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Ressing M, Becker C, Müller C, Mahmoudpour SH, Calaminus G, Langer T, Erdmann F, Voigt M, Kaiser M, Kaatsch P, Blettner M, Spix C. Equivalent doses for anticancer agents used in pediatric oncology: A literature review and evaluation of a novel approach for conversion factors. Cancer Rep (Hoboken) 2023; 6:e1811. [PMID: 36975206 PMCID: PMC10172172 DOI: 10.1002/cnr2.1811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/27/2023] [Accepted: 02/24/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Epidemiological research on late effects of therapy shows the necessity to aggregate chemotherapy agents to substance classes. This requires using conversion factors by substance classes. AIMS The aim of this study was to identify previously used conversion factors from the literature, to present a novel approach for additional factors, and to compare these approaches. METHODS AND RESULTS A literature review was performed, which identified two main principles of deriving conversion factors: effect-equivalence and equimolar. Thirty-five articles presenting effect equivalence-based factors in the widest sense were found in the literature. Ten articles presented the equimolar approach which can be applied to almost all chemotherapy substances. Based on a comprehensive list of treatment protocols used in German pediatric oncology, we derived alternative conversion factors from typical doses. We compared the conversion factors using Pearson correlation coefficients and linear regression. At least two types of conversion factor were available for each of the 49 substances included. The equivalent effect-based and the typical dose-based factors were highly correlated with a regression coefficient close to 1. The equimolar factors are independent. CONCLUSIONS For substances for which no conversion factor based on some type of effect equivalence has been published so far, a factor based on a typical doses-approach may be used in epidemiological late effects research. Doses aggregated based on the equimolar approach may not be compatible with doses aggregated based on equivalent effects.
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Affiliation(s)
- Meike Ressing
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Cornelia Becker
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | | | - Seyed Hamidreza Mahmoudpour
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Gabriele Calaminus
- Department of Pediatric Hematology and OncologyUniversity Hospital BonnBonnGermany
| | - Thorsten Langer
- Pediatric Oncology and HematologyUniversity Hospital for Children and AdolescentsLübeckGermany
| | - Friederike Erdmann
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Mathias Voigt
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Melanie Kaiser
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Peter Kaatsch
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
| | - Claudia Spix
- German Childhood Cancer Registry (GCCR), Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)University Medical Center of the Johannes Gutenberg‐University MainzMainzGermany
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Howarth S, Quinton R, Mohammed A. Estradiol treatment in a large cohort of younger women with congenital hypogonadism: how much is enough? Clin Endocrinol (Oxf) 2023; 98:454-456. [PMID: 36342078 DOI: 10.1111/cen.14845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Sophie Howarth
- Translational & Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Richard Quinton
- Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals NHS Trust
- Translational & Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Azmi Mohammed
- Department of Endocrinology, Diabetes & Metabolism, County Durham & Darlington NHS Trust, Darlington, UK
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Ashique S, Gupta K, Gupta G, Mishra N, Singh S, Wadhwa S, Gulati M, Dureja H, Zacconi F, Oliver BG, Paudel KR, Hansbro PM, Chellappan DK, Dua K. Vitamin D-A prominent immunomodulator to prevent COVID-19 infection. Int J Rheum Dis 2023; 26:13-30. [PMID: 36308699 PMCID: PMC9874620 DOI: 10.1111/1756-185x.14477] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 06/23/2022] [Revised: 09/15/2022] [Accepted: 10/07/2022] [Indexed: 01/27/2023]
Abstract
COVID-19 remains a life-threatening infectious disease worldwide. Several bio-active agents have been tested and evaluated in an effort to contain this disease. Unfortunately, none of the therapies have been successful, owing to their safety concerns and the presence of various adverse effects. Various countries have developed vaccines as a preventive measure; however, they have not been widely accepted as effective strategies. The virus has proven to be exceedingly contagious and lethal, so finding an effective treatment strategy has been a top priority in medical research. The significance of vitamin D in influencing many components of the innate and adaptive immune systems is examined in this study. This review aims to summarize the research on the use of vitamin D for COVID-19 treatment and prevention. Vitamin D supplementation has now become an efficient option to boost the immune response for all ages in preventing the spread of infection. Vitamin D is an immunomodulator that treats infected lung tissue by improving innate and adaptive immune responses and downregulating the inflammatory cascades. The preventive action exerted by vitamin D supplementation (at a specific dose) has been accepted by several observational research investigations and clinical trials on the avoidance of viral and acute respiratory dysfunctions. To assess the existing consensus about vitamin D supplementation as a strategy to treat and prevent the development and progression of COVID-19 disease, this review intends to synthesize the evidence around vitamin D in relation to COVID-19 infection.
