1
|
Vincent C, Allan S, Naylor G, Stephen R, Bray S, Thornton A, Kirk A. Fission chamber data acquisition system for neutron flux measurements on the Mega-Amp Spherical Tokamak Upgrade. Rev Sci Instrum 2022; 93:093509. [PMID: 36182454 DOI: 10.1063/5.0106725] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Neutron flux measurements are important in fusion devices for both safety requirements and physics studies. A new system has been built for the Mega-Amp Spherical Tokamak Upgrade (MAST Upgrade) that provides neutron count, DC, and Campbell mode measurements for a 1 µs period at 1 MHz. The acquisition system uses a Red Pitaya board to sample current from two fission chambers mounted on the side of the MAST-U vessel. The system-on-chip design of the Zynq-7020 on the Red Pitaya also allows a web server implementation using Flask for data retrieval and diagnostic configuration over the MAST Upgrade network.
Collapse
Affiliation(s)
- C Vincent
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - S Allan
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - G Naylor
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - R Stephen
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - S Bray
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - A Thornton
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| | - A Kirk
- United Kingdom Atomic Energy Authority, Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB, United Kingdom
| |
Collapse
|
2
|
Miltz AR, Rodger AJ, Sewell J, Gilson R, Allan S, Scott C, Sadiq T, Farazmand P, McDonnell J, Speakman A, Sherr L, Phillips AN, Johnson AM, Collins S, Lampe FC. Recreational drug use and use of drugs associated with chemsex among HIV-negative and HIV-positive heterosexual men and women attending sexual health and HIV clinics in England. Int J Drug Policy 2021; 91:103101. [PMID: 33494013 PMCID: PMC8188422 DOI: 10.1016/j.drugpo.2020.103101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 11/27/2020] [Accepted: 12/22/2020] [Indexed: 11/27/2022]
Abstract
Background There is little information on the prevalence of recreational drug use among UK heterosexual men and women, in particular on use of drugs associated with ‘chemsex’ within gay communities. The aim of this study was to examine among HIV-negative and HIV-positive heterosexual men and women in England: (i) the prevalence of recreational drug use (including use of drugs associated with chemsex), (ii) socio-economic/lifestyle correlates of drug use, and (iii) the association of drug use with sexual behavior measures and mental health symptoms. Methods Data are from the AURAH study of HIV-negative individuals attending sexual health clinics across England (2013–2014) and the ASTRA study of HIV-positive individuals attending HIV outpatient clinics in England (2011–2012). Prevalence of recreational drug use (past three months) and associations are presented separately among the four sample groups: HIV-negative (N = 470) and HIV-positive (N = 373) heterosexual men and HIV-negative (N = 676) and HIV-positive (N = 637) women. Results The age standardized prevalence of any drug use was 22.9%, 17.1%, 15.3%, and 7.1% in the four sample groups respectively. In all groups, cannabis was the drug most commonly used (range from 4.7% to 17.9%) followed by cocaine (1.6% to 8.5%). The prevalence of use of drugs associated with chemsex was very low among HIV-negative participants (1.0% heterosexual men, 0.2% women) and zero among HIV-positive men and women. In age-adjusted analysis, factors linked to drug use overall and/or to cannabis and cocaine use specifically in the four sample groups included Black/mixed Caribbean and white (vs. Black/mixed African) ethnicity, lower level of education , cigarette smoking, and higher risk alcohol consumption. Associations of recreational drug use with measures of condomless sex, depression, and anxiety were observed in the four groups, but were particularly strong/apparent among women. Conclusion Providers need to be aware of cannabis and cocaine use and its potential link with sexual risk behavior and symptoms of depression and anxiety among heterosexual men and women attending sexual health and HIV clinics.
Collapse
Affiliation(s)
- Ada R Miltz
- Institute for Global Health, University College London, London, UK.
| | - Alison J Rodger
- Institute for Global Health, University College London, London, UK
| | - Janey Sewell
- Institute for Global Health, University College London, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK
| | - Sris Allan
- City of Coventry Healthcare Centre, Coventry, UK
| | | | - Tariq Sadiq
- Courtyard Clinic, St George's Healthcare NHS Trust, London, UK
| | | | - Jeffrey McDonnell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Andrew Speakman
- Institute for Global Health, University College London, London, UK
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | | | - Anne M Johnson
- Institute for Global Health, University College London, London, UK
| | | | - Fiona C Lampe
- Institute for Global Health, University College London, London, UK
| | | |
Collapse
|
3
|
Miltz AR, Rodger AJ, Phillips AN, Sewell J, Edwards S, Allan S, Sherr L, Johnson AM, Burman WJ, Lampe FC. Opposing associations of depression with sexual behaviour: implications for epidemiological investigation among gay, bisexual and other men who have sex with men. Sex Transm Infect 2021; 97:613-618. [PMID: 33431606 PMCID: PMC8606445 DOI: 10.1136/sextrans-2020-054634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/18/2020] [Accepted: 12/06/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this report is to investigate the nature of the relationship between depression and condomless sex (CLS) among gay, bisexual and other men who have sex with men (GBMSM). METHODS Data are from the Antiretrovirals, Sexual Transmission Risk and Attitude (ASTRA) study of people living with HIV and attending one of eight HIV outpatient clinics in England (2011-2012) and the Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) study of HIV-negative/unknown status individuals attending one of 20 genitourinary medicine clinics in England (2013-2014). This analysis included GBMSM only. For each study, the prevalence of depressive symptoms (Patient Health Questionnaire-9 score ≥10) was presented according to three categories of sex in the past 3 months (considering anal/vaginal sex with men/women and anal sex with men in separate definitions): (1) no sex, (2) condom-protected sex only and (3) CLS. Multinomial logistic regression with 'condom-protected sex only' as the reference group was used to adjust for age and (for ASTRA participants) time since HIV diagnosis. RESULTS There were opposing associations of depression with recent sexual behaviour: the prevalence of depression was higher among those who reported no sex and those who reported CLS, compared with those who reported condom-protected sex only. Among the 2170 HIV-positive GBMSM in ASTRA, considering anal/vaginal sex with men/women, the prevalence of depressive symptoms was 32%, 20% and 28%, respectively, among men reporting no sex (n=783), condom-protected sex only (n=551) and CLS (n=836) (global p<0.001). Among the 1477 HIV-negative GBMSM in AURAH, the prevalence of depressive symptoms was 12%, 8% and 13%, respectively, for no sex (n=137), condom-protected sex only (n=487) and CLS (n=853) (global p=0.017). Patterns were similar after adjustment and when only considering anal sex between men. CONCLUSIONS Depression may be linked both to lack of sexual activity and to sexual risk taking. When investigating associations between depression and CLS, it is important to separate out individuals reporting condom-protected sex only from those reporting no sex.
Collapse
Affiliation(s)
- Ada R Miltz
- Institute for Global Health, University College London, London, UK
| | - Alison J Rodger
- Institute for Global Health, University College London, London, UK
| | | | - Janey Sewell
- Institute for Global Health, University College London, London, UK
| | - Simon Edwards
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Sris Allan
- City of Coventry NHS Healthcare Centre, Coventry, UK
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Anne M Johnson
- Institute for Global Health, University College London, London, UK
| | | | - Fiona C Lampe
- Institute for Global Health, University College London, London, UK
| | | |
Collapse
|
4
|
Packer L, Allan S, Bradnam S, Jednorog S, Łaszyńska E, Roberts N, Wilson C, Worrall R. Backwards extrapolation activation diagnostics and their dynamic range for pulsed neutron source measurements. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Miltz AR, Rodger AJ, Lepri AC, Sewell J, Nwokolo NC, Allan S, Scott C, Ivens D, Lascar M, Speakman A, Phillips AN, Sherr L, Collins S, Elford J, Lampe FC. Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation. AIDS Behav 2020; 24:1793-1806. [PMID: 31782068 PMCID: PMC7220884 DOI: 10.1007/s10461-019-02724-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study is to investigate five hypothesized mechanisms of causation between depression and condomless sex with ≥ 2 partners (CLS2+) among gay, bisexual, and other men who have sex with men (GBMSM), involving alternative roles of self-efficacy for sexual safety and recreational drug use. Data were from the AURAH cross-sectional study of 1340 GBMSM attending genitourinary medicine clinics in England (2013–2014). Structural equation modelling (SEM) was used to investigate which conceptual model was more consistent with the data. Twelve percent of men reported depression (PHQ-9 ≥ 10) and 32% reported CLS2+ in the past 3 months. AURAH data were more consistent with the model in which depression was considered to lead to CLS2+ indirectly via low self-efficacy for sexual safety (indirect Beta = 0.158; p < 0.001) as well as indirectly via higher levels of recreational drug use (indirect Beta = 0.158; p < 0.001). SEM assists in understanding the relationship between depression and CLS among GBMSM.
Collapse
Affiliation(s)
- A R Miltz
- Institute for Global Health, University College London, London, UK.
| | - A J Rodger
- Institute for Global Health, University College London, London, UK
| | - A Cozzi Lepri
- Institute for Global Health, University College London, London, UK
| | - J Sewell
- Institute for Global Health, University College London, London, UK
| | | | - S Allan
- City of Coventry Healthcare Centre, Coventry, UK
| | - C Scott
- West London Centre for Sexual Health, London, UK
| | - D Ivens
- Royal Free Hospital, London, UK
| | - M Lascar
- Whipps Cross Hospital, London, UK
| | - A Speakman
- Institute for Global Health, University College London, London, UK
| | - A N Phillips
- Institute for Global Health, University College London, London, UK
| | - L Sherr
- Institute for Global Health, University College London, London, UK
| | | | - J Elford
- City, University of London, London, UK
| | - F C Lampe
- Institute for Global Health, University College London, London, UK
| |
Collapse
|
6
|
Solomon D, Sabin CA, Burns F, Gilson R, Allan S, de Ruiter A, Dhairyawan R, Fox J, Gilleece Y, Jones R, Post F, Reeves I, Ross J, Ustianowski A, Shepherd J, Tariq S. The association between severe menopausal symptoms and engagement with HIV care and treatment in women living with HIV. AIDS Care 2020; 33:101-108. [PMID: 32279528 PMCID: PMC8043570 DOI: 10.1080/09540121.2020.1748559] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
Using data from the PRIME Study, an observational study of the menopause in women living with HIV in England, we explored the association between menopausal symptoms and: (i) antiretroviral therapy (ART) adherence and (ii) HIV clinic attendance. We measured menopausal symptom severity with the Menopause Rating Scale (MRS, score ≥17 indicating severe symptoms), adherence with the CPCRA Antiretroviral Medication Adherence Self-Report Form, and ascertained HIV clinic attendance via self-report. Odds ratios were obtained using logistic regression. Women who reported severe menopausal symptoms had greater odds of suboptimal ART adherence (adjusted odds ratio (AOR) 2.22; 95% CI 1.13, 4.35) and suboptimal clinic attendance (AOR 1.52; 95% CI 1.01, 2.29). When psychological, somatic and urogenital domains of the MRS were analysed individually there was no association between adherence and severe symptoms (all p > 0.1), however there was an association between suboptimal HIV clinic attendance and severe somatic (AOR 1.98; 95% CI 1.24, 3.16) and psychological (AOR 1.76; 95% CI 1.17, 2.65) symptoms. Severe menopausal symptoms were significantly associated with sub-optimal ART adherence and HIV clinic attendance, however we cannot infer causality, highlighting the need for longitudinal data.
