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Flink-Bochacki R, McLeod C, Lipe H, Rapkin RB, Rubin S, Heuser C. P036Exploring us obstetrician-gynecologists’ characterization of periviable pregnancy-ending interventions: A mixed methods study. Contraception 2022. [DOI: 10.1016/j.contraception.2022.09.061] [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: 11/19/2022]
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Martin-Lecamp G, Saunier A, Vandenhende M, Duffau P, Richez C, Delbrel X, Rubin S, Ly K, Sailler L, Viallard J, Thiebaut R, Bonnet F. La dose de corticothérapie est-elle associée à l’évolution de la concentration lymphocytaire T CD4+ au cours du traitement des maladies auto-immunes ? Cohorte INFIM, 2016–2021. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Koblish HK, Wu L, Wang LCS, Liu PC, Wynn R, Rios-Doria J, Spitz S, Liu H, Volgina A, Zolotarjova N, Kapilashrami K, Behshad E, Covington M, Yang YO, Li J, Diamond S, Soloviev M, O'Hayer K, Rubin S, Kanellopoulou C, Yang G, Rupar M, DiMatteo D, Lin L, Stevens C, Zhang Y, Thekkat P, Geschwindt R, Marando C, Yeleswaram S, Jackson J, Scherle P, Huber R, Yao W, Hollis G. Characterization of INCB086550: A Potent and Novel Small-Molecule PD-L1 Inhibitor. Cancer Discov 2022; 12:1482-1499. [PMID: 35254416 PMCID: PMC9394386 DOI: 10.1158/2159-8290.cd-21-1156] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [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] [Received: 08/27/2021] [Revised: 12/22/2021] [Accepted: 02/28/2022] [Indexed: 01/07/2023]
Abstract
Blocking the activity of the programmed cell death protein 1 (PD-1) inhibitory receptor with therapeutic antibodies against either the ligand (PD-L1) or PD-1 itself has proven to be an effective treatment modality for multiple cancers. Contrasting with antibodies, small molecules could demonstrate increased tissue penetration, distinct pharmacology, and potentially enhanced antitumor activity. Here, we describe the identification and characterization of INCB086550, a novel, oral, small-molecule PD-L1 inhibitor. In vitro, INCB086550 selectively and potently blocked the PD-L1/PD-1 interaction, induced PD-L1 dimerization and internalization, and induced stimulation-dependent cytokine production in primary human immune cells. In vivo, INCB086550 reduced tumor growth in CD34+ humanized mice and induced T-cell activation gene signatures, consistent with PD-L1/PD-1 pathway blockade. Preliminary data from an ongoing phase I study confirmed PD-L1/PD-1 blockade in peripheral blood cells, with increased immune activation and tumor growth control. These data support continued clinical evaluation of INCB086550 as an alternative to antibody-based therapies. SIGNIFICANCE We have identified a potent small-molecule inhibitor of PD-L1, INCB086550, which has biological properties similar to PD-L1/PD-1 monoclonal antibodies and may represent an alternative to antibody therapy. Preliminary clinical data in patients demonstrated increased immune activation and tumor growth control, which support continued clinical evaluation of this approach. See related commentary by Capparelli and Aplin, p. 1413. This article is highlighted in the In This Issue feature, p. 1397.
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Affiliation(s)
| | | | | | | | | | - Jonathan Rios-Doria
- Incyte Research Institute, Wilmington, DE
- Corresponding Author: Jonathan Rios-Doria, Incyte Corporation, 1801 Augustine Cut Off, Wilmington, DE 19803. Phone: 302-498-6914; E-mail:
| | | | - Hao Liu
- Incyte Research Institute, Wilmington, DE
| | | | | | | | | | | | | | - Jingwei Li
- Incyte Research Institute, Wilmington, DE
| | | | | | | | | | | | | | - Mark Rupar
- Incyte Research Institute, Wilmington, DE
| | | | - Luping Lin
- Incyte Research Institute, Wilmington, DE
| | | | - Yue Zhang
- Incyte Research Institute, Wilmington, DE
| | | | | | | | | | | | | | - Reid Huber
- Incyte Research Institute, Wilmington, DE
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duPont NC, Enserro D, Brady MF, Moxley K, Walker JL, Cosgrove C, Bixel K, Tewari KS, Thaker P, Wahner Hendrickson AE, Rubin S, Fujiwara K, Casey AC, Soper J, Burger RA, Monk BJ. Prognostic significance of ethnicity and age in advanced stage epithelial ovarian cancer: An NRG oncology/gynecologic oncology group study. Gynecol Oncol 2022; 164:398-405. [PMID: 34857397 PMCID: PMC9400113 DOI: 10.1016/j.ygyno.2021.11.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/04/2021] [Accepted: 11/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Age and ethnicity are among several factors that influence overall survival (OS) in ovarian cancer. The study objective was to determine whether ethnicity and age were of prognostic significance in women enrolled in a clinical trial evaluating the addition of bevacizumab to front-line therapy. METHODS Women with advanced stage ovarian, primary peritoneal, or fallopian tube cancer were enrolled in a phase III clinical trial. All women had surgical staging and received adjuvant chemotherapy with one of three regimens. Cox proportional hazards models were used to evaluate the relationship between OS with age and race/ethnicity among the study participants. RESULTS One-thousand-eight-hundred-seventy-three women were enrolled in the study. There were 280 minority women and 328 women over the age of 70. Women age 70 and older had a 34% increase risk for death when compared to women under 60 (HR = 1.34; 95% CI 1.16-1.54). Non-Hispanic Black women had a 54% decreased risk of death with the addition of maintenance bevacizumab (HR = 0.46, 95% CI:0.26-0.83). Women of Asian descent had more hematologic grade 3 or greater adverse events and a 27% decrease risk of death when compared to non-Hispanic Whites (HR = 0.73; 95% CI: 0.59-0.90). CONCLUSIONS Non-Hispanic Black women showed a decreased risk of death with the addition of bevacizumab and patients of Asian ancestry had a lower death rate than all other minority groups, but despite these clinically meaningful improvements there was no statistically significant difference in OS among the groups.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/pathology
- Black or African American/statistics & numerical data
- Age Factors
- Aged
- Aged, 80 and over
- Angiogenesis Inhibitors/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Asian/statistics & numerical data
- Bevacizumab/therapeutic use
- Carboplatin/administration & dosage
- Carcinoma, Endometrioid/drug therapy
- Carcinoma, Endometrioid/pathology
- Carcinoma, Ovarian Epithelial/drug therapy
- Carcinoma, Ovarian Epithelial/pathology
- Chemotherapy, Adjuvant/methods
- Ethnicity/statistics & numerical data
- Fallopian Tube Neoplasms/drug therapy
- Fallopian Tube Neoplasms/pathology
- Female
- Hispanic or Latino/statistics & numerical data
- Humans
- Middle Aged
- Neoplasm Staging
- Neoplasms, Cystic, Mucinous, and Serous/drug therapy
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Paclitaxel/administration & dosage
- Peritoneal Neoplasms/drug therapy
- Peritoneal Neoplasms/pathology
- Prognosis
- Proportional Hazards Models
- Survival Rate
- White People/statistics & numerical data
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Affiliation(s)
| | - Danielle Enserro
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | - Mark F Brady
- NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | - Katherine Moxley
- University of Oklahoma, Oklahoma University Hospital Science Center, Oklahoma City, OK 73104, USA.