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Affiliation(s)
- Sumel Ashique
- Department of PharmaceuticsBharat Institute of Technology (BIT), School of PharmacyMeerutIndia
| | - Kirti Gupta
- Department of Pharmacology, MM College of PharmacyMaharishi Markandeshwar (Deemed to be) UniversityAmbalaIndia
| | - Gaurav Gupta
- School of PharmacySuresh Gyan Vihar UniversityJaipurIndia,Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical SciencesSaveetha UniversityChennaiIndia,Uttaranchal Institute of Pharmaceutical SciencesUttaranchal UniversityDehradunIndia
| | - Neeraj Mishra
- Department of Pharmaceutics, Amity Institute of PharmacyAmity University Madhya Pradesh (AUMP)GwaliorIndia
| | - Sachin Kumar Singh
- School of Pharmaceutical SciencesLovely Professional UniversityJalandharIndia,Faculty of Health, Australian Research Centre in Complementary and Integrative MedicineUniversity of Technology SydneyNew South WalesUltimoAustralia
| | - Sheetu Wadhwa
- School of Pharmaceutical SciencesLovely Professional UniversityJalandharIndia
| | - Monica Gulati
- School of Pharmaceutical SciencesLovely Professional UniversityJalandharIndia
| | - Harish Dureja
- Department of Pharmaceutical SciencesMaharshi Dayanand UniversityRohtakIndia
| | - Flavia Zacconi
- Facultad de Química y de FarmaciaPontificia Universidad Católica de ChileSantiagoChile,Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
| | - Brian G. Oliver
- Woolcock Institute of Medical ResearchUniversity of SydneyNew South WalesSydneyAustralia,School of Life Sciences, Faculty of ScienceUniversity of Technology Sydney2007New South WalesSydneyAustralia
| | - Keshav Raj Paudel
- Centre for InflammationCentenary Institute and University of Technology Sydney, Faculty of Science, School of Life SciencesNew South WalesSydneyAustralia
| | - Philip M. Hansbro
- Centre for InflammationCentenary Institute and University of Technology Sydney, Faculty of Science, School of Life SciencesNew South WalesSydneyAustralia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of PharmacyInternational Medical UniversityKuala LumpurMalaysia
| | - Kamal Dua
- School of Life Sciences, Faculty of ScienceUniversity of Technology Sydney2007New South WalesSydneyAustralia,Discipline of Pharmacy, Graduate School of HealthUniversity of Technology SydneyNew South WalesSydneyAustralia
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Steffen R, Schmitt HJ, Zavadska D. Tick-borne encephalitis vaccine-a wave of news. J Travel Med 2022; 29:6541144. [PMID: 35238909 DOI: 10.1093/jtm/taac030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/26/2022] [Indexed: 11/13/2022]
Abstract
Tick-borne encephalitis vaccine efficacy approximates 90% after the initial two doses, but the duration of protection is unknown. Emerging evidence indicates that vaccine effectiveness does not depend on the seropersistence of antibodies but on the boostability. Thus, conventional recommendations with booster doses every 3 or 5 years need to be reconsidered.
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Affiliation(s)
- Robert Steffen
- Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Traveller's Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich CH-8001, Switzerland.,Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX 77010, USA
| | - Heinz-Josef Schmitt
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, University of Cologne, Cologne D-50937, Germany
| | - Dace Zavadska
- Department of Paediatrics, Rigas Stradiņa Universitate, Children's Clinical University Hospital, Riga LV-1007, Latvia
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Doroftei B, Ilie OD, Anton N, Timofte SI, Ilea C. Mathematical Modeling to Predict COVID-19 Infection and Vaccination Trends. J Clin Med 2022; 11:jcm11061737. [PMID: 35330062 PMCID: PMC8956009 DOI: 10.3390/jcm11061737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background: COVID-19 caused by the Severe Acute Respiratory Syndrome Coronavirus 2 placed the health systems around the entire world in a battle against the clock. While most of the existing studies aimed at forecasting the infections trends, our study focuses on vaccination trend(s). Material and methods: Based on these considerations, we used standard analyses and ARIMA modeling to predict possible scenarios in Romania, the second-lowest country regarding vaccinations from the entire European Union. Results: With approximately 16 million doses of vaccine against COVID-19 administered, 7,791,250 individuals had completed the vaccination scheme. From the total, 5,058,908 choose Pfizer−BioNTech, 399,327 Moderna, 419,037 AstraZeneca, and 1,913,978 Johnson & Johnson. With a cumulative 2147 local and 17,542 general adverse reactions, the most numerous were reported in recipients of Pfizer−BioNTech (1581 vs. 8451), followed by AstraZeneca (138 vs. 6033), Moderna (332 vs. 1936), and Johnson & Johnson (96 vs. 1122). On three distinct occasions have been reported >50,000 individuals who received the first or second dose of a vaccine and >30,000 of a booster dose in a single day. Due to high reactogenicity in case of AZD1222, and time of launching between the Pfizer−BioNTech and Moderna vaccine could be explained differences in terms doses administered. Furthermore, ARIMA(1,1,0), ARIMA(1,1,1), ARIMA(0,2,0), ARIMA(2,1,0), ARIMA(1,2,2), ARI-MA(2,2,2), ARIMA(0,2,2), ARIMA(2,2,2), ARIMA(1,1,2), ARIMA(2,2,2), ARIMA(2,1,1), ARIMA(2,2,1), and ARIMA (2,0,2) for all twelve months and in total fitted the best models. These were regarded according to the lowest MAPE, p-value (p < 0.05, p < 0.01, and p < 0.001) and through the Ljung−Box test (p < 0.05, p < 0.01, and p < 0.001) for autocorrelations. Conclusions: Statistical modeling and mathematical analyses are suitable not only for forecasting the infection trends but the course of a vaccination rate as well.
