacher M, Farhod A, Kedr W, Elsabe B, Fadel S, Van Gool S, De Vleeschouwer S, Koks C, Garg A, Ehrhardt M, Riva M, De Vleeschouwer S, Agostinis P, Graf N, Van Gool S, Yao TW, Yoshida Y, Zhang J, Ozawa T, James D, Nicolaides T, Kebudi R, Cakir FB, Gorgun O, Agaoglu FY, Darendeliler E, Van Gool S, De Vleeschouwer S, Al-Kofide A, Al-Shail E, Khafaga Y, Al-Hindi H, Dababo M, Haq AU, Anas M, Barria MG, Siddiqui K, Hassounah M, Ayas M, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Vugts D, Hoekstra O, van Dongen G, Kaspers G, Cockle J, Ilett E, Scott K, Bruning-Richardson A, Picton S, Short S, Melcher A, Benesch M, Warmuth-Metz M, von Bueren AO, Hoffmann M, Pietsch T, Kortmann RD, Eyrich M, Graf N, Rutkowski S, Fruhwald MC, Faber J, Kramm C, Porkholm M, Valanne L, Lonnqvist T, Holm S, Lannering B, Riikonen P, Wojcik D, Sehested A, Clausen N, Harila-Saari A, Schomerus E, Thorarinsdottir HK, Lahteenmaki P, Arola M, Thomassen H, Saarinen-Pihkala UM, Kivivuori SM, Buczkowicz P, Hoeman C, Rakopoulos P, Pajovic S, Morrison A, Bouffet E, Bartels U, Becher O, Hawkins C, Gould TWA, Rahman CV, Smith SJ, Barrett DA, Shakesheff KM, Grundy RG, Rahman R, Barua N, Cronin D, Gill S, Lowisl S, Hochart A, Maurage CA, Rocourt N, Vinchon M, Kerdraon O, Escande F, Grill J, Pick VK, Leblond P, Burzynski G, Janicki T, Burzynski S, Marszalek A, Ramani N, Zaky W, Kannan G, Morani A, Sandberg D, Ketonen L, Maher O, Corrales-Medina F, Meador H, Khatua S, Brassesco M, Delsin L, Roberto G, Silva C, Ana L, Rego E, Scrideli C, Umezawa K, Tone L, Kim SJ, Kim CY, Kim IA, Han JH, Choi BS, Ahn HS, Choi HS, Haque F, Rahman R, Layfield R, Grundy R, Gandola L, Pecori E, Biassoni V, Schiavello E, Chiruzzi C, Spreafico F, Modena P, Bach F, Pignoli E, Massimino M, Drogosiewicz M, Dembowska-Baginska B, Jurkiewicz E, Filipek I, Perek-Polnik M, Swieszkowska E, Perek D, Bender S, Jones DT, Warnatz HJ, Hutter B, Zichner T, Gronych J, Korshunov A, Eils R, Korbel JO, Yaspo ML, Lichter P, Pfister SM, Yadavilli S, Becher OJ, Kambhampati M, Packer RJ, Nazarian J, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Vaidya S, Koh DM, Leach MO, Pearson AD, Zacharoulis S, Lechon FC, Fowkes L, Khabra K, Martin-Retortillo LM, Marshall LV, Schrey D, Barone G, Vaidya S, Koh DM, Pearson AD, Zacharoulis S, Panditharatna E, Stampar M, Siu A, Gordish-Dressman H, Devaney J, Kambhampati M, Hwang EI, Packer RJ, Nazarian J, Chung AH, Mittapalli RK, Elmquist WF, Becher OJ, Castel D, Debily MA, Philippe C, Truffaux N, Taylor K, Calmon R, Boddaert N, Le Dret L, Saulnier P, Lacroix L, Mackay A, Jones C, Puget S, Sainte-Rose C, Blauwblomme T, Varlet P, Grill J, Entz-Werle N, Maugard C, Bougeard G, Nguyen A, Chenard MP, Schneider A, Gaub MP, Tsoli M, Vanniasinghe A, Luk P, Dilda P, Haber M, Hogg P, Ziegler D, Simon S, Tsoli M, Vanniasinghe A, Monje M, Gurova K, Gudkov A, Haber M, Ziegler D, Zapotocky M, Churackova M, Malinova B, Zamecnik J, Kyncl M, Tichy M, Puchmajerova A, Stary J, Sumerauer