| | - Joan L Walker
- University of Oklahoma, Oklahoma University Hospital Science Center, Oklahoma City, OK 73104, USA.
| | | | | | | | | | | | - Stephen Rubin
- Abramson Cancer Center at University of Pennsylvania, Philadelphia, PA 19111, USA.
| | - Keiichi Fujiwara
- Saitama Medical University/International Medical Center, Saitama, JP 350-1298, Japan.
| | | | - John Soper
- University of North Carolina, Chapel Hill, NC 27599, USA.
| | - Robert A Burger
- Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), Phoenix, AZ, USA.
| | - Bradley J Monk
- University of Arizona College of Medicine, Phoenix Creighton University School of Medicine at St. Joseph's Hospital, Phoenix, AZ, USA.
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Reeves M, Goldfarb C, Rubin S, Kuperstock J, DiBianco. CLINICAL ORAL ABSTRACTS. Contraception 2021. [DOI: 10.1016/j.contraception.2021.03.008] [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: 11/16/2022]
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Rubin S, Bougaran P, Martin S, Abelanet A, Delobel V, Jeannigros S, Bats M, Dufourcq P, Couffinhal T, Duplàa C. No direct involvement of Phactr-1 in non-atherosclerotic arteriopathies: Results from 3 different Phactr-1 transgenic knockout mice. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Boulestreau R, Lorthioir A, Persu A, Rubin S, Gosse P, Cremer A, Debeugny S, Halimi J, Tharaux P. First prospective multicentric registry on malignant hypertension: Rational, design and early results from 100 patients of the french HAMA cohort. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.144] [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: 11/29/2022]
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Boulestreau R, Rubin S, Brockers C, Puel C, Doublet J, Cremer A, Gosse P. Evidence on malignant hypertension therapeutic management: The forgotten past. Insight from a historical literature review. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.154] [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: 10/22/2022]
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Boulestreau R, Brockers C, Rubin S, Doublet J, Halimi J, Cremer A, Gosse P. Therapeutic management of malignant hypertension: Proof of concept of an entirely oral therapeutic approach. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.141] [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: 10/22/2022]
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Orieux A, Picard F, Vermorel A, Kaminski H, Couzi L, Merville P, Rubin S. Le syndrome cardio-rénal post transplantation est une cause fréquente de retard de reprise de fonction : une étude de cohorte. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rubin S, Abelanet A, Bougaran P, Jeanningros S, Pascale D, Duplaa C, Couffinhal T. Rôle biologique de PHACTR-1, gène décrit comme impliqué dans la pathogénèse des maladies vasculaires : une étude in-vivo. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Orieux A, Rigothier C, Combe C, Prevel R, Gruson D, Boyer A, Rubin S. Insuffisance rénale chronique après un épisode d’insuffisance rénale aiguë en réanimation : des leçons pour une consultation post-réanimation efficace. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Garrett N, Bikah Bi Nguema Engoang JA, Rubin S, Vickery KD, Winkelman TNA. Health system resource use among populations with complex social and behavioral needs in an urban, safety-net health system. Healthc (Amst) 2020; 8:100448. [PMID: 32919587 DOI: 10.1016/j.hjdsi.2020.100448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Costs incurred by health systems when caring for populations with social or behavioral complexity are poorly understood. We compared the frequency and costs of unreimbursed care among individuals with complexity factors (homelessness, a history of county jail incarceration, and/or substance use disorder or mental illness [SUD/MI]). METHODS We conducted a cross-sectional analysis using electronic health record data for adults aged 18 and older between January 1, 2016 and December 31, 2017 from a Midwestern safety-net health system. Zero-inflated negative binomial regression models were used to assess risk-adjusted associations between complexity factors and care coordination encounters, missed appointments, and excess inpatient days. RESULTS Our sample included 154,719 unique patients; 6.8% were identified as homeless, 7.8% had a history of county jail incarceration, and 20.6% had SUD/MI. Individuals with complexity factors were more likely to be African-American, Native American, or covered by Medicaid. In adjusted models, homelessness and SUD/MI were significantly associated with care coordination encounters (RR 1.8 [95% CI,1.7-2.0]; RR 1.9 [95% CI,1.8-2.0]), missed appointments (RR 1.5 [95% CI,1.4-1.6]; RR 1.7 [95% CI,1.7-1.8]), and excess inpatient days (RR 1.5 [95% CI,1.3-1.8]; RR 2.8 [95% CI,2.5-3.1]). County jail incarceration was associated with a significant increase in missed appointments. In 2017, SUD/MI accounted for 81.8% ($7,773,000/$9,502,000) of excess costs among those with social or behavioral complexity. CONCLUSIONS Social and behavioral complexity are independently associated with high levels of unreimbursed health system resource use. IMPLICATIONS Future payment models should account for the health system resources required to care for populations with complex social and behavioral needs. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Nancy Garrett
- Analytics Center of Excellence, Hennepin Healthcare, Minneapolis, MN, USA; Aetna, Hartford, CT, USA
| | | | - Stephen Rubin
- Analytics Center of Excellence, Hennepin Healthcare, Minneapolis, MN, USA
| | - Katherine Diaz Vickery
- Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA; Health, Homelessness, And Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Tyler N A Winkelman
- Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA; Health, Homelessness, And Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA.