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Affiliation(s)
- Bogdan Doroftei
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (B.D.); (N.A.); (C.I.)
| | - Ovidiu-Dumitru Ilie
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, No. 20A, 700505 Iasi, Romania;
- Correspondence:
| | - Nicoleta Anton
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (B.D.); (N.A.); (C.I.)
| | - Sergiu-Ioan Timofte
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, No. 20A, 700505 Iasi, Romania;
| | - Ciprian Ilea
- Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No. 16, 700115 Iasi, Romania; (B.D.); (N.A.); (C.I.)
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Wu Q, Liu M, Fang Z, Li C, Zou F, Hu L, Zhang W. Efficacy and safety of empagliflozin at different doses in patients with type 2 diabetes mellitus: A network meta-analysis based on randomized controlled trials. J Clin Pharm Ther 2021; 47:270-286. [PMID: 34544199 DOI: 10.1111/jcpt.13521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/07/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE As an oral hypoglycaemic drug that significantly reduces cardiovascular risk, empagliflozin is often used in patients with type 2 diabetes mellitus (T2DM). However, the dosage and administration of empagliflozin are still controversial clinically. To determine the most appropriate dose, we performed this network meta-analysis. METHODS We identified randomized controlled trials (RCTs) about empagliflozin from eight databases. We analysed the pharmacodynamics, adverse effects (AEs), and pharmacokinetics of empagliflozin at different doses. RESULTS We identified 8264 articles, of which 23 RCTs with 10518 patients were included. Regarding haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG), high-daily doses (10, 25, 50 mg) were significantly better than low doses (1, 2.5, 5 mg). For total AEs, there was a dose-response trend in which safety decreased with increasing doses. According to SUCRA sequencing, the order for lowering HbA1c was 25 > 50 > 10 > 5 > 1 mg, for lowering FPG was 50 > 25 > 10 > 5 > 2.5 > 1 mg and for safety was 1> 5 > 10 > 25> 2.5 > 50 mg. When considering HbA1c, FPG and total AEs, we performed a hierarchical cluster analysis and network meta-analysis to find that 25 mg performed best among different doses, which was more significant after long-term use (≥ 12 weeks). Pharmacokinetic parameters exhibited significant dose-response relationships. WHAT IS NEW AND CONCLUSION High-daily doses (10, 25, 50 mg) had better efficacy than low doses (1, 2.5, 5 mg). When considering HbA1c, FPG and total AEs, 25 mg performed best among the different doses in patients with T2DM.