D, Boult J, Vinci M, Taylor K, Perryman L, Box G, Jury A, Popov S, Ingram W, Monje M, Eccles S, Jones C, Robinson S, Emir S, Demir HA, Bayram C, Cetindag F, Kabacam GB, Fettah A, Boult J, Li J, Vinci M, Jury A, Popov S, Jamin Y, Cummings C, Eccles S, Bamber J, Sinkus R, Jones C, Robinson S, Nandhabalan M, Bjerke L, Vinci M, Burford A, Ingram W, Mackay A, von Bueren A, Baudis M, Clarke P, Collins I, Workman P, Jones C, Taylor K, Mackay A, Vinci M, Popov S, Ingram W, Entz-Werle N, Monje M, Olaciregui N, Mora J, Carcaboso A, Bullock A, Jones C, Vinci M, Mackay A, Burford A, Taylor K, Popov S, Ingram W, Monje M, Alonso M, Olaciregui N, de Torres C, Cruz O, Mora J, Carcaboso A, Jones C, Filipek I, Drogosiewicz M, Perek-Polnik M, Swieszkowska E, Dembowska-Baginska B, Jurkiewicz E, Perek D, Nguyen A, Pencreach E, Mackay A, Moussalieh FM, Guenot D, Namer I, Chenard MP, Jones C, Entz-Werle N, Pollack I, Jakacki R, Butterfield L, Hamilton R, Panigrahy A, Potter D, Connelly A, Dibridge S, Whiteside T, Okada H, Ahsan S, Raabe E, Haffner M, Warren K, Quezado M, Ballester L, Nazarian J, Eberhart C, Rodriguez F, Ramachandran C, Nair S, Quirrin KW, Khatib Z, Escalon E, Melnick S, Classen CF, Hofmann M, Schmid I, Simon T, Maass E, Russo A, Fleischhack G, Becker M, Hauch H, Sander A, Kramm C, Grasso C, Truffaux N, Berlow N, Liu L, Debily MA, Davis L, Huang E, Woo P, Tang Y, Ponnuswami A, Chen S, Huang Y, Hutt-Cabezas M, Warren K, Dret L, Meltzer P, Mao H, Quezado M, van Vuurden D, Abraham J, Fouladi M, Svalina MN, Wang N, Hawkins C, Raabe E, Hulleman E, Li XN, Keller C, Spellman PT, Pal R, Grill J, Monje M, Jansen MHA, Sewing ACP, Lagerweij T, Vuchts DJ, van Vuurden DG, Caretti V, Wesseling P, Kaspers GJL, Hulleman E, Cohen K, Raabe E, Pearl M, Kogiso M, Zhang L, Qi L, Lindsay H, Lin F, Berg S, Li XN, Muscal J, Amayiri N, Tabori U, Campbel B, Bakry D, Aronson M, Durno C, Gallinger S, Malkin D, Qaddumi I, Musharbash A, Swaidan M, Bouffet E, Hawkins C, Al-Hussaini M, Rakopoulos P, Shandilya S, McCully C, Murphy R, Akshintala S, Cole D, Macallister RP, Cruz R, Widemann B, Warren K, Salloum R, Smith A, Glaunert M, Ramkissoon A, Peterson S, Baker S, Chow L, Sandgren J, Pfeifer S, Popova S, Alafuzoff I, de Stahl TD, Pietschmann S, Kerber MJ, Zwiener I, Henke G, Kortmann RD, Muller K, von Bueren A, Sieow NYF, Hoe RHM, Tan AM, Chan MY, Soh SY, Hawkins C, Burrell K, Chornenkyy Y, Remke M, Golbourn B, Buczkowicz P, Barzczyk M, Taylor M, Rutka J, Dirks P, Zadeh G, Agnihotri S, Hashizume R, Ihara Y, Andor N, Chen X, Lerner R, Huang X, Tom M, Solomon D, Mueller S, Petritsch C, Zhang Z, Gupta N, Waldman T, James D, Dujua A, Co J, Hernandez F, Doromal D, Hegde M, Wakefield A, Brawley V, Grada Z, Byrd T, Chow K, Krebs S, Heslop H, Gottschalk S, Yvon E, Ahmed N, Truffaux N, Philippe C, Cornilleau G, Paulsson J, Andreiuolo F, Guerrini-Rousseau L, Puget S, Geoerger B, Vassal G, Ostman A, Grill J, Parsons DW, Lin F, Trevino LR, Gao F, Shen X, Hampton