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Ackroyd SA, Hernandez E, Roberts ME, Chu C, Rubin S, Mantia-Smaldone G, Houck K. Postoperative complications of epidural analgesia at hysterectomy for gynecologic malignancies: an analysis of the National Surgical Quality Improvement Program. Int J Gynecol Cancer 2020; 30:1203-1209. [DOI: 10.1136/ijgc-2020-001339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/04/2022] Open
Abstract
ObjectiveThe aim of this study was to identify the rate of 30-day postoperative complications after the use of epidural in women undergoing hysterectomy for gynecologic malignancy. Secondary outcome was the impact of epidural on hospital length of stay.MethodsA retrospective cohort study was conducted using the American College of Surgeons’ National Surgical Quality Improvement Program database. This large dataset includes perioperative risk factors and 30-day post-operative outcomes from more than 680 hospitals. Women who underwent abdominal hysterectomy for a gynecologic malignancy from January 2014 to December 2017 were included. Adult patients (18 years or older) who underwent abdominal hysterectomy were identified using common procedure terminology and international classification of diseases codes. Only laparotomy cases were included, and minimally invasive cases (laparoscopy, transvaginal) were excluded due to the small prevalence of epidural cases in this cohort. All patients received general anesthesia. If patients were noted to have “epidural anesthesia” they were included in the epidural cohort and those receiving other adjuvant techniques (regional blocks or spinal anesthesia) were excluded. The primary outcome of interest was the 30-day occurrence of a pulmonary embolism, deep-vein thrombosis, pneumonia, and urinary tract infection. Those who received epidural analgesia were matched in a 1:1 ratio with a similar group of patients who did not receive epidural analgesia using a calculated propensity score to control for confounding factors.ResultsA total of 2035 (13.8%) patients undergoing abdominal hysterectomy for a gynecologic malignancy received epidural analgesia. 1:1 propensity-matched samples included 2035 patients in both epidural and no-epidural groups. Patient characteristics between groups were similar. Overall 30-day complication rates were higher in the epidural group (75.9% vs 62.0%, P<0.01). Specific complications that were higher in the epidural group included: blood transfusion (28.9% vs 22.8%); wound disruption (2.0% vs 1.1%); surgical site infection (10.1% vs 7.2%); and delay in return of bowel function (12.3% vs 9.3%) (all P<0.05). Hospital length of stay was significantly longer in the epidural group as compared with the no-epidural group (5.69 days vs 4.79 days, P<0.01) and readmissions were higher in the epidural group (10.5% vs 9.7%, P<0.01), but there was no difference in 30-day mortality between the groups (P=0.62).DiscussionThe rate of 30-day complications and length of stay among women undergoing an abdominal hysterectomy for gynecologic malignancy was higher for those who received epidural analgesia, but there was no difference in 30-day mortality. Although epidural analgesia can provide a number of benefits when used for postoperative pain control, the possible association with increased 30-day morbidity and length of stay needs to be considered.
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Rubin S, Adams J, Cox J, Pereira C, Dighe M, Alessio A. Abstract No. 473 Machine learning with ultrasound to automate risk stratification and reduce fine-needle aspiration in a thyroid cancer. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Papatla K, Halpern MT, Hernandez E, Brown J, Benrubi D, Houck K, Chu C, Rubin S. Second primary anal and oropharyngeal cancers in cervical cancer survivors. Am J Obstet Gynecol 2019; 221:478.e1-478.e6. [PMID: 31128108 DOI: 10.1016/j.ajog.2019.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/10/2019] [Accepted: 05/17/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human papilloma virus infection is responsible for approximately 31,500 new cancers in the United States annually. Almost all cervical cancers are linked to human papilloma virus infection. As early identification and treatment of cervical cancer improve, the incidence of cervical cancer has decreased and survival has improved. However, survivors continue to remain at risk for other human papilloma virus-related malignancies. The purpose of this study was to assess the risk of primary anal and oropharyngeal cancers among women with a history of squamous cell carcinoma of the cervix. STUDY DESIGN A population-based cohort of 21,060 women diagnosed with cervical squamous cell carcinoma from 1973 through 2014 was identified from the Surveillance, Epidemiology, and End Results Program-9 data. Standardized incidence ratios for anal and oropharyngeal cancers were calculated to estimate the risk of a second primary human papilloma virus-related malignancy based on incidence in the general population. Results were further stratified by age (20-53, 54 years old or older) and latency period (2-11, 12-59, 60-119, 120 months or longer). The number needed to screen for oropharyngeal and anal cancers was estimated using study results and Centers for Disease Control and Prevention-reported incidence rates. RESULTS Cervical squamous cell cancer survivors had a higher risk of being diagnosed with oropharyngeal cancer (standardized incidence ratio, 4.36, 95% confidence interval, 1.19-11.15) and anal cancer (standardized incidence ratio, 2.20, 95% confidence interval, 1.28-3.52). Patients diagnosed with cervical cancer between ages 20 and 53 years had an increased risk of anal cancer (standardized incidence ratio, 3.53, 95% confidence interval, 1.15-8.23). Age 54 years or older at cervical cancer diagnosis was associated with increased oropharyngeal cancer risk only (standardized incidence ratio, 5.04, 95% confidence interval, 1.37-12.91). Latency stratification was significant for increased OPC risk between 2-11 months and 12-59 months after diagnosis. At 120 months or longer, there was an increased risk of both oropharyngeal cancer (standardized incidence ratio, 7.97, 95% confidence interval, 2.17-20.42) and anal cancer (standardized incidence ratio, 2.60, 95% confidence interval, 1.34-4.54). The estimated number needed to screen for oropharyngeal cancer (number needed to screen for oropharyngeal cancer, 282) and anal cancer (number needed to screen for anal cancer, 1272) is significantly less than the number needed to screen for cervical cancer. CONCLUSION Squamous cell cervical cancer survivors have a substantially increased risk of anal and oropharyngeal cancers. This increased risk is significant 10 or more years after the cervical cancer diagnosis. Health care providers and survivors should be aware of this increased risk. The development of effective and economical surveillance methods for anal and oropharyngeal cancers in cervical cancer survivors is urgently needed.