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Affiliation(s)
- Qian Wu
- Department of Endocrinology, The second affiliated hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Miaowen Liu
- Department of Endocrinology, The second affiliated hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Zige Fang
- Department of Endocrinology, The second affiliated hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Chenxi Li
- Department of Endocrinology, The second affiliated hospital of Nanchang University, Nanchang, China
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Fang Zou
- Department of Endocrinology, The second affiliated hospital of Nanchang University, Nanchang, China
| | - Lei Hu
- Department of Endocrinology, The second affiliated hospital of Nanchang University, Nanchang, China
| | - Wenxiong Zhang
- Department of Cardio-Thoracic Surgery, The second affiliated hospital of Nanchang University, Nanchang, China
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Fernández-Miranda JJ, Díaz-Fernández S, López-Muñoz F. Adherence, Tolerability and Effective Doses of Aripiprazole Once-monthly in the Long-term Treatment of Patients with Severe Schizophrenia. Curr Pharm Des 2021; 27:4078-4085. [PMID: 34218772 DOI: 10.2174/1381612827666210701160013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/27/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The evaluation of long-term effectiveness and tolerability of Aripiprazole Once-monthly (AOM) is yet scarce, and severely ill patients have not been specifically studied. OBJECTIVE The aim of the study was to explore the long-term adherence, effectiveness and tolerability of AOM in the treatment of patients with severe (Clinical Global Impression-Severity, CGI-S ≥ 5) schizophrenia, and whether high-dose therapy may benefit patients inadequately controlled on standard doses. METHOD Six-year mirror-image study, with 36-month prospective follow-up, was conducted on patients with severe schizophrenia who underwent treatment with AOM (n = 60). Assessment included the CGI-S, the WHO Disability Assessment Schedule (WHO-DAS), the Medication Adherence Report Scale (MARS), laboratory tests, and weight and adverse effects reported. Reasons for treatment discontinuation, hospital admissions and psychiatric medications in the previous three years and during the follow-up were recorded. RESULTS The average dose was found to be 780 (120) mg/28 days. Tolerability was good, with few side effects or biological parameters alterations reported. There were three discharges due to adverse effects, two due to lack of effectiveness and one treatment abandoning. Weight and prolactin levels were found to be decreased. CGI-S and WHO-DAS decreased (p < 0.001), and MARS increased (p < 0.001). There were less treatment abandoning, hospital admissions (p < 0.0001) and concomitant medication (p<0.01) than during the previous 36 months. CONCLUSION Treatment adherence and tolerability of AOM were found to be remarkable, even in those patients on high doses. AOM showed effectiveness in patients with severe schizophrenia, who recorded less hospitalizations and clinical severity and disability, although a considerable percentage of them needed higher doses than labeled.
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Affiliation(s)
| | - Silvia Díaz-Fernández
- Asturian Mental Health Service Área V - Servicio de Salud del Principado de Asturias (SESPA), Gijón, Spain
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Mercadante S, Maltoni M, Russo D, Adile C, Ferrera P, Rossi R, Rosati M, Casuccio A. The Prevalence and Characteristics of Breakthrough Cancer Pain in Patients Receiving Low Doses of Opioids for Background Pain. Cancers (Basel) 2021; 13:cancers13051058. [PMID: 33801478 PMCID: PMC7958843 DOI: 10.3390/cancers13051058] [Citation(s) in RCA: 7] [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] [Received: 12/28/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary The aim of this study was to assess the prevalence and characteristics of breakthrough cancer pain (BTcP) in patients receiving low doses of opioids for background pain. This prospective study showed that in this population, BTcP prevalence was 69.8%. Many patients did not achieve a sufficient level of satisfaction with BTcP medications, particularly with oral morphine. Data also suggest that better optimization of background analgesia, though apparently acceptable, may limit the number of BTcP episodes. Abstract The aim of this study was to assess the prevalence and characteristics of breakthrough cancer pain (BTcP) in patients receiving low doses of opioids for background pain. A consecutive sample of advanced cancer patients receiving less than 60 mg/day of oral morphine equivalent (OME) was selected. Epidemiological data, background pain intensity, and current analgesic therapy were recorded. The presence of BTcP was diagnosed according to a standard algorithm. The number of BTcP episodes, intensity of BTcP, its predictability and triggers, onset duration, interference with daily activities, BTcP medications, satisfaction with BTcP medication, and time to meaningful pain relief were collected. A total of 126 patients were screened. The mean intensity of background pain was 2.71 (1.57), and the mean OME was 28.5 mg/day (SD15.8). BTP episodes were recorded in 88 patients (69.8%). The mean number/day of BTP episodes was 4.1 (SD 7.1, range 1–30). In a significant percentage of patients, BTcP was both predictable and unpredictable (23%). The BTcP onset was less than 20 min in the majority of patients. The mean duration of untreated episodes was 47.5 (SD 47.6) minutes. The mean time to meaningful pain relief after taking a BTcP medication was >20 min in 44.5% of patients. The efficacy of BTcP medication was not considered good in more than 63% of patients. Gender (females) (OR = 4.16) and lower Karnofsky (OR = 0.92) were independently associated with BTcP. A higher number of BTcP episodes/day was associated with gender (females) (p = 0.036), short duration of BTcP (p = 0.005), poorer efficacy of BTcP medication (none or mild) (p = 0.001), and late meaningful pain relief (p = 0.024). The poor efficacy of BTcP medication was independently associated with a higher number of episodes/day (OR = 0.22). In patients who were receiving low doses of opioids, BTcP prevalence was 69.8%. Many patients did not achieve a sufficient level of satisfaction with BTcP medications, particularly with oral morphine. Data also suggest that better optimization of background analgesia, though apparently acceptable, may limit the number of BTcP episodes.