Collapse
Affiliation(s)
| | | | - Fiona Burns
- Institute for Global Health, University College London, UK.,Royal Free London NHS Foundation Trust, UK
| | - Richard Gilson
- Institute for Global Health, University College London, UK
| | - Sris Allan
- Coventry and Warwickshire Partnership NHS Trust, UK
| | | | | | - Julie Fox
- Guy's & St Thomas' NHS Foundation Trust, UK
| | - Yvonne Gilleece
- Brighton & Sussex University Hospitals NHS Trust, UK.,Brighton & Sussex Medical School, UK
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, UK
| | - Frank Post
- King's College Hospital NHS Foundation Trust, UK
| | - Iain Reeves
- Homerton University Hospital NHS Foundation Trust, UK
| | - Jonathan Ross
- University Hospital Birmingham NHS Foundation Trust, UK
| | | | | | - S Tariq
- Institute for Global Health, University College London, UK
| |
Collapse
|
7
|
Toorabally N, Mercer CH, Mitchell KR, Blell M, Burns F, Gilson R, McGregor-Read J, Allan S, De Ruiter A, Dhairyawan R, Fox J, Gilleece Y, Jones R, Mackie N, Obeyesekera S, Post F, Reeves I, Rosenvinge M, Ross J, Sarner L, Sullivan A, Tariq A, Ustianowski A, Sabin CA, Tariq S. Association of HIV status with sexual function in women aged 45-60 in England: results from two national surveys. AIDS Care 2020; 32:286-295. [PMID: 31411046 PMCID: PMC7034538 DOI: 10.1080/09540121.2019.1653436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 08/02/2019] [Indexed: 01/23/2023]
Abstract
Increasing numbers of women living with HIV are reaching their midlife. We explore the association of HIV status with sexual function (SF) in women aged 45-60 using two national cross-sectional surveys: the third British National Survey of Sexual Attitudes and Lifestyles ("Natsal-3") and "PRIME", a survey of women living with HIV attending HIV clinics across England. Both studies asked the same questions about SF that take account not only sexual difficulties but also the relationship context and overall level of satisfaction, which collectively allowed an overall SF score to be derived. We undertook analyses of sexually-active women aged 45-60 from Natsal-3 (N = 1228, presumed HIV-negative given the low estimated prevalence of HIV in Britain) and PRIME (N = 386 women living with HIV). Women living with HIV were compared to Natsal-3 participants using multivariable logistic regression (adjusting for key confounders identified a priori: ethnicity, ongoing relationship status, depression and number of chronic conditions) and propensity scoring. Relative to Natsal-3 participants, women living with HIV were more likely to: have low overall SF (adjusted odds ratio (AOR) 3.75 [2.15-6.56]), report ≥1 sexual problem(s) lasting ≥3 months (AOR 2.44 [1.49-4.00]), and report almost all 8 sexual problems asked about (AORs all ≥2.30). The association between HIV status and low SF remained statistically significant when using propensity scoring (AOR 2.43 [1.68-3.51]). Among women living with HIV (only), low SF was more common in those who were postmenopausal vs. Premenopausal (55.6% vs. 40.4%). This study suggests a negative association between HIV status and sexual function in women aged 45-60. We recommend routine assessment of SF in women living with HIV.
Collapse
Affiliation(s)
| | - Catherine H. Mercer
- Institute for Global Health, University College London, London, UK
- NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - Kirstin R. Mitchell
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mwenza Blell
- The Policy Ethics and Life Sciences (PEALS) Research Centre, School of Geography, Politics, and Sociology, Newcastle University, Newcastle, UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK
- Ian Charleson Day Centre, Royal Free London NHS Foundation Trust, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK
| | | | - Sris Allan
- City of Coventry Health Centre (Integrated Sexual Health Services), Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Annemiek De Ruiter
- Harrison Wing, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
- ViiV Healthcare, London, UK
| | | | - Julie Fox
- Harrison Wing, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
| | - Yvonne Gilleece
- Lawson Unit, Brighton & Sussex University Hospitals NHS Trust, Brighton, UK
| | - Rachael Jones
- Kobler Outpatient Clinic, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Nicola Mackie
- The Wharfside Clinic, Imperial College Healthcare NHS Trust, London, UK
| | | | - Frank Post
- Caldecot Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Iain Reeves
- Jonathan Mann Clinic, Homerton University Hospital Foundation Trust, London, UK
| | | | - Jonathan Ross
- Queen Elizabeth Hospital Birmingham HIV Clinic, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Liat Sarner
- Grahame Hayton Unit, Barts NHS Trust, London, UK
| | - Ann Sullivan
- Kobler Outpatient Clinic, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Anjum Tariq
- Wolverhampton Sexual Health Service, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Andrew Ustianowski
- Department of Infectious Diseases, North Manchester General Hospital, Penine Acute Hospitals NHS Trust, Manchester, UK
| | - Caroline A. Sabin
- Institute for Global Health, University College London, London, UK
- NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
| |
Collapse
|
8
|
Stirrup OT, Sabin CA, Phillips AN, Williams I, Churchill D, Tostevin A, Hill T, Dunn DT, Asboe D, Pozniak A, Cane P, Chadwick D, Churchill D, Clark D, Collins S, Delpech V, Douthwaite S, Dunn D, Fearnhill E, Porter K, Tostevin A, Stirrup O, Fraser C, Geretti AM, Gunson R, Hale A, Hué S, Lazarus L, Leigh-Brown A, Mbisa T, Mackie N, Orkin C, Nastouli E, Pillay D, Phillips A, Sabin C, Smit E, Templeton K, Tilston P, Volz E, Williams I, Zhang H, Fairbrother K, Dawkins J, O’Shea S, Mullen J, Cox A, Tandy R, Fawcett T, Hopkins M, Booth C, Renwick L, Renwick L, Schmid ML, Payne B, Hubb J, Dustan S, Kirk S, Bradley-Stewart A, Hill T, Jose S, Thornton A, Huntington S, Glabay A, Shidfar S, Lynch J, Hand J, de Souza C, Perry N, Tilbury S, Youssef E, Gazzard B, Nelson M, Mabika T, Mandalia S, Anderson J, Munshi S, Post F, Adefisan A, Taylor C, Gleisner Z, Ibrahim F, Campbell L, Baillie K, Gilson R, Brima N, Ainsworth J, Schwenk A, Miller S, Wood C, Johnson M, Youle M, Lampe F, Smith C, Tsintas R, Chaloner C, Hutchinson S, Walsh J, Mackie N, Winston A, Weber J, Ramzan F, Carder M, Leen C, Wilson A, Morris S, Gompels M, Allan S, Palfreeman A, Lewszuk A, Kegg S, Faleye A, Ogunbiyi V, Mitchell S, Hay P, Kemble C, Martin F, Russell-Sharpe S, Gravely J, Allan S, Harte A, Tariq A, Spencer H, Jones R, Pritchard J, Cumming S, Atkinson C, Mital D, Edgell V, Allen J, Ustianowski A, Murphy C, Gunder I, Trevelion R, Babiker A. Associations between baseline characteristics, CD4 cell count response and virological failure on first-line efavirenz + tenofovir + emtricitabine for HIV. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30037-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
9
|
Tam LL, Mcguigan B, Connor A, Allan S, Sanmugarajah J. Abstract P1-13-06: Exploring the real-life incidence of toxicities amongst obese breast cancer patients receiving adjuvant chemotherapy dosed based on absolute body weight. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Obesity is an established risk factor for developing breast cancer and is also a negative prognostic indicator for higher recurrence risk.1 Adjuvant chemotherapy reduces the likelihood of metastatic recurrence and improves disease-free and overall survival.2 However, the practice of optimal dosing of adjuvant breast cancer chemotherapy amongst obese patients remains contentious with concerns regarding excessive toxicity if obese patients are dosed based on actual body weight (ABW).2-4 A 2014 study reported that obese patients were five times more likely to have dose reductions in cycle 1 than non-obese patients.5 Inadequate dosing amongst obese breast cancer patients may have deleterious implications on ultimate prognosis.2-4 This study aimed to investigate whether chemotherapy dosing using ABW in obese breast cancer patients is associated with comparable incidences of toxicity.
Methods:
A retrospective cross-sectional study was conducted amongst 257 patients (aged ≥18) treated in the adjuvant setting with doxorubicin-cyclophosphamide-paclitaxel (AC-P) or docetaxel-cyclophosphamide (TC) with/without trastuzumab between 2014 and 2017. Obesity was classified as a body mass index (BMI) of ≥30, with morbid obesity defined as a BMI≥35. Chemotherapy dosing based on body surface area calculated using ABW was considered the standard protocol with any variations from this dosing method for cycle 1 being recorded. Subsequent dose adjustments were also noted. The primary outcome was tolerability of chemotherapy regimens dosed using ABW with outcome measures of toxicity defined as the incidence of febrile neutropaenia, the incidence of grade 3 or 4 non-haematological toxicities and the number of hospitalisations during the treatment course.
Results:
257 patients were eligible (1 male, 256 females). Median age was 55 (range, 31-78). AC-P was the most commonly used regimen (48.6%), followed by TC (40.1%). Obesity and morbid obesity were noted amongst 17.9% and 15.6% of patients respectively; with 63.8% with a BMI≥25. Chemotherapy dosing was largely based on ABW, with only 4.3% of patients dosed based on ABW or had their dosing body surface area capped at 2.0m2. In patients with a BMI≥25, 25% had febrile neutropaenia compared to 21.8% in those with normal BMI (p=0.58). Incidence of febrile neutropaenia during treatment by BMI – underweight: 33.3% (p=0.61); normal: 24.1%; overweight: 24.4% (p=0.97); obese: 17.4% (p=0.37); morbidly obese: 25%(p=0.92). Grade 3-4 non-haematological toxicities had comparable incidences between the normal BMI group as opposed to the overweight/obese group (23.0% vs 18.9% respectively, p=0.44). Hospitalisations by BMI - underweight: 50% (p=0.85); normal BMI: 46%; overweight: 42.3% (p=0.64); obese: 54.3%(p=0.36); morbidly obese: 57.5%(p=0.23).