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Orieux A, Boyer A, Rigothier C, Clouzeau B, Gruson D, Combe C, Rubin S. Incidence de l’insuffisance rénale chronique trois ans après une insuffisance rénale aiguë non sévère en réanimation : une étude de cohorte. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Burguet L, Taton B, Prezelin-Reydit M, Rubin S, Picard W, Gruson D, Ryman A, Contin C, Combe C, Delmas Y. Le rapport protéinurie/créatinurie améliore nettement la discrimination SHU/PTT à l’ère des thérapies ciblées : un test simple et performant. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ackroyd SA, Brown J, Houck K, Chu C, Mantia-Smaldone G, Rubin S, Hernandez E. A preoperative risk score to predict red blood cell transfusion in patients undergoing hysterectomy for ovarian cancer. Am J Obstet Gynecol 2018; 219:598.e1-598.e10. [PMID: 30240655 DOI: 10.1016/j.ajog.2018.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/04/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Patients with ovarian cancer experience a high rate of anemia throughout their treatment course, with rates that range from 19-95%. Blood transfusions offer symptom relief but may be costly, are limited in supply, and have been associated with worse 30-day surgical morbidity and mortality rates. OBJECTIVE The purpose of this study was to identify risk factors for blood transfusion with packed red blood cell and to develop a transfusion risk score to identify patients who undergo surgery for ovarian cancer and who are at lowest risk for a blood transfusion. Our aim was to help clinicians identify those patients who may not require a crossmatch to encourage resource use and cost-savings. STUDY DESIGN This is a retrospective database cohort study of 3470 patients who underwent hysterectomy for ovarian cancer with the use the National Surgical Quality Improvement Program database from 2014-2016. The association between risk factors with respect to 30-day postoperative blood transfusion was modeled with the use of logistic regression. A risk score to predict blood transfusion was created. RESULTS Eight hundred ninety-one (25.7%) patients received a blood transfusion. In multivariate analysis, blood transfusion was associated independently with age (odds ratio, 1.90, P<.01), African American race (odds ratio, 2.30; P<.01), ascites (odds ratio, 1.89; P=.02), preoperative hematocrit level <30% (odds ratio, 10.70; P<.01), preoperative platelet count >400×109/L (odds ratio, 1.75; P<.01), occurrence of disseminated cancer (odds ratio, 1.71; P<.01), open surgical approach (odds ratio, 7.88; P<.01), operative time >3 hours (odds ratio, 2.19; P<.01), and additional surgical procedures that included large bowel resection (odds ratio, 4.23; P<.01), bladder/ureter resection (odds ratio, 1.69; P=.02), and pelvic exenteration (P=.02). A preoperative risk score that used age, race, ascites, preoperative hematocrit level, platelets, presence of disseminated cancer, planned hysterectomy approach, and procedures accurately predicted blood transfusion with good discriminatory ability (C-statistic=0.80 [P<.001]; C-statistic=0.69 [P<.001] for derivation and validation datasets, respectively) and calibration (Hosmer-Lemeshow goodness-of-fit, P=.081; P=.56 for derivation and validation datasets, respectively). CONCLUSION Patients who undergo hysterectomy for ovarian cancer experience a high incidence of blood transfusions in the perioperative period. Preoperative risk factors and planned surgical procedures can be used in our transfusion risk score to help predict anticipated blood requirements.
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Rigothier C, Preterre J, Bur P, Mucha S, Rubin S, Kalisky J, Devillard R, Combe C. Fabrication d’un réseau glomérulaire microvascularisé : néoformation d’une membrane basale glomérulaire. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Harhay M, Crowther M, Diamond J, DiSanto T, Rubin S, Penfil Z, Bermudez C, Christie J, Cantu E. Organ Sequence Number (SN) is Not a Proxy for Organ Quality. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Garassino M, Rubin S, Zhao Y, Luo Y, Samkari A, Hui R. 193TiP Phase 3 study of epacadostat plus pembrolizumab with or without platinum-based chemotherapy vs pembrolizumab plus chemotherapy for first-line metastatic non-small cell lung cancer (mNSCLC): ECHO-306/KEYNOTE-715. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30466-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Paz-Ares L, Rubin S, Zhao Y, Xu L, Samkari A, Awad M. 195TiP A phase 3, randomized, double-blind study of epacadostat plus pembrolizumab vs pembrolizumab as first-line therapy for metastatic non-small cell lung cancer (mNSCLC) expressing high PD-L1 levels (ECHO-305/KEYNOTE-654). J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30468-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Slowinski R, Wilk S, Farion KJ, Pike J, Rubin S, Michalowski W. Design and Development of a Mobile System for Supporting Emergency Triage. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1633918] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
Our objective was to design and develop a mobile clinical decision support system for emergency triage of different acute pain presentations. The system should interact with existing hospital information systems, run on mobile computing devices (handheld computers) and be suitable for operation in weak-connectivity conditions (with unstable connections between mobile clients and a server).
Methods:
The MET (Mobile Emergency Triage) system was designed following an extended client-server architecture. The client component, responsible for triage decision support, is built as a knowledge-based system, with domain ontology separated from generic problem solving methods and used for the automatic creation of a user interface.
Results:
The MET system is well suited for operation in the Emergency Department of a hospital. The system’s external interactions are managed by the server, while the MET clients, running on handheld computers are used by clinicians for collecting clinical data and supporting triage at the bedside. The functionality of the MET client is distributed into specialized modules, responsible for triaging specific types of acute pain presentations. The modules are stored on the server, and on request they can be transferred and executed on the mobile clients. The modular design provides for easy extension of the system’s functionality. A clinical trial of the MET system validated the appropriateness of the system’s design, and proved the usefulness and acceptance of the system in clinical practice.
Conclusions:
The MET system captures the necessary hospital data, allows for entry of patient information, and provides triage support. By operating on handheld computers, it fits into the regular emergency department workflow without introducing any hindrances or disruptions. It supports triage anytime and anywhere, directly at the point of care, and also can be used as an electronic patient chart, facilitating structured data collection.
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Farion K, Michalowski W, O’Sullivan D, Rubin S, Weiss D, Wilk S. Clinical Decision Support System for Point of Care Use. Methods Inf Med 2018; 48:381-90. [DOI: 10.3414/me0574] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Accepted: 01/12/2009] [Indexed: 11/09/2022]
Abstract
Summary
Objectives: The objective of this research was to design a clinical decision support system (CDSS) that supports heterogeneous clinical decision problems and runs on multiple computing platforms. Meeting this objective required a novel design to create an extendable and easy to maintain clinical CDSS for point of care support. The proposed solution was evaluated in a proof of concept implementation.
Methods: Based on our earlier research with the design of a mobile CDSS for emergency triage we used ontology-driven design to represent essential components of a CDSS. Models of clinical decision problems were derived from the ontology and they were processed into executable applications during runtime. This allowed scaling applications’ functionality to the capabilities of computing platforms. A prototype of the system was implemented using the extended client-server architecture and Web services to distribute the functions of the system and to make it operational in limited connectivity conditions.
Results: The proposed design provided a common framework that facilitated development of diversified clinical applications running seamlessly on a variety of computing platforms. It was prototyped for two clinical decision problems and settings (triage of acute pain in the emergency department and postoperative management of radical pros-tatectomy on the hospital ward) and implemented on two computing platforms – desktop and handheld computers.
Conclusions: The requirement of the CDSS heterogeneity was satisfied with ontology-driven design. Processing of application models described with the help of ontological models allowed having a complex system running on multiple computing platforms with different capabilities. Finally, separation of models and runtime components contributed to improved extensibility and maintainability of the system.