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Affiliation(s)
- Sebastiano Mercadante
- Main Regional Center for Pain Relief and Supportive/Palliative Care, La Maddalena Cancer Center, 90146 Palermo, Italy; (C.A.); (P.F.)
- Correspondence:
| | - Marco Maltoni
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.M.); (R.R.); (M.R.)
| | - Domenico Russo
- Hospice and the Palliative Care Service, Clinica San Marco, 04100 Latina, Italy;
| | - Claudio Adile
- Main Regional Center for Pain Relief and Supportive/Palliative Care, La Maddalena Cancer Center, 90146 Palermo, Italy; (C.A.); (P.F.)
| | - Patrizia Ferrera
- Main Regional Center for Pain Relief and Supportive/Palliative Care, La Maddalena Cancer Center, 90146 Palermo, Italy; (C.A.); (P.F.)
| | - Romina Rossi
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.M.); (R.R.); (M.R.)
| | - Marta Rosati
- Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy; (M.M.); (R.R.); (M.R.)
| | - Alessandra Casuccio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy;
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Johnson TN, Abduljalil K, Nicolas JM, Muglia P, Chanteux H, Nicolai J, Gillent E, Cornet M, Sciberras D. Use of a physiologically based pharmacokinetic-pharmacodynamic model for initial dose prediction and escalation during a paediatric clinical trial. Br J Clin Pharmacol 2020; 87:1378-1389. [PMID: 32822519 DOI: 10.1111/bcp.14528] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/31/2020] [Accepted: 08/07/2020] [Indexed: 11/29/2022] Open
Abstract
AIMS To build and verify a physiologically based pharmacokinetic (PBPK) model for radiprodil in adults and link this to a pharmacodynamic (PD) receptor occupancy (RO) model derived from in vitro data. Adapt this model to the paediatric population and predict starting and escalating doses in infants based on RO. Use the model to guide individualized dosing in a clinical trial in 2- to 14-month-old children with infantile spasms. METHODS A PBPK model for radiprodil was developed to investigate the systemic exposure of the drug after oral administration in fasted and fed adults; this was then linked to RO via a PD model. The model was then expanded to include developmental physiology and ontogeny to predict escalating doses in infants that would result in a specific RO of 20, 40 and 60% based on average unbound concentration following a twice daily (b.i.d.) dosing regimen. Dose progression in the clinical trial was based on observed concentration-time data against PBPK predictions. RESULTS For paediatric predictions, the elimination of radiprodil, based on experimental evidence, had no ontogeny. Predicted b.i.d. doses ranged from 0.04 mg/kg for 20% RO, 0.1 mg/kg for 40% RO to 0.21 mg/kg for 60% RO. For all infants recruited in the study, observed concentration-time data following the 0.04 mg/kg and subsequent doses were within the PBPK model predicted 5th and 95th percentiles. CONCLUSION To our knowledge, this is the first time a PBPK model linked to RO has been used to guide dose selection and escalation in the live phase of a paediatric clinical trial.
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Munir N, Mahmood Z, Yameen M, Mustafa G. Therapeutic Response of Epimedium gandiflorum's Different Doses to Restore the Antioxidant Potential and Reproductive Hormones in Male Albino Rats. Dose Response 2020; 18:1559325820959563. [PMID: 32973420 PMCID: PMC7493261 DOI: 10.1177/1559325820959563] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
Current study was planned to explore the therapeutic response of different doses of hydroethanolic extract of Epimedium grandiflorum leaves in male albino rats. Phytochemical analysis, HPLC and FTIR spectroscopy results revealed the presence of wide range of phenolic compounds and functional groups, respectively. Further, extract not induced significant hemolysis (7.56 ± 1.297%) against PBS (3.65 ± 0.35%) as negative control; while have significant clot lysis (44 ± 5.2%) potential, exhibited DPPH (78.87 ± 5.427%) scavenging, H2O2 (31.82 ± 3.491%) scavenging, antioxidant and reducing power activities. In vivo experimentation in albino male rats' revealed that administration of different doses (50, 100, 200 mg/Kg b.w.) of extract orally for 42 days after CCl4 intoxication significantly (P < 0.05) restore the selected parameters including liver enzymes, renal profiles, and stress markers and significantly (P < 0.05) increased reproductive hormones like testosterone, luteinizing hormone, follicle stimulating hormone and prolactin while significantly (P < 0.05) decreased progesterone and estradiol toward normal in dose dependent manner. Significant (P < 0.05) improvement in the structural architecture of testicular tissue particularly in high dose group (200 mg/Kg b.w.) was also observed. Results revealed E. grandiflorum has significant therapeutic response to address the healthcare problems particularly of impotency.