Conclusion:
This study demonstrates that obese breast cancer patients do not experience higher toxicities when their adjuvant chemotherapy is dosed based on ABW. This supports current guidelines for dosing amongst obese patients.
Citation Format: Tam LL, Mcguigan B, Connor A, Allan S, Sanmugarajah J. Exploring the real-life incidence of toxicities amongst obese breast cancer patients receiving adjuvant chemotherapy dosed based on absolute body weight [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-06.
Collapse
Affiliation(s)
- LL Tam
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - B Mcguigan
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - A Connor
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - S Allan
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - J Sanmugarajah
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| |
Collapse
|
10
|
Sommer W, OJ M, Pruner B, Paster T, Bean A, Dehnadi A, Hanekamp M, Rosales I, Smith N, Colvin R, Benichou G, Allan S, Kawai T, Madsen C. Donor Brain Death Affects Tolerance Induction in Nonhuman Primates. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- W. Sommer
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
- Department for Cardiothoracic-, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - M. OJ
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - B. Pruner
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - T. Paster
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - A. Bean
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - A. Dehnadi
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - M. Hanekamp
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - I. Rosales
- Department of Pathology, Massachusetts General Hospital, Harvard University, Boston, United States
| | - N. Smith
- Department of Pathology, Massachusetts General Hospital, Harvard University, Boston, United States
| | - R.B. Colvin
- Department of Pathology, Massachusetts General Hospital, Harvard University, Boston, United States
| | - G. Benichou
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - S. Allan
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - T. Kawai
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| | - C. Madsen
- Center for Transplantation Sciences, Massachusetts General Hospital, Harvard University, Boston, United States
| |
Collapse
|
11
|
Thurston MD, Allan S. Sexuality and sexual experiences during gender transition: A thematic synthesis. Clin Psychol Rev 2018; 66:39-50. [PMID: 30477689 DOI: 10.1016/j.cpr.2017.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/19/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
AIM To establish what impact, if any, the gender-affirmation process, has on sexuality and sexual experiences. INTRODUCTION Sexuality is a multi-faceted construct that influences our attraction to others. Gender transition is the process of aligning our physical sex characteristics with our psychological gender. Our sexuality and our gender identity are often mistakenly assumed to be inextricably linked. It is important to consider and understand the influence of the gender-affirmation process on sexuality and sexual experiences. METHOD A thematic synthesis of the available qualitative literature regarding sexuality, and sexual experiences in both transgender people and their partners were appraised, and synthesised. Thomas and Harden's (2008) stepwise process for conducting a thematic synthesis was followed. RESULTS A total of seven articles were of relevance and included in the review. Two analytical and six sub-themes were found. The two analytical themes are: 'Re-negotiating previous 'norms" and 'Establishing identity'. CONCLUSION During the gender-affirmation process, sexuality, and sexual experiences alter. This has clinical implications for transgender people and their partners, in particular, valuable therapeutic discussion points that need to be considered during the gender-affirmation process.
Collapse
Affiliation(s)
- M D Thurston
- Department of Clinical Psychology, Derby Children's Hospital, Royal Derby Hospital, Uttoxeter Road, Derby, Derbyshire DE22 3NE, United Kingdom; Clinical Psychology, University of Leicester, Centre for Medicine, Leicester, Leicestershire LE1 7HA, United Kingdom.
| | - S Allan
- Clinical Psychology, University of Leicester, Centre for Medicine, Leicester, Leicestershire LE1 7HA, United Kingdom
| |
Collapse
|
12
|
Dawson L, Allan S, Brough D, Ritchie J, Weber P, Wren S. Targeting the immune system in disease. Highlights from the Society for Medicines Research meeting. Manchester, UK - March 8, 2018. DRUG FUTURE 2018. [DOI: 10.1358/dof.2018.043.04.2808577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
13
|
Hassan AS, Hare J, Kamini G, Yindom LM, Kamali A, Karita E, Kilemba W, Price MA, Borrow P, Bjorkman P, Albert J, Kaleebu P, Allan S, Fast P, Hunter E, Gilmour J, Ndung'u T, Rowland-Jones S, Sanders EJ, Esbjornsson J. A35 Viral evolution and innate immune responses during acute HIV-1 infection and their association with disease pathogenesis. Virus Evol 2017; 3:vew036.034. [PMID: 28845248 PMCID: PMC5565927 DOI: 10.1093/ve/vew036.034] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A S Hassan
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - J Hare
- IAVI Human Immunology Laboratory, Lomndon, UK
| | - G Kamini
- Kwazulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa
| | - L M Yindom
- Nuffield Department of Medicine, University of Oxford, UK
| | - A Kamali
- Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda
| | - E Karita
- Rwanda and Lusaka, Rwanda/Zambia HIV Research Group (RZHRG) Kigali, Zambia
| | - W Kilemba
- Rwanda and Lusaka, Rwanda/Zambia HIV Research Group (RZHRG) Kigali, Zambia
| | | | - P Borrow
- Nuffield Department of Medicine, University of Oxford, UK
| | - P Bjorkman
- Department of laboratory medicine, Lund University, Sweden
| | - J Albert
- Department of Microbiology Tumor and Cell Biology, Karolinska Institute, Sweden
| | - P Kaleebu
- Medical Research Council/Uganda Virus Research Institute (MRC/UVRI), Uganda
| | - S Allan
- Rwanda and Lusaka, Rwanda/Zambia HIV Research Group (RZHRG) Kigali, Zambia
| | | | - E Hunter
- Rwanda and Lusaka, Rwanda/Zambia HIV Research Group (RZHRG) Kigali, Zambia
| | - J Gilmour
- IAVI Human Immunology Laboratory, Lomndon, UK
| | - T Ndung'u
- Kwazulu-Natal Research Institute for Tuberculosis and HIV, Durban, South Africa
| | | | - E J Sanders
- KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - J Esbjornsson
- Nuffield Department of Medicine, University of Oxford, UK
| |
Collapse
|
14
|
Miltz AR, Rodger AJ, Sewell J, Speakman A, Phillips AN, Sherr L, Gilson RJ, Asboe D, Nwokolo NC, Clarke A, Gompels MM, Allan S, Collins S, Lampe FC. Clinically significant depressive symptoms and sexual behaviour among men who have sex with men. BJPsych Open 2017; 3:127-137. [PMID: 28507772 PMCID: PMC5421094 DOI: 10.1192/bjpo.bp.116.003574] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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] [Received: 07/14/2016] [Revised: 01/13/2017] [Accepted: 03/06/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The relationship between depression and sexual behaviour among men who have sex with men (MSM) is poorly understood. AIMS To investigate prevalence and correlates of depressive symptoms (Patient Health Questionnaire-9 score ≥10) and the relationship between depressive symptoms and sexual behaviour among MSM reporting recent sex. METHOD The Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) is a cross-sectional study of UK genitourinary medicine clinic attendees without diagnosed HIV (2013-2014). RESULTS Among 1340 MSM, depressive symptoms (12.4%) were strongly associated with socioeconomic disadvantage and lower supportive network. Adjusted for key sociodemographic factors, depressive symptoms were associated with measures of condomless sex partners in the past 3 months (≥2 (prevalence ratio (PR) 1.42, 95% CI 1.17-1.74; P=0.001), unknown or HIV-positive status (PR 1.43, 95% CI 1.20-1.71; P<0.001)), sexually transmitted infection (STI) diagnosis (PR 1.46, 95% CI 1.19-1.79; P<0.001) and post-exposure prophylaxis use in the past year (PR 1.83, 95% CI 1.33-2.50; P<0.001). CONCLUSIONS Management of mental health may play a role in HIV and STI prevention. DECLARATION OF INTEREST A.N.P. has received payments for presentations made at meetings sponsored by Gilead in spring 2015. N.C.N. has received support for attendance at conferences, speaker fees and payments for attendance at advisory boards from Gilead Sciences, Viiv Healthcare, Janssen Pharmaceuticals and Bristol-Myers Squibb and a research grant from Gilead Sciences. D.A. served on the advisory board for Gilead in January 2016. M.M.G. has had sponsorship to attend conferences by Bristol-Myers Squibb, been on the BioCryst advisory board and run trials for Merck, Gilead, SSAT, BioCryst and Novartis. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
Collapse
Affiliation(s)
- Ada R Miltz
- , MSc, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Alison J Rodger
- , MD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Janey Sewell
- , BNurs, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Andrew Speakman
- , PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Andrew N Phillips
- , PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Lorraine Sherr
- , PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK
| | - Richard J Gilson
- , MBBS, Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, Mortimer Market Centre, University College London, London, UK
| | | | | | | | | | - Sris Allan
- , MBBS, City of Coventry Healthcare Centre, Coventry, UK
| | | | - Fiona C Lampe
- , PhD, HIV Epidemiology and Biostatistics Group, Research Department of Infection and Population Health, University College London, London, UK, for the AURAH Study Group
| | | |
Collapse
|
15
|
Sanmugarajah J, Allan S, Bagchi R, Laakso EL. Abstract P5-12-02: Can a supervised exercise program compared to usual care prevent aromatase inhibitor-induced musculoskeletal pain in women with breast cancer? Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-12-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Aromatase Inhibitors (AIs) are commonly prescribed as hormone therapy for post-menopausal women with estrogen receptor-positive breast cancer. A number of authors have reported AI side effects that include increased risk for developing osteoporosis, joint pain, weight gain and depression. For example, 30-40% of post-menopausal women treated with AIs experience mild to severe joint pain. Although the exact causes of AI-induced joint pain are unknown, the side-effects are most likely due to low estrogen levels in the body. . Denysschen et al. (2014) reported a significantly lower number of painful joints, reduced depressive symptoms, increased muscle strength, and improvement in quality of life in patients with AI-induced joint pain after an 8 week upper and lower body resistance exercise program. Objective: To investigate whether a supervised exercise program could reduce or prevent musculoskeletal pain in patients with breast cancer undergoing AI therapy. Methods: Twenty participants with breast cancer have thus far been randomised to either: (a) usual care and advice regarding benefits of regular exercise; or (b) usual care + 12 week supervised and home-based exercise program consisting of upper and lower body resistance exercises with self-selected aerobic exercises. Participants accrued 150 mins / week of moderate intensity aerobic exercise at 60-70% HRmax on 5 or more days of each week including 2 supervised sessions / week. Initial exercise intensity is individualized and generally begins at 55% to 60% of HRmax (15 to 30 minutes per session) and progresses to 60% - 70% of HRmax by week 6. Strength training consisted of 2 supervised sessions per week, of two sets of 10 to 12 repetitions of eight different strength exercises at 60% to 75% of estimated one repetition maximum. On at least 3 other days, using the same dosing principles participants executed 4 lower and 4 upper body resistance exercises at home using resistance bands. The primary outcome measures were pain (brief pain inventory; BPI) scores and grip strength (JAMAR dynamometer (kg)) measured at baseline, 3, 6 and 12 months. Two-way repeated ANOVAs were undertaken to evaluate differences between groups and factors. Results: Mean pain scores across 12 months were largely maintained (p>0.05) for participants undertaking the exercise program compared to control participants whose mean BPI scores progressively increased from baseline through to 12 month follow-up. In the exercise group, mean pain scores increased by one BPI unit between baseline and 12 month follow-up. In the control group, mean pain scores increased by five BPI units between baseline and 12 month follow-up. A clinically significant difference in BPI scores is a change of two or more BPI units (Mease et al, 2011). Grip strength measures were significantly different (P<0.001) between groups at each time point with a trend towards improved grip strength between baseline and 6 months in the exercise group. Grip strength decreased in both groups between 6 and 12 months. Conclusion: By managing physical performance and pain as side effects of AIs, a 12 week supervised exercise program may contribute to preventing non-adherence with or withdrawal from AI therapy.