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Norquist BM, Brady MF, Harrell MI, Walsh T, Lee MK, Gulsuner S, Bernards SS, Casadei S, Burger RA, Tewari KS, Backes F, Mannel RS, Glaser G, Bailey C, Rubin S, Soper J, Lankes HA, Ramirez NC, King MC, Birrer MJ, Swisher EM. Mutations in Homologous Recombination Genes and Outcomes in Ovarian Carcinoma Patients in GOG 218: An NRG Oncology/Gynecologic Oncology Group Study. Clin Cancer Res 2017; 24:777-783. [PMID: 29191972 DOI: 10.1158/1078-0432.ccr-17-1327] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 09/26/2017] [Accepted: 11/21/2017] [Indexed: 12/30/2022]
Abstract
Purpose: We hypothesized that mutations in homologous recombination repair (HRR) genes beyond BRCA1 and BRCA2 improve outcomes for ovarian carcinoma patients treated with platinum therapy and would impact the relative benefit of adding prolonged bevacizumab.Experimental Design: We sequenced DNA from blood and/or neoplasm from 1,195 women enrolled in GOG-0218, a randomized phase III trial in advanced ovarian carcinoma of bevacizumab added to carboplatin and paclitaxel. Defects in HRR were defined as damaging mutations in 16 genes. Proportional hazards models were used to estimate relative hazards for progression-free survival (PFS) and overall survival (OS).Results: Of 1,195 women with ovarian carcinoma, HRR mutations were identified in 307 (25.7%). Adjusted hazards for progression and death compared with those without mutations were lower for women with non-BRCA HRR mutations [HR = 0.73; 95% confidence interval (CI), 0.57-0.94; P = 0.01 for PFS; HR = 0.67; 95% CI, 0.50-0.90; P = 0.007 for OS] and BRCA1 mutations (HR = 0.80; 95% CI, 0.66-0.97; P = 0.02 for PFS; HR = 0.74; 95% CI, 0.59-0.94; P = 0.01 for OS) and were lowest for BRCA2 mutations (HR = 0.52; 95% CI, 0.40-0.67; P < 0.0001 for PFS; HR = 0.36; 95% CI, 0.25-0.53; P < 0.0001 for OS). A test of interaction showed no difference in the effect of bevacizumab on PFS between cases with and without mutations.Conclusions: HRR mutations, including non-BRCA genes, significantly prolong PFS and OS in ovarian carcinoma and should be stratified for in clinical trials. The benefit of adding bevacizumab was not significantly modified by mutation status. Clin Cancer Res; 24(4); 777-83. ©2017 AACR.
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Affiliation(s)
- Barbara M Norquist
- Division of Gynecologic Oncology, University of Washington, Seattle, Washington.
| | - Mark F Brady
- The NRG Oncology Statistical and Data Center, Roswell Park Cancer Center Institute, Buffalo, New York
| | - Maria I Harrell
- Division of Gynecologic Oncology, University of Washington, Seattle, Washington
| | - Tom Walsh
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Ming K Lee
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Suleyman Gulsuner
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Sarah S Bernards
- Division of Gynecologic Oncology, University of Washington, Seattle, Washington
| | - Silvia Casadei
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Robert A Burger
- Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Krishnansu S Tewari
- Division of Gynecologic Oncology, University of California at Irvine, Orange, California
| | - Floor Backes
- Division of Gynecologic Oncology, The Ohio State University Medical Center, Columbus, Ohio
| | - Robert S Mannel
- Division of Gynecologic Oncology, University of Oklahoma, Oklahoma City, Oklahoma
| | - Gretchen Glaser
- Division of Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Cheryl Bailey
- Division of Gynecologic Oncology, Minnesota Oncology, Minneapolis, Minnesota
| | - Stephen Rubin
- Division of Gynecologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - John Soper
- Division of Gynecologic Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Heather A Lankes
- Department of Pathology and Laboratory Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Nilsa C Ramirez
- Department of Pathology and Laboratory Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Mary Claire King
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Michael J Birrer
- Division of Hematology/Oncology, University of Alabama, Birmingham, Alabama
| | - Elizabeth M Swisher
- Division of Gynecologic Oncology, University of Washington, Seattle, Washington.,Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington
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Houston D, Tooze J, Visser M, Tylavsky F, Rubin S, Newman A, Harris T, Kritchevsky S. PROTEIN INTAKE AND INCIDENT SARCOPENIA IN OLDER ADULTS: THE HEALTH ABC STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D.K. Houston
- Wake Forest School of Medicine, Winston Salem, North Carolina,
| | - J.A. Tooze
- Wake Forest School of Medicine, Winston Salem, North Carolina,
| | - M. Visser
- Vrije Universiteit, Amsterdam, Netherlands,
| | - F.A. Tylavsky
- University of Tennessee Health Science Center, Memphis, Tennessee,
| | - S. Rubin
- University of California, San Francisco, California,
| | - A. Newman
- University of Pittsburgh, Pittsburgh, Pennsylvania,
| | - T.B. Harris
- National Institute on Aging, Bethesda, Maryland
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Cripe J, Handorf E, Brown J, Jain A, Rubin S, Mantia-Smaldone G. National Cancer Database Report of Lymphadenectomy Trends in Endometrial Cancer. Int J Gynecol Cancer 2017; 27:1408-1415. [PMID: 28525495 DOI: 10.1097/igc.0000000000001005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Lymph node involvement has a significant impact on prognosis that may direct adjuvant therapy. The role of routine lymph node staging (LNS) is controversial given conflicting results in multiple studies. Our aims are to describe treatment patterns of LNS, identify factors impacting LNS, and quantify the contemporary trends. METHODS/MATERIALS The National Cancer Data Base was queried for patients undergoing hysterectomy for endometrioid and serous uterine carcinomas from 2003 to 2012. For endometrioid tumors, LNS was considered indicated if at least 1 of 4 criteria was met. Multivariate logistic regression and Cox proportional hazards model were used. RESULTS A total of 161,683 patients were identified who received hysterectomy for 155,893 (96.4%) endometrioid and 5790 (3.6%) serous carcinomas. Receipt of LNS was significantly associated with greater than 50% myometrial invasion (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.55-1.73), grades 3 to 4 (OR, 3.03; 95% CI, 2.83-3.25), and tumor size greater than 2 cm (OR, 1.17; 95% CI, 1.28-1.26). Of the 97,152 patients with endometrioid carcinoma who met criteria for comprehensive staging, 73,268 (75.4%) underwent LNS. Patients with endometrioid carcinoma meeting criteria for LNS were less likely to receive LNS if they were of African American race (OR, 0.92; 95% CI, 0.86-0.98), had Medicaid insurance status (OR, 0.75; 95% CI, 0.69-0.81), had Medicare insurance (OR, 0.82; 95% CI, 0.79-0.86), or received care at a community program (OR, 0.39; 95% CI, 0.33-0.46). CONCLUSIONS Nationally, most patients with greater than 50% myometrial invasion, grades 3 to 4, and/or tumor size greater than 2 cm receive LNS, but this was significantly impacted by insurance status, demographic characteristics, and facility location/type.