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Affiliation(s)
- Naveed Munir
- Department of Biochemistry, Government College University Faisalabad, Punjab, Pakistan
| | - Zahed Mahmood
- Department of Biochemistry, Government College University Faisalabad, Punjab, Pakistan
| | - Muhammad Yameen
- Department of Biochemistry, Government College University Faisalabad, Punjab, Pakistan
| | - Ghulam Mustafa
- Department of Biochemistry, Government College University Faisalabad, Punjab, Pakistan
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11
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López-Moreno A, Suárez A, Avanzi C, Monteoliva-Sánchez M, Aguilera M. Probiotic Strains and Intervention Total Doses for Modulating Obesity-Related Microbiota Dysbiosis: A Systematic Review and Meta-analysis. Nutrients 2020; 12:E1921. [PMID: 32610476 PMCID: PMC7400323 DOI: 10.3390/nu12071921] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 05/26/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a growing health threat worldwide. Administration of probiotics in obesity has also parallelly increased but without any protocolization. We conducted a systematic review exploring the administration pattern of probiotic strains and effective doses for obesity-related disorders according to their capacity of positively modulating key biomarkers and microbiota dysbiosis. Manuscripts targeting probiotic strains and doses administered for obesity-related disorders in clinical studies were sought. MEDLINE, Scopus, Web of Science, and Cochrane Library databases were searched using keywords during the last fifteen years up to April 2020. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. From 549 interventional reports identified, we filtered 171 eligible studies, from which 24 full-text assays were used for calculating intervention total doses (ITD) of specific species and strains administered. Nine of these reports were excluded in the second-step because no specific data on gut microbiota modulation was found. Six clinical trials (CT) and 9 animal clinical studies were retained for analysis of complete outcome prioritized (body mass index (BMI), adiposity parameters, glucose, and plasma lipid biomarkers, and gut hormones). Lactobacillus spp. administered were double compared to Bifidobacterium spp.; Lactobacillus as single or multispecies formulations whereas most Bifidobacteria only through multispecies supplementations. Differential factors were estimated from obese populations' vs. obesity-induced animals: ITD ratio of 2 × 106 CFU and patterns of administrations of 11.3 weeks to 5.5 weeks, respectively. Estimation of overall probiotics impact from selected CT was performed through a random-effects model to pool effect sizes. Comparisons showed a positive association between the probiotics group vs. placebo on the reduction of BMI, total cholesterol, leptin, and adiponectin. Moreover, negative estimation appeared for glucose (FPG) and CRP. While clinical trials including data for positive modulatory microbiota capacities suggested that high doses of common single and multispecies of Lactobacillus and Bifidobacterium ameliorated key obesity-related parameters, the major limitation was the high variability between studies and lack of standardized protocols. Efforts in solving this problem and searching for next-generation probiotics for obesity-related diseases would highly improve the rational use of probiotics.
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Affiliation(s)
- Ana López-Moreno
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
| | - Antonio Suárez
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
| | - Camila Avanzi
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
| | - Mercedes Monteoliva-Sánchez
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
| | - Margarita Aguilera
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain; (C.A.); (M.M.-S.)
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada Armilla, 18016 Granada, Spain;
- IBS: Instituto de Investigación Biosanitaria ibs., 18012 Granada, Spain
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12
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Colindres R, Wascotte V, Brecx A, Clarke C, Hervé C, Kim JH, Levin MJ, Oostvogels L, Zahaf T, Schuind A, Cunningham AL. Post hoc analysis of reactogenicity trends between dose 1 and dose 2 of the adjuvanted recombinant zoster vaccine in two parallel randomized trials. Hum Vaccin Immunother 2020; 16:2628-2633. [PMID: 32347767 PMCID: PMC7733973 DOI: 10.1080/21645515.2020.1741312] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
In two large clinical trials (ZOE-50 [NCT01165177] and ZOE-70 [NCT01165229]), two doses of the adjuvanted recombinant zoster vaccine (RZV) demonstrated >90% efficacy against herpes zoster in adults ≥50 years of age. Solicited adverse events (AEs) were collected for 7 days post-each dose in a study sub-cohort. The incidence of reported solicited AEs was higher for RZV compared to placebo recipients. Since reactogenicity may contribute to a person's willingness to be vaccinated, knowing about expected reactogenicity might help keep high compliance with the second dose. This post hoc analysis assessed the intensity of solicited AEs post-dose 2 reported to the same event's intensity post-dose 1. Intensity was graded from 0 to 3, grade 3 indicating the highest severity. Of the vaccinees who did not experience a specific AE post-dose 1, 72.6-91.7% did not experience the same event after dose 2. Although the frequency of grade 3 AEs post-dose 2 was the highest in participants reporting the same AEs at grade 3 post-dose 1, 65.8-89.3% of vaccinees with grade 3 specific AEs post-dose 1 reported the same AEs at lower intensity post-dose 2. These data can help inform health-care professionals about the frequency and intensity of AEs post-dose 2 with respect to post-dose 1.