Citation Format: Sanmugarajah J, Allan S, Bagchi R, Laakso E-L. Can a supervised exercise program compared to usual care prevent aromatase inhibitor-induced musculoskeletal pain in women with breast cancer? [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-12-02.
Collapse
Affiliation(s)
- J Sanmugarajah
- Gold Coast University Hospital, Gold Coast, Queensland, Australia; Menzies Health Institute/Griffith University, Gold Coast, Queensland, Australia
| | - S Allan
- Gold Coast University Hospital, Gold Coast, Queensland, Australia; Menzies Health Institute/Griffith University, Gold Coast, Queensland, Australia
| | - R Bagchi
- Gold Coast University Hospital, Gold Coast, Queensland, Australia; Menzies Health Institute/Griffith University, Gold Coast, Queensland, Australia
| | - E-L Laakso
- Gold Coast University Hospital, Gold Coast, Queensland, Australia; Menzies Health Institute/Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
16
|
Affiliation(s)
- Emma Hathorn
- University Hospitals NHS Foundation Trust, Birmingham, United Kingdom
| | - Erasmus Smit
- Public Health England, Birmingham, United Kingdom
| | | | | | - Sally A Bufton
- University Hospitals NHS Foundation Trust, Birmingham, United Kingdom
| | - Sris Allan
- Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
| | - David Mutimer
- University Hospitals NHS Foundation Trust, Birmingham, United Kingdom
| |
Collapse
|
17
|
Quilty L, Yiu Y, Shamsi H, Fredericks B, Premachandiran P, Allan S, Bagby R, Pollock B. The Faces of Impulsivity: A Five Factor Model Framework. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.05.267] [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: 10/21/2022]
|
18
|
Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, Corbelli GM, Estrada V, Geretti AM, Beloukas A, Asboe D, Viciana P, Gutiérrez F, Clotet B, Pradier C, Gerstoft J, Weber R, Westling K, Wandeler G, Prins JM, Rieger A, Stoeckle M, Kümmerle T, Bini T, Ammassari A, Gilson R, Krznaric I, Ristola M, Zangerle R, Handberg P, Antela A, Allan S, Phillips AN, Lundgren J. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA 2016; 316:171-81. [PMID: 27404185 DOI: 10.1001/jama.2016.5148] [Citation(s) in RCA: 915] [Impact Index Per Article: 114.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE A key factor in assessing the effectiveness and cost-effectiveness of antiretroviral therapy (ART) as a prevention strategy is the absolute risk of HIV transmission through condomless sex with suppressed HIV-1 RNA viral load for both anal and vaginal sex. OBJECTIVE To evaluate the rate of within-couple HIV transmission (heterosexual and men who have sex with men [MSM]) during periods of sex without condoms and when the HIV-positive partner had HIV-1 RNA load less than 200 copies/mL. DESIGN, SETTING, AND PARTICIPANTS The prospective, observational PARTNER (Partners of People on ART-A New Evaluation of the Risks) study was conducted at 75 clinical sites in 14 European countries and enrolled 1166 HIV serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex (September 2010 to May 2014). Eligibility criteria for inclusion of couple-years of follow-up were condomless sex and HIV-1 RNA load less than 200 copies/mL. Anonymized phylogenetic analysis compared couples' HIV-1 polymerase and envelope sequences if an HIV-negative partner became infected to determine phylogenetically linked transmissions. EXPOSURES Condomless sexual activity with an HIV-positive partner taking virally suppressive ART. MAIN OUTCOMES AND MEASURES Risk of within-couple HIV transmission to the HIV-negative partner. RESULTS Among 1166 enrolled couples, 888 (mean age, 42 years [IQR, 35-48]; 548 heterosexual [61.7%] and 340 MSM [38.3%]) provided 1238 eligible couple-years of follow-up (median follow-up, 1.3 years [IQR, 0.8-2.0]). At baseline, couples reported condomless sex for a median of 2 years (IQR, 0.5-6.3). Condomless sex with other partners was reported by 108 HIV-negative MSM (33%) and 21 heterosexuals (4%). During follow-up, couples reported condomless sex a median of 37 times per year (IQR, 15-71), with MSM couples reporting approximately 22,000 condomless sex acts and heterosexuals approximately 36,000. Although 11 HIV-negative partners became HIV-positive (10 MSM; 1 heterosexual; 8 reported condomless sex with other partners), no phylogenetically linked transmissions occurred over eligible couple-years of follow-up, giving a rate of within-couple HIV transmission of zero, with an upper 95% confidence limit of 0.30/100 couple-years of follow-up. The upper 95% confidence limit for condomless anal sex was 0.71 per 100 couple-years of follow-up. CONCLUSIONS AND RELEVANCE Among serodifferent heterosexual and MSM couples in which the HIV-positive partner was using suppressive ART and who reported condomless sex, during median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission (upper 95% confidence limit, 0.30/100 couple-years of follow-up). Additional longer-term follow-up is necessary to provide more precise estimates of risk.
Collapse
Affiliation(s)
- Alison J Rodger
- Research Department of Infection and Population Health, University College London, London, United Kingdom
| | - Valentina Cambiano
- Research Department of Infection and Population Health, University College London, London, United Kingdom
| | - Tina Bruun
- Department of Infectious Diseases/CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Pietro Vernazza
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St Gallen, Switzerland
| | | | - Jan van Lunzen
- University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | | | - Vicente Estrada
- Hospital Clinico San Carlos and Universidad Complutense, Madrid, Spain
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Apostolos Beloukas
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - David Asboe
- Chelsea and Westminster NHS Foundation Trust, London, United Kingdom
| | | | - Félix Gutiérrez
- Hospital General de Elche & Universidad Miguel Hernández, Alicante, Spain
| | - Bonaventura Clotet
- IrsiCaixa Foundation, UAB, UVIC-UCC, Hospital Universitari "Germans Trias i Pujol," Badalona, Catalonia, Spain
| | - Christian Pradier
- Department of Public Health, Nice University Hospital and EA 6312, University Nice Sophia-Antipolis, France
| | | | - Rainer Weber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Katarina Westling
- Unit of Infectious Diseases and Dermatology, Department of Medicine, Karolinska Institutet, and Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jan M Prins
- Academic Medical Center, Amsterdam, the Netherlands
| | | | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Tim Kümmerle
- Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany
| | | | | | - Richard Gilson
- Research Department of Infection and Population Health, University College London, London, United Kingdom
| | | | - Matti Ristola
- Helsinki University Central Hospital, Helsinki, Finland
| | | | - Pia Handberg
- Hvidovre Universitets Hospital, Hvidovre, Denamrk
| | - Antonio Antela
- Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Sris Allan
- Coventry and Warwickshire Hospital, Coventry, United Kingdom
| | - Andrew N Phillips
- Research Department of Infection and Population Health, University College London, London, United Kingdom
| | - Jens Lundgren
- Department of Infectious Diseases/CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | |
Collapse
|
19
|
Allan S. P055 Improving Clinical Standards in GU Medicine: A retrospective audit of Neisseria gonorrhoea 2007 - 2015: Abstract P055 Table 1. Br J Vener Dis 2016. [DOI: 10.1136/sextrans-2016-052718.109] [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: 11/04/2022]
|
20
|
Sewell J, Speakman A, Phillips AN, Lampe FC, Miltz A, Gilson R, Asboe D, Nwokolo N, Scott C, Day S, Fisher M, Clarke A, Anderson J, O'Connell R, Apea V, Dhairyawan R, Gompels M, Farazmand P, Allan S, Mann S, Dhar J, Tang A, Sadiq ST, Taylor S, Collins S, Sherr L, Hart G, Johnson AM, Miners A, Elford J, Rodger A. A Cross-Sectional Study on Attitudes to and Understanding of Risk of Acquisition of HIV: Design, Methods and Participant Characteristics. JMIR Res Protoc 2016; 5:e58. [PMID: 27091769 PMCID: PMC4858591 DOI: 10.2196/resprot.4873] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 11/05/2015] [Accepted: 11/29/2015] [Indexed: 11/13/2022] Open
Abstract
Background The annual number of new human immunodeficiency virus (HIV) infections in the United Kingdom among men who have sex with men (MSM) has risen, and remains high among heterosexuals. Increasing HIV transmission among MSM is consistent with evidence of ongoing sexual risk behavior in this group, and targeted prevention strategies are needed for those at risk of acquiring HIV. Objective The Attitudes to and Understanding of Risk of Acquisition of HIV (AURAH) study was designed to collect information on HIV negative adults at risk of HIV infection in the United Kingdom, based on the following parameters: physical and mental health, lifestyle, patterns of sexual behaviour, and attitudes to sexual risk. Methods Cross-sectional questionnaire study of HIV negative or undiagnosed sexual health clinic attendees in the United Kingdom from 2013-2014. Results Of 2630 participants in the AURAH study, 2064 (78%) were in the key subgroups of interest; 580 were black Africans (325 females and 255 males) and 1484 were MSM, with 27 participants belonging to both categories. Conclusions The results from AURAH will be a significant resource to understand the attitudes and sexual behaviour of those at risk of acquiring HIV within the United Kingdom. AURAH will inform future prevention efforts and targeted health promotion initiatives in the HIV negative population.