O, Lindsay H, Kosigo M, Qi L, Baxter PA, Su JM, Chintagumpala M, Dauser R, Adesina A, Plon SE, Li XN, Wheeler DA, Lau CC, Pietsch T, Gielen G, Muehlen AZ, Kwiecien R, Wolff J, Kramm C, Lulla RR, Laskowski J, Goldman S, Gopalakrishnan V, Fangusaro J, Mackay A, Taylor K, Vinci M, Jones C, Kieran M, Fontebasso A, Papillon-Cavanagh S, Schwartzentruber J, Nikbakht H, Gerges N, Fiset PO, Bechet D, Faury D, De Jay N, Ramkissoon L, Corcoran A, Jones D, Sturm D, Johann P, Tomita T, Goldman S, Nagib M, Bendel A, Goumnerova L, Bowers DC, Leonard JR, Rubin JB, Alden T, DiPatri A, Browd S, Leary S, Jallo G, Cohen K, Prados MD, Banerjee A, Carret AS, Ellezam B, Crevier L, Klekner A, Bognar L, Hauser P, Garami M, Myseros J, Dong Z, Siegel PM, Gump W, Ayyanar K, Ragheb J, Khatib Z, Krieger M, Kiehna E, Robison N, Harter D, Gardner S, Handler M, Foreman N, Brahma B, MacDonald T, Malkin H, Chi S, Manley P, Bandopadhayay P, Greenspan L, Ligon A, Albrecht S, Pfister SM, Ligon KL, Majewski J, Gupta N, Jabado N, Hoeman C, Cordero F, Halvorson K, Hawkins C, Becher O, Taylor I, Hutt M, Weingart M, Price A, Nazarian J, Eberhart C, Raabe E, Kantar M, Onen S, Kamer S, Turhan T, Kitis O, Ertan Y, Cetingul N, Anacak Y, Akalin T, Ersahin Y, Mason G, Nazarian J, Ho C, Devaney J, Stampar M, Kambhampati M, Crozier F, Vezina G, Packer R, Hwang E, Gilheeney S, Millard N, DeBraganca K, Khakoo Y, Kramer K, Wolden S, Donzelli M, Fischer C, Petriccione M, Dunkel I, Afzal S, Carret AS, Fleming A, Larouche V, Zelcer S, Johnston DL, Kostova M, Mpofu C, Decarie JC, Strother D, Lafay-Cousin L, Eisenstat D, Fryer C, Hukin J, Bartels U, Bouffet E, Hsu M, Lasky J, Moore T, Liau L, Davidson T, Prins R, Fouladi M, Bartels U, Warren K, Hassal T, Baugh J, Kirkendall J, Doughman R, Leach J, Jones B, Miles L, Hawkins C, Bouffet E, Hargrave D, Grill J, Jones C, Jacques T, Savage S, Goldman S, Leary S, Packer R, Saunders D, Wesseling P, Varlet P, van Vuurden D, Wallace R, Flutter B, Morgenestern D, Hargrave D, Blanco E, Howe K, Lowdell M, Samuel E, Michalski A, Anderson J, Arakawa Y, Umeda K, Watanabe KI, Mizowaki T, Hiraoka M, Hiramatsu H, Adachi S, Kunieda T, Takagi Y, Miyamoto S, Venneti S, Santi M, Felicella MM, Sullivan LM, Dolgalev I, Martinez D, Perry A, Lewis PW, Allis DC, Thompson CB, Judkins AR. HIGH GRADE GLIOMAS AND DIPG. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou071] [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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Jacobsen L, Baktoft H, Jepsen N, Aarestrup K, Berg S, Skov C. Effect of boat noise and angling on lake fish behaviour. J Fish Biol 2014; 84:1768-80. [PMID: 24813930 DOI: 10.1111/jfb.12395] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 03/03/2014] [Indexed: 05/26/2023]
Abstract