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Affiliation(s)
- James Cripe
- *Department of Gynecologic Oncology, Washington University, St Louis, MO; and †Department of Statistics and ‡Division of Gynecologic Oncology, Fox Chase Cancer Center, Philadelphia, PA
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Jordan SE, Stone D, Yu D, Ferriss JS, Hernandez E, Rubin S. Blood Loss from Robotic Assisted Hysterectomy. J Gynecol Surg 2017. [DOI: 10.1089/gyn.2016.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Scott E. Jordan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital and Fox Chase Cancer Center, Philadelphia, PA
| | - Dana Stone
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Daohai Yu
- Department of Clinical Sciences, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - J. Stuart Ferriss
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital and Fox Chase Cancer Center, Philadelphia, PA
| | - Enrique Hernandez
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital and Fox Chase Cancer Center, Philadelphia, PA
| | - Stephen Rubin
- Gynecologic Oncology Section, Fox Chase Cancer Center, Philadelphia, PA
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Rubin S, Suss ME, Biesheuvel PM, Bercovici M. Induced-Charge Capacitive Deionization: The Electrokinetic Response of a Porous Particle to an External Electric Field. Phys Rev Lett 2016; 117:234502. [PMID: 27982655 DOI: 10.1103/physrevlett.117.234502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Indexed: 06/06/2023]
Abstract
We demonstrate the phenomenon of induced-charge capacitive deionization that occurs around a porous and conducting particle immersed in an electrolyte, under the action of an external electric field. The external electric field induces an electric dipole in the porous particle, leading to its capacitive charging by both cations and anions at opposite poles. This regime is characterized by a long charging time, which results in significant changes in salt concentration in the electrically neutral bulk, on the scale of the particle. We qualitatively demonstrate the effect of advection on the spatiotemporal concentration field, which, through diffusiophoresis, may introduce corrections to the electrophoretic mobility of such particles.
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Affiliation(s)
- S Rubin
- Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - M E Suss
- Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
| | - P M Biesheuvel
- Wetsus, European Centre of Excellence for Sustainable Water Technology, Oostergoweg 9, 8911 MA Leeuwarden, The Netherlands
| | - M Bercovici
- Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa 3200003, Israel
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Walker J, Brady M, DiSilvestro P, Fujiwara K, Alberts D, Zheng W, Tewari K, Cohn D, Powell M, Van Le L, Rubin S, Davidson S, Gray H, Waggoner S, Myers T, Aghajanian C, Secord A, Mannel R. A phase III trial of bevacizumab with IV versus IP chemotherapy for ovarian, fallopian tube, and peritoneal carcinoma: An NRG Oncology Study. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.535] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leachman BK, Shaikh T, Chu C, Rubin S, Anderson P. Addition of Brachytherapy to Adjuvant External Beam Radiation in Patients with Cervical Cancer. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rubin S, Gosse P, Gruson D, Boyer A. Diagnostic et traitement de l’hypertension artérielle maligne en réanimation. Réponse aux auteurs. Réanimation 2015. [DOI: 10.1007/s13546-015-1093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Myers Virtue S, Manne SL, Darabos K, Heckman CJ, Ozga M, Kissane D, Rubin S, Rosenblum N. Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers. Psychooncology 2014; 24:1189-96. [PMID: 25521772 DOI: 10.1002/pon.3737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 10/10/2014] [Accepted: 11/18/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. METHODS The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. RESULTS The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p < 0.001) and higher patient-rated progress as rated in the sixth session (p = 0.016). CONCLUSION The findings highlight the importance of expressed emotions, particularly negative emotions about cancer-related topics, in therapeutic progress during psychotherapy among women diagnosed with gynecological cancer.
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Affiliation(s)
- Shannon Myers Virtue
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Sharon L Manne
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Kathleen Darabos
- Department of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Carolyn J Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Melissa Ozga
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - David Kissane
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.,Department of Psychiatry, Monash University, VIC, Australia
| | - Stephen Rubin
- Department of Gynecologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Norman Rosenblum
- Department of Gynecologic Oncology, Jefferson University Hospital, Philadelphia, PA, USA
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Ravi A, Prine L, deFiebre G, Miller N, Rubin S. Beyond the surface: patient postinsertion implant experience in a family-physician-staffed federally qualified health center network. Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rubin S, Jacobs A. “The easiest way”: decision-making process of urban adolescents choosing to use an IUD. Contraception 2014. [DOI: 10.1016/j.contraception.2014.05.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mantia-Smaldone G, Ronner L, Blair A, Gamerman V, Morse C, Orsulic S, Rubin S, Gimotty P, Adams S. The immunomodulatory effects of pegylated liposomal doxorubicin are amplified in BRCA1--deficient ovarian tumors and can be exploited to improve treatment response in a mouse model. Gynecol Oncol 2014; 133:584-90. [PMID: 24680909 DOI: 10.1016/j.ygyno.2014.03.565] [Citation(s) in RCA: 13] [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: 02/03/2014] [Revised: 03/17/2014] [Accepted: 03/19/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Women with BRCA-associated ovarian cancer demonstrate excellent responses to Pegylated Liposomal Doxorubicin (PLD). PLD has also been shown to enhance T cell recognition of tumor cells. Here we characterize immunophenotypic changes associated with BRCA1 dysfunction in ovarian cancer cells, and evaluate the T cell contribution to the therapeutic efficacy of PLD in a BRCA1- ovarian cancer model to determine whether enhanced anti-tumor immunity contributes to the improved response to PLD in BRCA1- ovarian cancers. METHODS The immunophenotype of BRCA1- and wild-type (WT) ovarian cancer cells and their response to PLD were compared in vitro using flow cytometry. T cell recruitment to BRCA1- tumors was evaluated with flow cytometry and immunohistochemistry. The contribution of T cell populations to the therapeutic effect of PLD in a BRCA1- model was evaluated using immunodepleting antibodies with PLD in vivo. RESULTS The cytotoxic response to PLD was similar in BRCA1- and WT cells in vitro. BRCA1- inactivation resulted in higher expression of Fas and MHC-I at baseline and after PLD exposure. PLD prolonged the survival of BRCA1- tumor bearing mice and increased intratumoral T cell recruitment. CD4+ depletion combined with PLD significantly prolonged overall survival (p=0.0204) in BRCA1- tumor-bearing mice. CONCLUSION Differences in the immunophenotype of BRCA1- and WT cells are amplified by PLD exposure. The enhanced immunomodulatory effects of PLD in BRCA1- tumors may be exploited therapeutically by eliminating suppressive CD4+ T cells. Our results support further study of combination therapy using PLD and immune agents, particularly in women with BRCA gene mutations.