Collapse
Affiliation(s)
- Janey Sewell
- Institute of Epidemiology and Health Care, Research Department of Infection and Population Health, UCL, London, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Allan S, Jefferson J. P5 Gonorrhoea audit: changing pattern of antibiotic sensitivity and persistence of dna detection 2007–2014: Abstract P5 Table 1. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052126.49] [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: 11/04/2022]
|
22
|
Jefferson J, Allan S. P125 Improving clinical standards in gu medicine: a retrospective audit of neisseria gonorrhoeae:. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052126.168] [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: 11/04/2022]
|
23
|
Jefferson J, Debrah-Mensah A, Allan S. P80 Would you like a HIV test? Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052126.123] [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]
|
24
|
Bouyoucef SE, Uusitalo V, Kamperidis V, De Graaf M, Maaniitty T, Stenstrom I, Broersen A, Scholte A, Saraste A, Bax J, Knuuti J, Furuhashi T, Moroi M, Awaya T, Masai H, Minakawa M, Kunimasa T, Fukuda H, Sugi K, Berezin A, Kremzer A, Clerc O, Kaufmann B, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz D, Kaufmann P, Buechel R, Ferreira M, Cunha M, Albuquerque A, Ramos D, Costa G, Lima J, Pego M, Peix A, Cisneros L, Cabrera L, Padron K, Rodriguez L, Heres F, Carrillo R, Mena E, Fernandez Y, Huizing E, Van Dijk J, Van Dalen J, Timmer J, Ottervanger J, Slump C, Jager P, Venuraju S, Jeevarethinam A, Yerramasu A, Atwal S, Mehta V, Lahiri A, Arjonilla Lopez A, Calero Rueda MJ, Gallardo G, Fernandez-Cuadrado J, Hernandez Aceituno D, Sanchez Hernandez J, Yoshida H, Mizukami A, Matsumura A, Smettei O, Abazid R, Sayed S, Mlynarska A, Mlynarski R, Golba K, Sosnowski M, Winther S, Svensson M, Jorgensen H, Bouchelouche K, Gormsen L, Holm N, Botker H, Ivarsen P, Bottcher M, Cortes CM, Aramayo G E, Daicz M, Casuscelli J, Alaguibe E, Neira Sepulveda A, Cerda M, Ganum G, Embon M, Vigne J, Enilorac B, Lebasnier A, Valancogne L, Peyronnet D, Manrique A, Agostini D, Menendez D, Rajpal S, Kocherla C, Acharya M, Reddy P, Sazonova I, Ilushenkova Y, Batalov R, Rogovskaya Y, Lishmanov Y, Popov S, Varlamova N, Prado Diaz S, Jimenez Rubio C, Gemma D, Refoyo Salicio E, Valbuena Lopez S, Moreno Yanguela M, Torres M, Fernandez-Velilla M, Lopez-Sendon J, Guzman Martinez G, Puente A, Rosales S, Martinez C, Cabada M, Melendez G, Ferreira R, Gonzaga A, Santos J, Vijayan S, Smith S, Smith M, Muthusamy R, Takeishi Y, Oikawa M, Goral JL, Napoli J, Montana O, Damico A, Quiroz M, Damico A, Forcada P, Schmidberg J, Zucchiatti N, Olivieri D, Jeevarethinam A, Venuraju S, Dumo A, Ruano S, Rakhit R, Davar J, Nair D, Cohen M, Darko D, Lahiri A, Yokota S, Ottervanger J, Maas A, Mouden M, Timmer J, Knollema S, Jager P, Sanja Mazic S, Lazovic B, Marina Djelic M, Jelena Suzic Lazic J, Tijana Acimovic T, Milica Deleva M, Vesnina Z, Zafrir N, Bental T, Mats I, Solodky A, Gutstein A, Hasid Y, Belzer D, Kornowski R, Ben Said R, Ben Mansour N, Ibn Haj Amor H, Chourabi C, Hagui A, Fehri W, Hawala H, Shugushev Z, Patrikeev A, Maximkin D, Chepurnoy A, Kallianpur V, Mambetov A, Dokshokov G, Teresinska A, Wozniak O, Maciag A, Wnuk J, Dabrowski A, Czerwiec A, Jezierski J, Biernacka K, Robinson J, Prosser J, Cheung G, Allan S, Mcmaster G, Reid S, Tarbuck A, Martin W, Queiroz R, Falcao A, Giorgi M, Imada R, Nogueira S, Chalela W, Kalil Filho R, Meneghetti W, Matveev V, Bubyenov A, Podzolkov V, Shugushev Z, Maximkin D, Chepurnoy A, Baranovich V, Faibushevich A, Kolzhecova Y, Volkova O, Kallianpur V, Peix A, Cabrera L, Padron K, Rodriguez L, Fernandez J, Lopez G, Mena E, Fernandez Y, Dondi M, Paez D, Butcher C, Reyes E, Al-Housni M, Green R, Santiago H, Ghiotto F, Hinton-Taylor S, Pottle A, Mason M, Underwood S, Casans Tormo I, Diaz-Exposito R, Plancha-Burguera E, Elsaban K, Alsakhri H, Yoshinaga K, Ochi N, Tomiyama Y, Katoh C, Inoue M, Nishida M, Suzuki E, Manabe O, Ito Y, Tamaki N, Tahilyani A, Jafary F, Ho Hee Hwa H, Ozdemir S, Kirilmaz B, Barutcu A, Tan Y, Celik F, Sakgoz S, Cabada Gamboa M, Puente Barragan A, Morales Vitorino N, Medina Servin M, Hindorf C, Akil S, Hedeer F, Jogi J, Engblom H, Martire V, Pis Diez E, Martire M, Portillo D, Hoff C, Balche A, Majgaard J, Tolbod L, Harms H, Bouchelouche K, Soerensen J, Froekiaer J, Gormsen L, Nudi F, Neri G, Procaccini E, Pinto A, Vetere M, Biondi-Zoccai G, Falcao A, Chalela W, Giorgi M, Imada R, Soares J, Do Val R, Oliveira M, Kalil Filho R, Meneghetti J, Tekabe Y, Anthony T, Li Q, Schmidt A, Johnson L, Groenman M, Tarkia M, Kakela M, Halonen P, Kiviniemi T, Pietila M, Yla-Herttuala S, Knuuti J, Roivainen A, Saraste A, Nekolla S, Swirzek S, Higuchi T, Reder S, Schachoff S, Bschorner M, Laitinen I, Robinson S, Yousefi B, Schwaiger M, Kero T, Lindsjo L, Antoni G, Westermark P, Carlson K, Wikstrom G, Sorensen J, Lubberink M, Rouzet F, Cognet T, Guedj K, Morvan M, El Shoukr F, Louedec L, Choqueux C, Nicoletti A, Le Guludec D, Jimenez-Heffernan A, Munoz-Beamud F, Sanchez De Mora E, Borrachero C, Salgado C, Ramos-Font C, Lopez-Martin J, Hidalgo M, Lopez-Aguilar R, Soriano E, Okizaki A, Nakayama M, Ishitoya S, Sato J, Takahashi K, Burchert I, Caobelli F, Wollenweber T, Nierada M, Fulsche J, Dieckmann C, Bengel F, Shuaib S, Mahlum D, Port S, Gemma D, Refoyo E, Cuesta E, Guzman G, Lopez T, Valbuena S, Fernandez-Velilla M, Del Prado S, Moreno M, Lopez-Sendon J, Harbinson M, Donnelly L, Einstein AJ, Johnson LL, Deluca AJ, Kontak AC, Groves DW, Stant J, Pozniakoff T, Cheng B, Rabbani LE, Bokhari S, Caobelli F, Schuetze C, Nierada M, Fulsche J, Dieckmann C, Bengel F, Aguade-Bruix S, Pizzi M, Romero-Farina G, Terricabras M, Villasboas D, Castell-Conesa J, Candell-Riera J, Brunner S, Gross L, Todica A, Lehner S, Di Palo A, Niccoli Asabella A, Magarelli C, Notaristefano A, Ferrari C, Rubini G, Sellem A, Melki S, Elajmi W, Hammami H, Ziadi M, Montero J, Ameriso J, Villavicencio R, Benito Gonzalez TF, Mayorga Bajo A, Gutierrez Caro R, Rodriguez Santamarta M, Alvarez Roy L, Martinez Paz E, Barinaga Martin C, Martin Fernandez J, Alonso Rodriguez D, Iglesias Garriz I, Gemma D, Refoyo E, Cuesta E, Guzman G, Valbuena S, Rosillo S, Del Prado S, Torres M, Moreno M, Lopez-Sendon J, Taleb S, Cherkaoui Salhi G, Regbaoui Y, Ait Idir M, Guensi A, Puente A, Rosales S, Martinez C, Cabada M, Benito Gonzalez TF, Mayorga Bajo A, Gutierrez Caro R, Rodriguez Santamarta M, Alvarez Roy L, Martinez Paz E, Martin Lopez CE, Castano Ruiz M, Martin Fernandez J, Iglesias Garriz I. Poster Session 2: Monday 4 May 2015, 08:00-18:00 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Walkden NR, Adamek J, Allan S, Dudson BD, Elmore S, Fishpool G, Harrison J, Kirk A, Komm M. Profile measurements in the plasma edge of mega amp spherical tokamak using a ball pen probe. Rev Sci Instrum 2015; 86:023510. [PMID: 25725845 DOI: 10.1063/1.4908572] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The ball pen probe (BPP) technique is used successfully to make profile measurements of plasma potential, electron temperature, and radial electric field on the Mega Amp Spherical Tokamak. The potential profile measured by the BPP is shown to significantly differ from the floating potential both in polarity and profile shape. By combining the BPP potential and the floating potential, the electron temperature can be measured, which is compared with the Thomson scattering (TS) diagnostic. Excellent agreement between the two diagnostics is obtained when secondary electron emission is accounted for in the floating potential. From the BPP profile, an estimate of the radial electric field is extracted which is shown to be of the order ∼1 kV/m and increases with plasma current. Corrections to the BPP measurement, constrained by the TS comparison, introduce uncertainty into the ER measurements. The uncertainty is most significant in the electric field well inside the separatrix. The electric field is used to estimate toroidal and poloidal rotation velocities from E × B motion. This paper further demonstrates the ability of the ball pen probe to make valuable and important measurements in the boundary plasma of a tokamak.