The effects of disturbances from recreational activities on the swimming speed and habitat use of roach Rutilus rutilus, perch Perca fluviatilis and pike Esox lucius were explored. Disturbances were applied for 4 h as (1) boating in short intervals with a small outboard internal combustion engine or (2) boating in short intervals combined with angling with artificial lures between engine runs. The response of the fish species was evaluated by high-resolution tracking using an automatic acoustic telemetry system and transmitters with sub-minute burst rates. Rutilus rutilus swimming speed was significantly higher during disturbances [both (1) and (2)] with an immediate reaction shortly after the engine started. Perca fluviatilis displayed increased swimming activity during the first hour of disturbance but not during the following hours. Swimming activity of E. lucius was not significantly different between disturbance periods and the same periods on days without disturbance (control). Rutilus rutilus increased their use of the central part of the lake during disturbances, whereas no habitat change was observed in P. fluviatilis and E. lucius. No difference in fish response was detected between the two types of disturbances (boating with and without angling), indicating that boating was the primary source of disturbance. This study highlights species-specific responses to recreational boating and may have implications for management of human recreational activities in lakes.
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Affiliation(s)
- L Jacobsen
- Technical University of Denmark, National Institute of Aquatic Resources, Vejlsøvej 39, 8600, Silkeborg, Denmark
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Schantz M, Berg S, Betz M, Kulozik U, Leick S, Rehage H, Schwarz K, Baum M, Richling E. TRIGGERED GASTROINTESTINAL RELEASE OF ANTHOCYANINS FROM BILBERRIES (VACCINIUM MYRTILLUS L.). ACTA ACUST UNITED AC 2014. [DOI: 10.17660/actahortic.2014.1017.46] [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: 11/17/2022]
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Berg BI, Gertsch A, Zeilhofer HF, Schwenzer-Zimmerer K, Berg S, Hassfeld S, Jürgens P. [Cone beam computed tomography and radiation dosage: application frequency and knowledge of dentists in Switzerland]. Swiss Dent J 2014; 124:419-433. [PMID: 24805266] [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: 06/03/2023]
Abstract
The use of cone beam computed tomography (CBCT) among Swiss dentists increases from year to year. The aim of this study was to investigate the application frequency and the knowledge about CBCT and radiation dosage in a representative Swiss dentist sample. A standardized questionnaire about knowledge on CBCT was personally handed out or sent by post to 1,000 dentists in Switzerland (return postage was free of charge). 278 dentists returned the questionnaire. Descriptive statistics, correlation analysis of general variables and written answers of the questionnaires were evaluated. Most dentists were aware of radiation dosage and potential use of the CBCT and are interested in continuing education on CBCT.