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Affiliation(s)
- Gina Mantia-Smaldone
- Section of Gynecologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
| | - Lukas Ronner
- Division of Gynecologic Oncology, Hospital of the University of Pennsylvania, 3rd Floor, PCAM, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Anne Blair
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, 501 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Victoria Gamerman
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, 501 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Christopher Morse
- Division of Gynecologic Oncology, Hospital of the University of Pennsylvania, 3rd Floor, PCAM, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Sandra Orsulic
- Women's Cancer Research Institute at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Stephen Rubin
- Section of Gynecologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Phyllis Gimotty
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, 501 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Sarah Adams
- Division of Gynecologic Oncology, University of New Mexico Cancer Center, 1201 Camino de Salud NE, 1 University of New Mexico, Albuquerque, NM 87106, USA
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Arnold E, Lane S, Webert KE, Chan A, Walker I, Tufts J, Rubin S, Poon MC, Heddle NM. What should men living with haemophilia need to know? The perspectives of Canadian men with haemophilia. Haemophilia 2013; 20:219-25. [DOI: 10.1111/hae.12297] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2013] [Indexed: 11/29/2022]
Affiliation(s)
- E. Arnold
- Department of Medicine; McMaster University; Hamilton ON Canada
| | - S. Lane
- Department of Medicine; McMaster University; Hamilton ON Canada
| | - K. E. Webert
- Canadian Blood Services; Hamilton ON Canada
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
| | - A. Chan
- Department of Pediatrics; McMaster University; Hamilton ON Canada
| | - I. Walker
- Department of Medicine; McMaster University; Hamilton ON Canada
| | - J. Tufts
- Department of Medicine; McMaster University; Hamilton ON Canada
| | - S. Rubin
- Department of Medicine; Horizon Health Network; Moncton NB Canada
| | - M-C. Poon
- Department of Medicine, Pediatrics and Oncology; University of Calgary; Calgary AB Canada
| | - N. M. Heddle
- Department of Medicine; McMaster University; Hamilton ON Canada
- Canadian Blood Services, Research and Development; Hamilton ON Canada
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Affiliation(s)
- S Rubin
- Renal Unit, Hôpital de la Côte Basque, Bayonne, France
| | - A Lacraz
- Renal Unit, Hôpital de la Côte Basque, Bayonne, France
| | - V Galantine
- Renal Unit, Hôpital de la Côte Basque, Bayonne, France
| | - P Gosse
- Cardiology and Hypertension, Hopital Saint André, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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Ravi A, Rubin S, Waltermaurer E, Miller N, Prine L. Comparison of iud insertion experience and clinician utilization at 6 months between adolescents and non-adolescents in a federally qualified health center network. Contraception 2013. [DOI: 10.1016/j.contraception.2013.05.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rubin S, McKee M. Does competency matter? Factors associated with primary care providers’ frequently counseling adolescents about intrauterine contraception. Contraception 2013. [DOI: 10.1016/j.contraception.2013.05.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ravi A, Rubin S, Waltermaurer E, Miller N, Prine L. Intrauterine contraception during the first 6 months: a comparison between adolescents and non-adolescents' clinical concerns, continuation and infection. Contraception 2013. [DOI: 10.1016/j.contraception.2013.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rubin S, Broder A, McKee D. Competency and condoms: factors associated with frequently counseling adolescents about intrauterine contraception in primary care. Contraception 2013. [DOI: 10.1016/j.contraception.2013.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Coleman R, Sill M, Aghajanian C, Gray H, Tewari K, Rubin S, Rutherford T, Chan J, Swisher E. A phase II evaluation of the potent, highly selective PARP inhibitor veliparib in the treatment of persistent or recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer in patients who carry a germline BRCA1 or BRCA2 mutation – a Gynecologic Oncology Group study. Gynecol Oncol 2013. [DOI: 10.1016/j.ygyno.2013.04.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Myers SB, Manne SL, Kissane DW, Ozga M, Kashy DA, Rubin S, Heckman C, Rosenblum N, Morgan M, Graff JJ. Social-cognitive processes associated with fear of recurrence among women newly diagnosed with gynecological cancers. Gynecol Oncol 2013; 128:120-127. [PMID: 23088925 PMCID: PMC3534914 DOI: 10.1016/j.ygyno.2012.10.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 10/04/2012] [Accepted: 10/13/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This cross sectional study aimed to characterize fears of recurrence among women newly diagnosed with gynecologic cancer. The study also evaluated models predicting the impact of recurrence fears on psychological distress through social and cognitive variables. METHODS Women (N=150) who participated in a randomized clinical trial comparing a coping and communication intervention to a supportive counseling intervention to usual care completed baseline surveys that were utilized for the study. The survey included the Concerns about Recurrence Scale (CARS), Beck Depression Inventory (BDI), Impact of Event Scale (IES), and measures of social (holding back from sharing concerns and negative responses from family and friends) and cognitive (positive reappraisal, efficacy appraisal, and self-esteem appraisal) variables. Medical data was obtained via medical chart review. RESULTS Moderate-to-high levels of recurrence fears were reported by 47% of the women. Younger age (p<.01) and functional impairment (p<.01) correlated with greater recurrence fears. A social-cognitive model of fear of recurrence and psychological distress was supported. Mediation analyses indicated, that as a set, the social and cognitive variables mediated the association between fear of recurrence and both depression and cancer-specific distress. Holding back and self-esteem showed the strongest mediating effects. CONCLUSION Fears of recurrence are prevalent among women newly diagnosed with gynecologic cancer. Social and cognitive factors play a role in women's adaptation to fears and impact overall psychological adjustment. These factors may be appropriate targets for intervention.