Collapse
Affiliation(s)
- N R Walkden
- CCFE, Culham Science Centre, Abingdon,Oxon OX14 3DB, United Kingdom
| | - J Adamek
- Institute of Plasma Physics of AS CR, v. v. i., Za Slovankou 3, 182 00 Praha 8, Czech Republic
| | - S Allan
- CCFE, Culham Science Centre, Abingdon,Oxon OX14 3DB, United Kingdom
| | - B D Dudson
- Department of Physics, York Plasma Institute, University of York, Heslington, York YO10 5DD, United Kingdom
| | - S Elmore
- CCFE, Culham Science Centre, Abingdon,Oxon OX14 3DB, United Kingdom
| | - G Fishpool
- CCFE, Culham Science Centre, Abingdon,Oxon OX14 3DB, United Kingdom
| | - J Harrison
- CCFE, Culham Science Centre, Abingdon,Oxon OX14 3DB, United Kingdom
| | - A Kirk
- CCFE, Culham Science Centre, Abingdon,Oxon OX14 3DB, United Kingdom
| | - M Komm
- Institute of Plasma Physics of AS CR, v. v. i., Za Slovankou 3, 182 00 Praha 8, Czech Republic
| |
Collapse
|
26
|
Krüsi A, Pacey K, Bird L, Taylor C, Chettiar J, Allan S, Bennett D, Montaner JS, Kerr T, Shannon K. Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada-a qualitative study. BMJ Open 2014; 4:e005191. [PMID: 24889853 PMCID: PMC4054637 DOI: 10.1136/bmjopen-2014-005191] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers' working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). DESIGN Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. SETTING Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers' safety over arrest, while continuing to target clients. PARTICIPANTS 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. OUTCOME MEASURES Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers' working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January-November 2013). RESULTS Sex workers' narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants' accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. CONCLUSIONS These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally.
Collapse
Affiliation(s)
- A Krüsi
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - K Pacey
- Pivot Legal Society, Vancouver, British Columbia, Canada
| | - L Bird
- Sex Workers United Against Violence, Vancouver, British Columbia, Canada
| | - C Taylor
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - J Chettiar
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Sex Workers United Against Violence, Vancouver, British Columbia, Canada
| | - S Allan
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - D Bennett
- Pivot Legal Society, Vancouver, British Columbia, Canada
| | - J S Montaner
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - T Kerr
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia
| | - K Shannon
- Gender and Sexual Health Initiative, British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
27
|
Oppenheim DE, Spreafico R, Etuk A, Malone D, Amofah E, Peña-Murillo C, Murray T, McLaughlin L, Choi BS, Allan S, Belousov A, Passioukov A, Gerdes C, Umaña P, Farzaneh F, Ross P. Glyco-engineered anti-EGFR mAb elicits ADCC by NK cells from colorectal cancer patients irrespective of chemotherapy. Br J Cancer 2014; 110:1221-7. [PMID: 24496456 PMCID: PMC3950873 DOI: 10.1038/bjc.2014.35] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 12/23/2013] [Accepted: 01/07/2014] [Indexed: 12/18/2022] Open
Abstract
Background: The epidermal growth factor receptor (EGFR) is overexpressed in colorectal cancer (CRC), and is correlated with poor prognosis, making it an attractive target for monoclonal antibody (mAb) therapy. A component of the therapeutic efficacy of IgG1 mAbs is their stimulation of antibody-dependent cellular cytotoxicity (ADCC) by natural killer (NK) cells bearing the CD16 receptor. As NK cells are functionally impaired in cancer patients and may be further compromised upon chemotherapy, it is crucial to assess whether immunotherapeutic strategies aimed at further enhancing ADCC are viable. Methods: CRC patients before, during and after chemotherapy were immunophenotyped by flow cytometry for major white blood cell populations. ADCC-independent NK cell functionality was assessed in cytotoxicity assays against K562 cells. ADCC-dependent killing of EGFR+ A431 cancer cells by NK cells was measured with a degranulation assay where ADCC was induced by GA201, an anti-EGFR mAb glyco-engineered to enhance ADCC. Results: Here, we confirm the observation that NK cells in cancer patients are dysfunctional. However, GA201 was able to induce robust NK cell-dependent cytotoxicity in CRC patient NK cells, effectively overcoming their impairment. Conclusions: These findings support the evaluation of the therapeutic potential of GA201 in combination with chemotherapy in CRC patients.
Collapse
Affiliation(s)
- D E Oppenheim
- 1] Comprehensive Biomedical Research Centre, King's College London, King's Health Partners, London, UK [2] Experimental Cancer Medicine Centre, King's College London, King's Health Partners, London, UK [3] Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - R Spreafico
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - A Etuk
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - D Malone
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - E Amofah
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - C Peña-Murillo
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - T Murray
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - L McLaughlin
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - B S Choi
- Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - S Allan
- Department of Medical Oncology, Guy's and St Thomas' Hospital, King's College London School of Medicine, King's Health Partners, 4th Floor Thomas Guy House, Guy's Hospital, St Thomas Street, London SE1 9RT, UK
| | - A Belousov
- Roche Diagnostics GmbH, Nonnenwald 2, Penzberg 82377, Germany
| | - A Passioukov
- Roche Glycart AG, Wagistrasse 18, Schlieren 8952, Switzerland
| | - C Gerdes
- Roche Glycart AG, Wagistrasse 18, Schlieren 8952, Switzerland
| | - P Umaña
- Roche Glycart AG, Wagistrasse 18, Schlieren 8952, Switzerland
| | - F Farzaneh
- 1] Comprehensive Biomedical Research Centre, King's College London, King's Health Partners, London, UK [2] Experimental Cancer Medicine Centre, King's College London, King's Health Partners, London, UK [3] Department of Haematological Medicine, King's College London School of Medicine, King's Health Partners, 123 Coldharbour Lane, London SE5 9NU, UK
| | - P Ross
- 1] Comprehensive Biomedical Research Centre, King's College London, King's Health Partners, London, UK [2] Experimental Cancer Medicine Centre, King's College London, King's Health Partners, London, UK [3] Department of Medical Oncology, Guy's and St Thomas' Hospital, King's College London School of Medicine, King's Health Partners, 4th Floor Thomas Guy House, Guy's Hospital, St Thomas Street, London SE1 9RT, UK
| |
Collapse
|
28
|
Sharp SR, Allan S. P129 Improving clinical standards in GU medicine: a retrospective audit of Neisseria gonorrhoeae:. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.129] [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]
|
29
|
Sharp SR, Allan S. P130 Antibiotic resistance profiles of Neisseria gonorrhoeae(GC): a comparison of data 2007–2011: Abstract P130 Table1. Br J Vener Dis 2012. [DOI: 10.1136/sextrans-2012-050601c.130] [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: 11/04/2022]
|
30
|
Taylor S, Jayasuriya A, Fisher M, Allan S, Wilkins E, Gilleran G, Heald L, Fidler S, Owen A, Back D, Smit E. Lopinavir/ritonavir single agent therapy as a universal combination antiretroviral therapy stopping strategy: results from the STOP 1 and STOP 2 studies. J Antimicrob Chemother 2011; 67:675-80. [PMID: 22169189 DOI: 10.1093/jac/dkr491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES We designed two different studies to evaluate two different combination antiretroviral therapy (cART) stopping strategies namely a 'staggered stop' approach (STOP 1 study) and a 'protected stop' approach (STOP 2 study) to find the best 'universal stop' strategy. PATIENTS AND METHODS Patients who stopped cART for any reason were recruited. In STOP 1, 10 patients on efavirenz continued dual nucleos(t)ide reverse transcriptase inhibitors (NRTIs) for 1 week after discontinuing efavirenz. Efavirenz concentrations were measured weekly for up to 3 weeks. In STOP 2, 20 patients stopped their cART and replaced it with two tablets of lopinavir/ritonavir (Kaletra) (100/50 mg) twice daily for 4 weeks. Lopinavir, efavirenz, nevirapine and tenofovir concentrations were measured weekly for up to 4 weeks. Virological and resistance testing were performed. RESULTS In STOP 1 five patients still had efavirenz present (median t(1/2)=148.4 h) 3 weeks after stopping. In STOP 2, 15/20 patients had a viral load (VL) of <40 copies/mL and 3/20 patients had a reduction in VL by 4 weeks. Six patients opted not to stop lopinavir/ritonavir and still had <40 copies/mL at week 8. Week 1-4 median trough lopinavir concentrations were well above the EC(95). Six patients still had detectable concentrations of original cART persisting for >1 week after stopping. No patients developed new resistance mutations. CONCLUSIONS Plasma efavirenz concentrations can persist up to 3 weeks after patients stop efavirenz-containing regimens. This suggests a strategy of stopping efavirenz only 1 week before NRTIs may not be long enough for some individuals. The use of lopinavir/ritonavir monotherapy for a 4 week period may be an alternative pharmacologically and virologically effective universal stopping strategy which warrants further investigation.
Collapse
Affiliation(s)
- Stephen Taylor
- Department of Sexual Health and HIV Medicine, Directorate of Infection, Birmingham Heartlands Hospital, Birmingham, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Giles J, Greenhalgh A, Denes A, Thornton P, Rothwell N, McColl B, Allan S. 48 Endovascular inflammation may occur via tissue-specific mechanisms. Heart 2011. [DOI: 10.1136/heartjnl-2011-300920b.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
32
|
Müller GC, Junnila A, Qualls W, Revay EE, Kline DL, Allan S, Schlein Y, Xue RD. Control of Culex quinquefasciatus in a storm drain system in Florida using attractive toxic sugar baits. Med Vet Entomol 2010; 24:346-351. [PMID: 20546128 DOI: 10.1111/j.1365-2915.2010.00876.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Attractive toxic sugar baits (ATSBs) were used to control mosquitoes in the storm drains of a residential area on the outskirts of St Augustine, Florida. The drainage system was newly constructed and no mosquitoes were breeding inside it. The area covered by the storm drains was divided in half; 10 drains served as control drains and 16 drains served as experimental drains. The baits, which consisted of a mixture of brown sugar, fruit juice, green dye marker and boric acid, were presented at the entrances of the treated drains and exit traps were positioned over the drain openings and the connecting tubes leading to retention ponds. Similar baits with orange dye and without toxin were presented at the entrances of control drains. A total of 220 pupae of Culex quinquefasciatus (Diptera: Culicidae) were released in each control and toxin-treated drain, and the numbers of recovered mosquitoes were examined to determine the effectiveness of ATSBs in the storm drain system. An average of 178.2 mosquitoes exited each drain in the control area; 87.0% of these had fed on the baits and were stained orange, whereas 13.0% were unstained. In the toxin-treated drains, 83.7% of hatched females and 86.6% of hatched males were controlled by the baits.