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Affiliation(s)
- Britt-Isabelle Berg
- Klinik für Mund-, Kieferund Gesichtschirurgie, Universitätsspital Basel, Basel, Schweiz
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Berg S, Sundqvist M, Christenson K, Welin A, Björnsdottir H, Bylund J, Wekell P, Söderkvist P, Karlsson A. P02-025 - Homozygous Q705K sequence variant in NLRP3. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953098 DOI: 10.1186/1546-0096-11-s1-a132] [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: 11/30/2022] Open
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Georgiadis A, Berg S, Makurat A, Maitland G, Ott H. Pore-scale micro-computed-tomography imaging: nonwetting-phase cluster-size distribution during drainage and imbibition. Phys Rev E Stat Nonlin Soft Matter Phys 2013; 88:033002. [PMID: 24125339 DOI: 10.1103/physreve.88.033002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Indexed: 05/16/2023]
Abstract
We investigated the cluster-size distribution of the residual nonwetting phase in a sintered glass-bead porous medium at two-phase flow conditions, by means of micro-computed-tomography (μCT) imaging with pore-scale resolution. Cluster-size distribution functions and cluster volumes were obtained by image analysis for a range of injected pore volumes under both imbibition and drainage conditions; the field of view was larger than the porosity-based representative elementary volume (REV). We did not attempt to make a definition for a two-phase REV but used the nonwetting-phase cluster-size distribution as an indicator. Most of the nonwetting-phase total volume was found to be contained in clusters that were one to two orders of magnitude larger than the porosity-based REV. The largest observed clusters in fact ranged in volume from 65% to 99% of the entire nonwetting phase in the field of view. As a consequence, the largest clusters observed were statistically not represented and were found to be smaller than the estimated maximum cluster length. The results indicate that the two-phase REV is larger than the field of view attainable by μCT scanning, at a resolution which allows for the accurate determination of cluster connectivity.
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Affiliation(s)
- A Georgiadis
- Shell Global Solutions International BV, Rijswijk, The Netherlands and Department of Chemical Engineering, Imperial College London, United Kingdom
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Hammarskjöld F, Mernelius S, Andersson RE, Berg S, Hanberger H, Löfgren S, Malmvall BE, Petzold M, Matussek A. Possible transmission of Candida albicans on an intensive care unit: genotype and temporal cluster analyses. J Hosp Infect 2013; 85:60-5. [PMID: 23927923 DOI: 10.1016/j.jhin.2013.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 06/03/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nosocomial transmission of Candida spp. has not been fully explored and previous studies have shown conflicting results. AIM To evaluate the possible nosocomial transmission of Candida spp. on an intensive care unit (ICU). METHODS A prospective study was conducted for a period of 19 months, including all patients on our ICU with growth of Candida spp. from surveillance and directed cultures. Molecular typing with repetitive sequence-based polymerase chain reaction was used to define genotype relationships between the Candida albicans and Candida glabrata isolates. Candida isolates obtained from blood cultures taken from patients in our county outside the ICU were used as a reference. Temporal cluster analysis was performed to evaluate genotype distribution over time. FINDINGS Seventy-seven patients with 78 ICU stays, representing 12% of all ICU stays, were found to harbour 180 isolates of Candida spp. Molecular typing revealed 27 C. albicans genotypes and 10 of C. glabrata. Possible clustering, indicated by overlapping stays of patients with indistinguishable candida genotypes, was observed on seven occasions with C. albicans and on two occasions with C. glabrata. Two C. albicans genotypes were found significantly more often in the ICU group compared with the reference group. Moreover, C. albicans genotypes isolated from more than one patient were significantly more often found in the ICU group. Temporal cluster analysis revealed a significantly increased number of pairs with indistinguishable genotypes at a 21-day interval, indicating clustering. CONCLUSION This study indicates possible transmission of C. albicans between ICU patients based on genotyping and temporal cluster analysis.