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Affiliation(s)
- Romulo Colindres
- GSK , Rockville, MD, USA.,independent Biotech and Vaccines Consultant
| | | | | | | | | | | | - Myron J Levin
- Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus , Aurora, CO, USA
| | | | | | | | - Anthony L Cunningham
- The Westmead Institute for Medical Research, University of Sydney , Sydney, Australia
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López-Moreno A, Aguilera M. Probiotics Dietary Supplementation for Modulating Endocrine and Fertility Microbiota Dysbiosis. Nutrients 2020; 12:E757. [PMID: 32182980 PMCID: PMC7146451 DOI: 10.3390/nu12030757] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 02/12/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022] Open
Abstract
Human microbiota seems to play a key role in endocrine and reproductive systems. Fortunately, microbiota reproductive dysbiosis start to be treated by probiotics using typical species from genus Lactobacillus. This work presents the compiled and analysed results from the most up-to-date information from clinical trials regarding microbiota, fertility, probiotics and oral route administration, reviewing open access scientific documents. These studies analyse the clinical impact of probiotics administered on several endocrine disorders' manifestations in women: mastitis; vaginal dysbiosis; pregnancy complication disorders; and polycystic ovary syndrome. In all cases, the clinical modulation achieved by probiotics was evaluated positively through the improvement of specific disease outcomes with the exception of the pregnancy disorders studies, where the sample sizes results were statistically insufficient. High amounts of studies were discarded because no data were provided on specific probiotic strains, doses, impact on the individual autochthon microbiota, or data regarding specific hormonal values modifications and endocrine regulation effects. However, most of the selected studies with probiotics contained no protocolised administration. Therefore, we consider that intervention studies with probiotics might allocate the focus, not only in obtaining a final outcome, but in how to personalise the administration according to the disorder to be palliated.
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Affiliation(s)
- Ana López-Moreno
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, 18016 Armilla, Granada, Spain
| | - Margarita Aguilera
- Department of Microbiology, Faculty of Pharmacy, University of Granada, Campus of Cartuja, 18071 Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada, 18016 Armilla, Granada, Spain
- IBS: Instituto de Investigación Biosanitaria ibs., 18012 Granada, Spain
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14
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Alur-Gupta S, Cooney LG, Senapati S, Sammel MD, Barnhart KT. Two-dose versus single-dose methotrexate for treatment of ectopic pregnancy: a meta-analysis. Am J Obstet Gynecol 2019; 221:95-108.e2. [PMID: 30629908 DOI: 10.1016/j.ajog.2019.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 10/31/2018] [Revised: 12/18/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To compare the treatment success and failure rates, as well as side effects and surgery rates, between methotrexate protocols. DATA SOURCES PubMed, Embase, and the Cochrane library searched up to July 2018. STUDY ELIGIBILITY CRITERIA Randomized controlled trials that compared women with ectopic pregnancies receiving the single-dose, two-dose, or multi-dose methotrexate protocols. STUDY APPRAISAL AND SYNTHESIS METHODS Odds of treatment success, treatment failure, side effects, and surgery for tubal rupture, as well as length of follow-up until treatment success, were compared using random and fixed effects meta-analysis. Sensitivity analyses compared treatment success in the groups with high human chorionic gonadatropin (hCG) values and a large adnexal mass, as defined by individual studies. The Cochrane Collaboration tool was used to assess risk of bias. RESULTS The 2-dose protocol was associated with higher treatment success compared to the single-dose protocol (odds ratio [OR], 1.84; 95% CI, 1.13, 3.00). The 2-dose protocol was more successful in women with high hCG (OR, 3.23; 95% CI, 1.53, 6.84) and in women with a large adnexal mass (OR, 2.93; 95% CI, 1.23, 6.9). The odds of surgery for tubal rupture were lower in the 2-dose protocol (OR, 0.65; 95% CI, 0.26, 1.63), but this was not statistically significant. The length of follow-up was 7.9 days shorter for the 2-dose protocol (95% CI, -12.2, -3.5). The odds of side effects were higher in the 2-dose protocol (OR, 1.53; 95% CI, 1.01, 2.30). Compared to the single-dose protocol, the multi-dose protocol was associated with a nonsignificant reduction in treatment failure (OR, 0.56; 95% CI, 0.28, 1.13) and a higher chance of side effects (OR, 2.10; 95% CI, 1.24, 3.54). The odds of surgery for tubal rupture (OR, 1.62; 95% CI, 0.41, 6.49) and time to follow-up (OR, -1.3; 95% CI, -5.4, 2.7) were similar. CONCLUSION The 2-dose methotrexate protocol is superior to the single-dose protocol for the treatment of ectopic pregnancy in terms of treatment success and time to success. Importantly, these findings hold true in patients thought to be at a lower likelihood of responding to medical management, such as those with higher hCGs and a large adnexal mass.