Collapse
Affiliation(s)
- G C Müller
- Department of Microbiology and Molecular Genetics, Institute for Medical Research Israel-Canada, Kuvin Centre for the Study of Infectious and Tropical Diseases, Hebrew University, Jerusalem, Israel.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Allan S, Daly RA, Yoganathan Y, Barrett S, Joseph A, Tariq A, Saing CW, Williams C, Lane C, Sikorska J. British HIV and ageing study. HIV and ageing: older people with HIV, who are they? J Int AIDS Soc 2010. [PMCID: PMC3113061 DOI: 10.1186/1758-2652-13-s4-p57] [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: 12/05/2022] Open
|
34
|
Shenkier TN, Hayes M, Gelmon KA, Chia S, Bajdik C, Norris B, Caroline S, Hassell P, O’Reilly SE, Allan S, Yerushalmi R. A phase II trial of a neoadjuvant platinum-containing regimen for locally advanced breast cancer: Pathologic response, long-term follow-up, and correlation with biomarkers. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e11510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e11510 Background: To determine the response, tolerability, and long-term outcome of a neoadjuvant platinum-containing regimen for locally advanced breast cancer (LABC). To search for correlation between pathologic complete response (pCR) and predefined biomarkers in this cohort. Patients and Methods: Patients with LABC received eight cycles of either sequence A or B. Sequence A was doxorubicin 60 mg/m2 and paclitaxel 175 mg/m2 (AT) q3w X 4 followed by cisplatin (C) 60 mg/m2 and paclitaxel 90 mg/m2 (CT) q2w X 4. Sequence B was CT x 4 followed by AT x 4. In addition to estrogen receptor and HER2, immunohistochemistry (IHC) for MDR-1, MRP-1, topoisomerase IIα(topoIIα) and p53 was performed. Results: 88 patients were evaluable for response and toxicity. Median follow-up was 97 months. The overall pCR rate was 21.5%. For subgroups ER+/HER2-, HER2 +, and double negative (ER-/ HER2-) disease the pCR was 5.9%,23.3% and 35% respectively, p=0.006. Five year(y) overall survival for the entire cohort was 71.1%. Five y overall survival was 88.1% (CI 77.1%, 99.1%) for the ER positive HER2 negative group compared to 68.5% (CI 51.3%, 85.7%) and 49.5 (CI 27.4%, 71.6%) in the HER2 positive and “double negative” group respectively (p=0.0077). Over-expression of topo IIα was correlated with pCR (p<0.001). There were no toxic deaths. Conclusions: A platinum-containing neoadjuvant regimen was well tolerated and achieved a pCR rate which compares favorably to other recent studies of multi-agent chemotherapy. Further studies tailored for specific breast cancer subtypes are required. No significant financial relationships to disclose.
Collapse
Affiliation(s)
| | - M. Hayes
- BC Cancer Agency, Vancouver, BC, Canada
| | | | - S. Chia
- BC Cancer Agency, Vancouver, BC, Canada
| | - C. Bajdik
- BC Cancer Agency, Vancouver, BC, Canada
| | - B. Norris
- BC Cancer Agency, Vancouver, BC, Canada
| | | | | | | | - S. Allan
- BC Cancer Agency, Vancouver, BC, Canada
| | | |
Collapse
|
35
|
Boneh A, Allan S, Mendelson D, Spriggs M, Gillam LH, Korman SH. Clinical, ethical and legal considerations in the treatment of newborns with non-ketotic hyperglycinaemia. Mol Genet Metab 2008; 94:143-7. [PMID: 18395481 DOI: 10.1016/j.ymgme.2008.02.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2008] [Accepted: 02/27/2008] [Indexed: 11/18/2022]
Abstract
Non-ketotic hyperglycinaemia (NKH) is a devastating neurometabolic disorder leading, in its classical form, to early death or severe disability and poor quality of life in survivors. Affected neonates may need ventilatory support during a short period of respiratory depression. The transient dependence on ventilation dictates urgency in decision-making regarding withdrawal of therapy. The occurrence of patients with apparent transient forms of the disease, albeit rare, adds uncertainty to the prediction of clinical outcome and dictates that the current practice of withholding or withdrawing therapy in these neonates be reviewed. Both bioethics and law take the view that treatment decisions should be based on the best interests of the patient. The medical-ethics approach is based on the principles of non-maleficence, beneficence, autonomy and justice. The law relating to withholding or withdrawing life-sustaining treatment is complex and varies between jurisdictions. Physicians treating newborns with NKH need to provide families with accurate and complete information regarding the disease and the relative probability of possible outcomes of the neonatal presentation and to explore the extent to which family members are willing to take part in the decision making process. Cultural and religious attitudes, which may potentially clash with bioethical and juridical principles, need to be considered.
Collapse
Affiliation(s)
- A Boneh
- Metabolic Service, Victorian Clinical Genetics Services, Murdoch Childrens Research Institute, Royal children's Hospital, Department of Paediatrics, University of Melbourne, Melbourne, Vic. 3052, Australia.
| | | | | | | | | | | |
Collapse
|
36
|
Haddock G, Cross AK, Allan S, Sharrack B, Callaghan J, Bunning RAD, Buttle DJ, Woodroofe MN. Brevican and phosphacan expression and localization following transient middle cerebral artery occlusion in the rat. Biochem Soc Trans 2007; 35:692-4. [PMID: 17635124 DOI: 10.1042/bst0350692] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The ECM (extracellular matrix) is a complex molecular framework that provides physical support to cells and tissues, while also providing signals for cell growth, migration, differentiation and survival. The ECM of the CNS (central nervous system) is unusual in that it is rich in CSPGs (chondroitin sulfate proteoglycans), hyaluronan and tenascins. The CSPGs are widely expressed throughout the developing and adult CNS and have a role in guiding or limiting neurite outgrowth and cell migration. Alterations in the synthesis or breakdown of the ECM may contribute to disease processes. Here, we examine changes in the brain-specific CSPGs, brevican and phosphacan, following transient middle cerebral artery occlusion, a model of stroke in the rat. We have investigated their expression at various time points as well as their spatial relationship with ADAMTS-4 (adisintegrin and metalloprotease with thrombospondin motifs 4). The co-localization of ADAMTS or its activity may indicate a functional role for this matrix–protease pair in degeneration/regeneration processes that occur in stroke.
Collapse
Affiliation(s)
- G Haddock
- Biomedical Research Centre, Faculty of Health and Well-being, Sheffield Hallam University, Howard St, Sheffield S1 1WB, UK.
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Harnett P, Buck M, Beale P, Goldrick A, Allan S, Fitzharris B, De Souza P, Links M, Kalimi G, Davies T, Stuart-Harris R. Phase II study of gemcitabine and oxaliplatin in patients with recurrent ovarian cancer: an Australian and New Zealand Gynaecological Oncology Group study. Int J Gynecol Cancer 2007; 17:359-66. [PMID: 17362313 DOI: 10.1111/j.1525-1438.2007.00763.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Gemcitabine and oxaliplatin have shown single-agent activity in relapsed ovarian cancer. This combination was used to determine response rates, time-to-event efficacy measures, and toxicity in patients with recurrent ovarian cancer. Patients with prior platinum-based chemotherapy who had measurable lesions and/or elevated CA-125 levels were identified as group A (platinum-refractory/platinum-resistant patients) and group B (platinum-sensitive patients). All patients received gemcitabine 1000 mg/m(2) on days 1 and 8 and oxaliplatin 130 mg/m(2) on day 8 every 21 days for up to eight cycles. Seventy-five patients (21 in group A and 54 in group B), with a median age of 58 years (range, 37-78), were enrolled. A median of six cycles (range, 1-8) was administered. By intent-to-treat analysis, 15 patients with measurable disease achieved partial response for an overall best response rate of 20.0% (9.5% in group A and 24.1% in group B). CA-125 response was observed in 48.4% patients (30.0% in group A and 57.1% in group B). Median time to progressive disease was 7.1 months (95% CI, 5.6-9.0 months) with 5.0 months in group A and 8.3 months in group B. Median overall survival was 17.8 months (95% CI, 12.9-21.3 months) with 9.2 months for group A and 20.0 months for group B. Major grade 3/4 toxicities were neutropenia (61.3%), leukopenia (24.0%), nausea (16.0%), and vomiting (22.7%). We conclude that the combination of oxaliplatin and gemcitabine is active in patients with recurrent ovarian cancer, but the regimen is unsatisfactory for further study due to modest response and relatively high toxicity.
Collapse
Affiliation(s)
- P Harnett
- Department of Medical Oncology, Westmead Hospital, Westmead, New South Wales, Australia.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Friedlander M, Buck M, Wyld D, Findlay M, Fitzharris B, De Souza P, Davies T, Kalimi G, Allan S, Perez D, Harnett P. Phase II study of carboplatin followed by sequential gemcitabine and paclitaxel as first-line treatment for advanced ovarian cancer. Int J Gynecol Cancer 2007; 17:350-8. [PMID: 17362312 DOI: 10.1111/j.1525-1438.2007.00795.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The aim of this exploratory phase II study was to evaluate sequential chemotherapy with carboplatin followed by gemcitabine-paclitaxel combination in chemonaive patients with advanced ovarian cancer. The primary objective was to evaluate time to progressive disease (TTPD); secondary objectives included the evaluation of 1- and 3-year survival, response rates, and toxicity. Following initial debulking surgery or biopsy, patients with FIGO stage IIC-IV disease received four cycles of carboplatin area under the curve (AUC) 6 (day 1) every 21 days, followed by four cycles of gemcitabine 1000 mg/m(2) (days 1 and 8) and paclitaxel 175 mg/m(2) (day 8) every 21 days. A total of 47 patients enrolled, 44 (93.6%) completed the initial four cycles, and 39 patients (82.9%) completed the planned eight cycles. The median and maximum lengths of follow-up were 31.2 and 43.7 months, respectively. Median TTPD was 13.8 months (95% CI, 11.6-21.0 months), and median survival time was 31.2 months (95% CI, 25.2-39.6 months). Survival at 1 and 3 years was 95.7% and 44.2%, respectively. Of the 43 evaluable patients, most (95.3%) of them achieved a CA-125 marker response based on Gynecologic Cancer Intergroup (GCIG) definition. The partial response rate in the seven patients with measurable disease was 46.4%. Myelosuppression was the major toxicity, with grade 3 and 4 neutropenia observed in 76.6% patients and thrombocytopenia in 12.8% patients. The sequential approach of carboplatin followed by gemcitabine-paclitaxel as first-line treatment for patients with ovarian cancer is feasible and well tolerated, and depending upon the findings from other major trials, it may merit further evaluation.