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Affiliation(s)
- F Hammarskjöld
- Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
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Harloff A, Berg S, Barker AJ, Schöllhorn J, Schumacher M, Weiller C, Markl M. Wall shear stress distribution at the carotid bifurcation: influence of eversion carotid endarterectomy. Eur Radiol 2013; 23:3361-9. [PMID: 23812310 DOI: 10.1007/s00330-013-2953-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 05/31/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To test the feasibility of four-dimensional (4D) flow MRI to quantify the systolic wall shear stress (WSSsystole) and oscillatory shear index (OSI) in high-grade internal carotid artery (ICA) stenosis before and after endarterectomy (CEA). METHODS Twenty patients with ≥60 % ICA stenosis were prospectively and consequently included. Four-dimensional flow MRI was used to measure individual time-resolved 3D blood flow velocities. Segmental WSSsystole and OSI were derived at eight wall segments in analysis planes positioned along the ICA, common (CCA) and external carotid artery (ECA). RESULTS Regional WSSsystole of all patients decreased after CEA (P < 0.05). Changes were most prominent at the ICA bulb but remained unchanged in the CCA and ECA. OSI was significantly lower after CEA in the lateral vessel walls (P < 0.05). For analysis planes at the stenosis in- and outlet, a reduction of mean WSSsystole by 32 % and 52 % (P < 0.001) and OSI distal to the stenosis (40 %, P = 0.01) was found after CEA. CONCLUSIONS Our findings show the potential of in vivo 4D flow MRI to quantify haemodynamic changes in wall shear stress even in patients with complex flow conditions.
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Affiliation(s)
- A Harloff
- Department of Neurology, University Hospital Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany,
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Von Scheven-Gête A, Pillet P, Krol P, Kone-Paut I, Rigante D, Bader-Meunier B, Hengten V, Berg S, Gattorno M, Hofer M. FRI0332 Evaluation of treatment in PFAPA syndrome: International cohort and literature review. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sonnesen L, Jensen KE, Petersson AR, Petri N, Berg S, Svanholt P. Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study. Dentomaxillofac Radiol 2013; 42:20130060. [PMID: 23503808 DOI: 10.1259/dmfr.20130060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Few studies have described morphological deviations in obstructive sleep apnoea (OSA) patients on two-dimensional (2D) lateral cephalograms, and the reliability of 2D radiographs has been discussed. The objective is to describe the morphology of the cervical vertebral column on cone beam CT (CBCT) in adult patients with OSA and to compare 2D lateral cephalograms with three-dimensional (3D) CBCT images. METHODS For all 57 OSA patients, the cervical vertebral column morphology was evaluated on lateral cephalograms and CBCT images and compared according to fusion anomalies and posterior arch deficiency. RESULTS The CBCT assessment showed that 21.1% had fusion anomalies of the cervical column, i.e. fusion between two cervical vertebrae (10.5%), block fusions (8.8%) or occipitalization (1.8%). Posterior arch deficiency occurred in 14% as partial cleft of C1 and in 3.5% in combination with block fusions. The agreement between the occurrence of morphological deviations in the cervical vertebral column between lateral cephalograms and CBCT images showed good agreement (κ = 0.64). CONCLUSIONS Prevalence and pattern in the cervical column morphology have now been confirmed on CBCT. The occurrence of morphological deviations in the cervical vertebral column showed good agreement between lateral cephalograms and CBCT images. This indicates that 2D lateral cephalograms (already available after indication in connection with, e.g. treatment planning) are sufficient for identifying morphological deviations in the cervical vertebral column. For a more accurate diagnosis and location of the deviations, CBCT is required. New 3D methods will suggest a need for new detailed characterization and division of deviations in cervical vertebral column morphology.
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Affiliation(s)
- L Sonnesen
- Department of Orthodontics, Institute of Odontology, Faculty of Health Sciences, University of Copenhagen, Denmark.