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Plummer R, Madi A, Jeffels M, Richly H, Nokay B, Rubin S, Ball HA, Weller S, Botbyl J, Gibson DM, Scheulen ME. A Phase I study of pazopanib in combination with gemcitabine in patients with advanced solid tumors. Cancer Chemother Pharmacol 2013; 71:93-101. [PMID: 23064954 PMCID: PMC3535414 DOI: 10.1007/s00280-012-1982-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 09/15/2012] [Indexed: 12/03/2022]
Abstract
PURPOSE Pazopanib plus gemcitabine combination therapy was explored in patients with advanced solid tumors. METHODS In a modified 3 + 3 enrollment scheme, oral once-daily pazopanib was administered with intravenous gemcitabine (Days 1 and 8, 21-day cycles). Three protocol-specified dose levels were tested: pazopanib 400 mg plus gemcitabine 1,000 mg/m(2), pazopanib 800 mg plus gemcitabine 1,000 mg/m(2), and pazopanib 800 mg plus gemcitabine 1,250 mg/m(2). Maximum-tolerated dose was based on dose-limiting toxicities during treatment Cycle 1. In the expansion phase, six additional patients were enrolled at the highest tolerable dose level. RESULTS Twenty-two patients were enrolled. At the highest dose level tested (pazopanib 800 plus gemcitabine 1,250), patients received >80% of their planned dose and the regimen was deemed safe and tolerable. The most common treatment-related adverse events included fatigue, neutropenia, nausea, and decreased appetite. Neutropenia and thrombocytopenia were the most common events leading to dose modifications. Pharmacokinetic interaction between pazopanib and gemcitabine was not observed. One objective partial response at the highest dose was observed in a patient with metastatic melanoma. Prolonged disease stabilization (>12 cycles) was reported in three patients (metastatic melanoma, cholangiocarcinoma, and colorectal carcinoma). CONCLUSION Combination pazopanib plus gemcitabine therapy is tolerable, with an adverse event profile reflective of that associated with the individual agents. There was no apparent pharmacokinetic interaction with pazopanib plus gemcitabine co-administration, although patient numbers were limited. Further investigation of combined pazopanib plus gemcitabine is warranted.
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Affiliation(s)
- Ruth Plummer
- Sir Bobby Robson Cancer Trials Research Centre, Northern Centre for Cancer Care, Newcastle upon Tyne, UK.
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Manne SL, Kashy DA, Rubin S, Hernandez E, Bergman C. Therapist and patient perceptions of alliance and progress in psychological therapy for women diagnosed with gynecological cancers. J Consult Clin Psychol 2012; 80:800-810. [PMID: 22746145 PMCID: PMC3763826 DOI: 10.1037/a0029158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goal was to understand both therapist and patient perspectives on alliance and session progress for women in treatment for gynecological cancer. We used a longitudinal version of the one-with-many design to partition variation in alliance and progress ratings into therapist, patient/dyad, and time-specific components. We also evaluated therapist and patient characteristics that predict alliance and session progress. METHOD Two hundred and three women and their therapists completed measures of alliance and session progress across a 6-session course of treatment. Participants also completed preintervention measures of self-esteem, depression, cancer-specific distress, emotional expressivity, and use of protective buffering. RESULTS Patients reported higher alliance and greater progress than did therapists. When therapists reported particularly strong alliance with particular patients, those patients concurred. More experienced therapists reported higher alliances and more progress but their patients did not agree. Patients who began treatment in more difficult psychosocial circumstances tended to have less positive session outcomes on average but evidenced more improvement across therapy sessions. CONCLUSIONS Patients rated their alliance and progress more positively than did their therapists, although there was substantial relative agreement between therapists and patients. Alliance and progress improved over time, particularly among patients who evidenced higher levels of distress and poorer physical functioning. More experienced therapists were more confident in their abilities but their patients did not share this perception.
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Affiliation(s)
- Sharon L Manne
- Cancer Prevention and Control Program, Cancer Institute of New Jersey
| | | | - Stephen Rubin
- Division of Gynecological Oncology, Hospital of the University of Pennsylvania
| | - Enrique Hernandez
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine
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Bahng AY, Chu C, Wileyto P, Rubin S, Lin LL. Risk factors for recurrence amongst high intermediate risk patients with endometrioid adenocarcinoma. J Gynecol Oncol 2012; 23:257-64. [PMID: 23094129 PMCID: PMC3469861 DOI: 10.3802/jgo.2012.23.4.257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 05/31/2012] [Accepted: 06/04/2012] [Indexed: 01/23/2023] Open
Abstract
Objective To determine risk factors associated with recurrence in patients with high intermediate risk (HIR) endometrioid adenocarcinoma. Methods A retrospective analysis of patients with HIR endometrioid adenocarcinoma who underwent hysterectomy, bilateral salpingo-oophorectomy, with or without pelvic/para-aortic lymphadenectomy at the University of Pennsylvania between 1990 and 2009 was performed. Results A total of 103 women with HIR endometrial cancer were identified. Multivariable analysis revealed that ≥2/3 myometrial invasion (HR, 4.79; p=0.010) and grade 3 disease (HR, 3.04; p=0.045) were independently predictive of distant metastases. The 5-year distant metastases free survival (DMFS) for patients with neither or one of these risk factors was 89%, and the 5-year DMFS for patients with both risk factors was 48% (p<0.001). Conclusion Patients with both grade 3 disease and deep third myometrial invasion have a high risk of distant metastases. Identifying these patients may be important in rationally selecting patients for systemic therapy.
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Affiliation(s)
- Agnes Y Bahng
- Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Cella D, Lai JS, Nowinski CJ, Victorson D, Peterman A, Miller D, Bethoux F, Heinemann A, Rubin S, Cavazos JE, Reder AT, Sufit R, Simuni T, Holmes GL, Siderowf A, Wojna V, Bode R, McKinney N, Podrabsky T, Wortman K, Choi S, Gershon R, Rothrock N, Moy C. Neuro-QOL: brief measures of health-related quality of life for clinical research in neurology. Neurology 2012; 78:1860-7. [PMID: 22573626 DOI: 10.1212/wnl.0b013e318258f744] [Citation(s) in RCA: 424] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To address the need for brief, reliable, valid, and standardized quality of life (QOL) assessment applicable across neurologic conditions. METHODS Drawing from larger calibrated item banks, we developed short measures (8-9 items each) of 13 different QOL domains across physical, mental, and social health and evaluated their validity and reliability. Three samples were utilized during short form development: general population (Internet-based, n = 2,113); clinical panel (Internet-based, n = 553); and clinical outpatient (clinic-based, n = 581). All short forms are expressed as T scores with a mean of 50 and SD of 10. RESULTS Internal consistency (Cronbach α) of the 13 short forms ranged from 0.85 to 0.97. Correlations between short form and full-length item bank scores ranged from 0.88 to 0.99 (0.82-0.96 after removing common items from banks). Online respondents were asked whether they had any of 19 different chronic health conditions, and whether or not those reported conditions interfered with ability to function normally. All short forms, across physical, mental, and social health, were able to separate people who reported no health condition from those who reported 1-2 or 3 or more. In addition, scores on all 13 domains were worse for people who acknowledged being limited by the health conditions they reported, compared to those who reported conditions but were not limited by them. CONCLUSION These 13 brief measures of self-reported QOL are reliable and show preliminary evidence of concurrent validity inasmuch as they differentiate people based upon number of reported health conditions and whether those reported conditions impede normal function.
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Affiliation(s)
- D Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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