Collapse
Affiliation(s)
- M Friedlander
- Prince of Wales Hospital, Randwick, New South Wales, Australia.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Das S, Allan S. Higher vaginal pH is associated with Neisseria gonorrhoeae and Chlamydia trachomatis infection in a predominantly white population. Sex Transm Dis 2006; 33:527-8. [PMID: 16865049 DOI: 10.1097/01.olq.0000230430.60398.e4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
40
|
Reck M, Perng R, Groen H, Riska H, Pirker R, Sederholm C, Caspar C, Boyer M, Berzinec P, Allan S. Initial safety results of an expanded access program (EAP) of erlotinib in non-small cell lung cancer (NSCLC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7190 Background: Erlotinib is an orally active and selective inhibitor of HER1/EGFR tyrosine kinase. In the BR.21 phase III trial, erlotinib significantly prolonged survival, delayed symptom progression, and improved quality of life in NSCLC patients (pts) (Shepherd et al, NEJM, 2005;353:123). The EAP is an open label, non-randomized, multicentre phase IV trial. Methods: Eligibility criteria included stage III/IV NSCLC pts who failed or were unsuitable for chemotherapy. Pts were given oral erlotinib, 150 mg/d, for as long as treatment provided clinical benefit without unacceptable toxicity. Pts were monitored monthly. Results: In Dec 05, data were available for 1,140 pts from 25 countries, median age 64 y (range 25–91). Key base-line characteristics (% pts) were: males 58%; Caucasian/Oriental 82/15; non-smoker/former or current-smoker 26/73. The % pts with ECOG PS 0/1/2/3 were 20/52/20/8. Most pts (55%) had adenocarcinoma. The % pts receiving erlotinib as 1st/2nd/3rd-line treatment were 12/47/40. As expected, rash was a common adverse event (AE: any grade [gr]: 65%; gr 3/4: 9%). Full safety data were available for 581 pts. Unexpected erlotinib-related AEs were only seen in <2% pts. Erlotinib-related AEs leading to treatment discontinuation were GI disorders in 21 pts (12 pts had gr 3/4 AEs) and skin disorders in 14 pts (6 pts had gr 3/4 rash). Only 10% of pts had dose reductions, mainly due to rash (66%; gr 3 in 8 pts) and diarrhea (17%; gr 3 in 2 pts). The median daily dose of erlotinib was 150mg. Serious erlotinib-related AEs were GI disorders (19 AEs; 11 gr 3/4), mainly diarrhea (8 AEs, 5 were gr 3). Pt accrual and analyses of response, survival data and assessment of various predictive biomarkers are ongoing. Response and survival data will be presented. Conclusions: These interim safety results of erlotinib in the real-life clinical setting in a large number of unselected pts with advanced NSCLC confirm the good tolerability observed in clinical trials. To date, the trial demonstrates that erlotinib is well tolerated, thus, allowing full dose administration to most pts. [Table: see text]
Collapse
Affiliation(s)
- M. Reck
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - R. Perng
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - H. Groen
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - H. Riska
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - R. Pirker
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - C. Sederholm
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - C. Caspar
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - M. Boyer
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - P. Berzinec
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| | - S. Allan
- Hospital Grosshansdorf, Hamburg, Germany; Taipei Veterans General Hospital, Taipei, Taiwan Republic of China; University Hospital Groningen, Groningen, The Netherlands; Helsinki University Central Hospital, Helsinki, Finland; Medical University of Vienna, Vienna, Austria; University Hospital, Linköping, Sweden; Kantonsspital Baden, Baden, Switzerland; Sydney Cancer Centre, Sydney, Australia; Specialized Hospital of St Zoerardus Zobor, Nitra, Slovakia; Palmerston North Hospital, Palmerston North, New Zealand
| |
Collapse
|
41
|
Jenkins V, Shilling V, Deutsch G, Bloomfield D, Morris R, Allan S, Bishop H, Hodson N, Mitra S, Sadler G, Shah E, Stein R, Whitehead S, Winstanley J. A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer. Br J Cancer 2006; 94:828-34. [PMID: 16523200 PMCID: PMC3216421 DOI: 10.1038/sj.bjc.6603029] [Citation(s) in RCA: 284] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The neuropsychological performance of 85 women with early stage breast cancer scheduled for chemotherapy, 43 women scheduled for endocrine therapy and/or radiotherapy and 49 healthy control subjects was assessed at baseline (T1), postchemotherapy (or 6 months) (T2) and at 18 months (T3). Repeated measures analysis found no significant interactions or main effect of group after controlling for age and intelligence. Using a calculation to examine performance at an individual level, reliable decline on multiple tasks was seen in 20% of chemotherapy patients, 26% of nonchemotherapy patients and 18% of controls at T2 (18%, 14 and 11%, respectively, at T3). Patients who had experienced a treatment-induced menopause were more likely to show reliable decline on multiple measures at T2 (OR=2.6, 95% confidence interval (CI) 0.823–8.266 P=0.086). Psychological distress, quality of life measures and self-reported cognitive failures did not impact on objective tests of cognitive function, but were significantly associated with each other. The results show that a few women experienced objective measurable change in their concentration and memory following standard adjuvant therapy, but the majority were either unaffected or even improve over time.
Collapse
Affiliation(s)
- V Jenkins
- Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, East Sussex BN1 9QG, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Cross AK, Haddock G, Stock CJ, Allan S, Surr J, Bunning RAD, Buttle DJ, Woodroofe MN. ADAMTS-1 and -4 are up-regulated following transient middle cerebral artery occlusion in the rat and their expression is modulated by TNF in cultured astrocytes. Brain Res 2006; 1088:19-30. [PMID: 16630594 DOI: 10.1016/j.brainres.2006.02.136] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 02/21/2006] [Accepted: 02/26/2006] [Indexed: 11/26/2022]
Abstract
ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) enzymes are a recently described group of metalloproteinases. The substrates degraded by ADAMTS-1, -4 and -5 suggest that they play a role in turnover of extracellular matrix in the central nervous system (CNS). ADAMTS-1 is also known to exhibit anti-angiogenic activity. Their main endogenous inhibitor is tissue inhibitor of metalloproteinases (TIMP)-3. The present study was designed to investigate ADAMTS-1, -4 and -5 and TIMP-3 expression after experimental cerebral ischaemia and to examine whether cytokines known to be up-regulated in stroke could alter their expression by astrocytes in vitro. Focal cerebral ischaemia was induced by transient middle cerebral artery occlusion in the rat using the filament method. Our results demonstrate a significant increase in expression of ADAMTS-1 and -4 in the occluded hemisphere but no significant change in TIMP-3. This was accompanied by an increase in mRNA levels for interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1ra) and tumour necrosis factor (TNF). ADAMTS-4 mRNA and protein were up-regulated by TNF in primary human astrocyte cultures. The increased ADAMTS-1 and -4 in experimental stroke, together with no change in TIMP-3, may promote ECM breakdown after stroke, enabling infiltration of inflammatory cells and contributing to brain injury. In vitro studies suggest that the in vivo modulation of ADAMTS-1 and -4 may be controlled in part by TNF.
Collapse
Affiliation(s)
- A K Cross
- Biomedical Research Centre, Faculty of Health and Wellbeing, Sheffield Hallam University, Howard Street, Sheffield S1 1WB, UK.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Bakhai A, Allan S, Davies G, Alemao E, Thilo K, Parker L, Yin D, Drummond M. W16-P-002 Physician perceived barriers to optimal management of hyperlipidemia. ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80398-8] [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: 11/28/2022]
|
44
|
Gilbert P, Allan S, Nicholls W, Olsen K. The assessment of psychological symptoms of patients referred to community mental health teams: distress, chronicity and life interference. Clin Psychol Psychother 2005. [DOI: 10.1002/cpp.426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
45
|
Affiliation(s)
- S Allan
- School of Biological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.
| | | |
Collapse
|
46
|
Affiliation(s)
- M J Tidman
- Department of Dermatology, The Royal Infirmary of Edinburgh, UK.
| | | | | | | |
Collapse
|
47
|
Abstract
There is good evidence to suggest that depression is highly correlated with perceptions of low rank and subordinate status (i.e. feeling inferior, low-self esteem, feeling that others look down on the self, and submissive behaviour). However, it is possible for people to feel inferior and anxious, and behave submissively but not necessarily be depressed. More recently two other processes, defeat and entrapment, have attracted attention as possible processes linked specifically to depression and anhedonia. This research explored the relationship of these variables (social rank variables and defeat and entrapment) to two measures of hedonic tone (low positive affectivity and anhedonia) and anxiety in both a clinical and student population. All variables were strongly associated with lowered hedonic tone and anxiety. However, partial correlations, and a structural equation model fitted to the data from combined groups, suggests that perceptions of defeat play a specifically important role in anhedonia as measured by low positive affect. Framed within an evolutionary model the data suggest that the mechanisms which evolved to help animals accommodate and respond to defeats may have important regulatory effects over positive affect, reducing exploration of and engagement with the environment.
Collapse
Affiliation(s)
- P Gilbert
- Mental Health Research Unit, Kingsway Hospital, Derby DE22 3LZ, UK.
| | | | | | | | | |
Collapse
|
48
|
Abstract
This study compares aspects of behaviour in two long-stay resident groups with residual psychiatric difficulties. One group was residing on traditional psychiatric hospital wards and the other group was based in a newly built bungalow complex set within the hospital grounds. This study compares behavioural profiles between these two resident groups. Results indicate that bungalow residents showed significantly lower levels of psychiatric difficulty than their 'ward-based' counterparts. To explore this result further we conducted an examination of possible selection bias at the time of initial assessment. Historical data on both groups were obtained from case notes and analysed to seek possible explanations for this result. These results are discussed with respect to the provision of mental health care in smaller retained hospital facilities and nursing practice, which emphasizes the provision of effective philosophies of care accentuating choice, a sense of autonomy and involvement in care.
Collapse
Affiliation(s)
- I M McGonagle
- Staff Development, Stafford Centre, Derbyshire Mental Health Services, Kingsway Hospital, Derby, UK.
| | | |
Collapse
|
49
|
Zaslav AL, Fox JE, Jacob J, Kazi R, Allan S, Shklooskaya T, Sohal D, Kleyman SM, Verma RS. Significance of a prenatally diagnosed del(10)(q23). Am J Med Genet 2002; 107:174-6. [PMID: 11807894 DOI: 10.1002/ajmg.10112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Structural chromosome mosaicism is rare. We report a case of prenatal mosaicism for a deletion of chromosome 10(q23). To our knowledge, there are only three reports of prenatally diagnosed cases of del(10)(q23). Two of these cases were due to an inherited fragile site. In the present case amniocentesis revealed 46,XY,del(10)(q23)[9]/46,XY[45]. Follow-up chromosome analysis of peripheral blood and placental tissue from a phenotypically normal liveborn male revealed the del(10)(q23) in only 3/100 blood cells grown in low-folate medium. It appears that prenatally diagnosed deleted (10q) mosaicism represents culture artifact and is not clinically significant.
Collapse
Affiliation(s)
- A L Zaslav
- Department of Pathology, Long Island Jewish Medical Center, The Long Island Campus of the Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Allan S. Mandatory overtime and patient abandonment. Oreg Nurse 1999; 64:11. [PMID: 12024572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|