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Wekell P, Friman V, Balci-Peynircioglu B, Yilmaz E, Fasth A, Berg S. Familial Mediterranean Fever -- an increasingly important childhood disease in Sweden. Acta Paediatr 2013. [PMID: 23194659 DOI: 10.1111/apa.12075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To characterize Familial Mediterranean Fever (FMF) in western Sweden, focusing on genotype, clinical picture, prevalence and age of onset as well as time to diagnosis. METHODS Patients with autoinflammatory diseases are continuously registered at the five main hospitals in Western Sweden. Case records of patients with FMF were analysed retrospectively. Population data on immigration was retrieved from Statistics Sweden. RESULTS Until 2008, 37 patients with FMF were identified. The prevalence among inhabitants of Turkish, Lebanese, Syrian and Iranian origin was 173, 124, 86 and 17/100 000, respectively. Median age at first symptoms was 4 years (range 3 month-37 years) and at diagnosis 10 years (range 2-44 years). Median time from first symptoms to diagnosis was 4 years (range <1 year-34 years). Among 32 patients screened for twelve common mutations, 75% were homozygotes or compound heterozygotes, 16% were heterozygotes and in 9% no mutation was found. In our cohort the frequencies of symptoms were fever 100%, peritonitis 92%, pleuritis 22% and arthritis 11%. CONCLUSIONS The majority of patients with FMF present during childhood. The prevalence among immigrants in western Sweden is in the same range as in their country of origin. Time to diagnosis needs to be shortened by means of increased awareness of the disease.
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Affiliation(s)
| | - V Friman
- Department of Infectious Diseases; University of Gothenburg; Sweden
| | - B Balci-Peynircioglu
- Department of Medical Biology; Faculty of Medicine; Hacettepe University; Ankara; Turkey
| | - E Yilmaz
- Department of Medical Biology; Faculty of Medicine; Hacettepe University; Ankara; Turkey
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Gillberg L, Berg S, de Verdier PJ, Lindbom L, Werr J, Hellström PM. Effective treatment of mouse experimental colitis by alpha 2 integrin antibody: comparison with alpha 4 antibody and conventional therapy. Acta Physiol (Oxf) 2013; 207:326-36. [PMID: 23009282 DOI: 10.1111/apha.12017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 08/22/2012] [Accepted: 09/17/2012] [Indexed: 12/16/2022]
Abstract
AIM To compare the therapeutic effect of α(2) and α(4) integrin-blocking antibodies to conventional inflammatory bowel disease drugs methotrexate, 5-aminosalicylic acid and azathioprine in the dextran sulphate sodium mouse colitis model. METHODS Colitis was induced in balb/c mice with 2.5-3.0% dextran sulphate sodium. Treatment was given daily for 7 days after the onset of colitis, by rectal installation. Clinical signs of disease were assessed daily using a disease activity index. After 19 days, all animals were killed and colon samples collected for histological grading and mRNA/protein analysis. All treatment groups were compared with an untreated control group and a treatment group receiving dextran sulphate sodium alone to monitor the potential degree of clinical remission. RESULTS Treatment with anti-α(2) antibodies and methotrexate reduced the body weight loss. At the end of treatment, anti-α(2) antibodies reduced rectal bleeding, while methotrexate reduced the disease activity index score. Histological evaluation showed that anti-α(2) antibodies, methotrexate, 5-aminosalicylic acid and azathioprine treatment reduced the acute inflammation; methotrexate was the only treatment with effect on the crypt score. Compared with the dextran sulphate sodium alone group, the methotrexate group showed down-regulation of IL-1β at the mRNA level, while the anti-α(2) antibody group displayed decreased protein expression of iNOS and IL-1β. CONCLUSIONS Specific blocking of extravascular trafficking of leucocytes with α(2)-antibodies could be a new beneficial drug target in inflammatory bowel disease.
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Affiliation(s)
- L. Gillberg
- Department of Medicine; Gastroenterology Unit; Karolinska Institutet; Stockholm; Sweden
| | - S. Berg
- Department of Medicine; Gastroenterology Unit; Karolinska Institutet; Stockholm; Sweden
| | | | - L. Lindbom
- Department of Physiology and Pharmacology; Microvascular Physiology Section; Karolinska Institutet; Stockholm; Sweden
| | - J. Werr
- Department of Physiology and Pharmacology; Microvascular Physiology Section; Karolinska Institutet; Stockholm; Sweden
| | - P. M. Hellström
- Department of Medical Sciences, Gastroenterology Unit; Uppsala University; Uppsala; Sweden
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