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Affiliation(s)
- Snigdha Alur-Gupta
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, PA.
| | - Laura G Cooney
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, PA
| | - Suneeta Senapati
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, PA
| | - Mary D Sammel
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
| | - Kurt T Barnhart
- Division of Reproductive Endocrinology and Infertility, University of Pennsylvania, Philadelphia, PA
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15
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Cieplińska K, Gajęcka M, Dąbrowski M, Rykaczewska A, Lisieska-Żołnierczyk S, Bulińska M, Zielonka Ł, Gajęcki MT. Time-Dependent Changes in the Intestinal Microbiome of Gilts Exposed to Low Zearalenone Doses. Toxins (Basel) 2019; 11:E296. [PMID: 31137638 PMCID: PMC6563319 DOI: 10.3390/toxins11050296] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 03/26/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/14/2022] Open
Abstract
Zearalenone is a frequent contaminant of cereals and their by-products in regions with a temperate climate. This toxic molecule is produced naturally by Fusarium fungi in crops. The aim of this study was to determine the influence of low zearalenone doses (LOAEL, NOAEL and MABEL) on the intestinal microbiome of gilts on different days of exposure (days 7, 21 and 42). Intestinal contents were sampled from the duodenal cap, the third part of the duodenum, jejunum, caecum and the descending colon. The experiment was performed on 60 clinically healthy gilts with average BW of 14.5 ± 2 kg, divided into three experimental groups and a control group. Group ZEN5 animals were orally administered ZEN at 5 μg /kg BW, group ZEN10-10 μg ZEN/kg BW and group ZEN15-15 µg ZEN/kg BW. Five gilts from every group were euthanized on analytical dates 1, 2 and 3. Differences in the log values of microbial counts, mainly Escherichia coli and Enterococcus faecalis, were observed between the proximal and distal segments of the intestinal tract on different analytical dates as well as in the entire intestinal tract. Zearalenone affected the colony counts of intestinal microbiota rather than microbiome diversity, and its effect was greatest in groups ZEN10 and ZEN15. Microbial colony counts were similar in groups ZEN5 and C. In the analysed mycobiome, ZEN exerted a stimulatory effect on the log values of yeast and mould counts in all intestinal segments, in particular in the colon, and the greatest increase was noted on the first analytical date.
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Affiliation(s)
- Katarzyna Cieplińska
- Microbiology Laboratory, Non-Public Health Care Centre, Limanowskiego 31A, 10-342 Olsztyn, Poland.
| | - Magdalena Gajęcka
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Michał Dąbrowski
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Anna Rykaczewska
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Sylwia Lisieska-Żołnierczyk
- Independent Public Health Care Centre of the Ministry of the Interior and Administration, and the Warmia and Mazury Oncology Centre in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland.
| | - Maria Bulińska
- Department of Discrete Mathematics and Theoretical Computer Science, Faculty of Mathematics and Computer Science, University of Warmia and Mazury in Olsztyn, Słoneczna 34, 10-710 Olsztyn, Poland.
| | - Łukasz Zielonka
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Maciej T Gajęcki
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
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16
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Cieplińska K, Gajęcka M, Nowak A, Dąbrowski M, Zielonka Ł, Gajęcki MT. The Genotoxicity of Caecal Water in Gilts Exposed to Low Doses of Zearalenone. Toxins (Basel) 2018; 10:E350. [PMID: 30200392 PMCID: PMC6162682 DOI: 10.3390/toxins10090350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/22/2018] [Accepted: 08/28/2018] [Indexed: 12/30/2022] Open
Abstract
Zearalenone is a toxic low-molecular-weight molecule that is naturally produced by moulds on crops as a secondary metabolite. The aim of this study was to determine the genotoxicity of caecal water collected successively from the caecal contents of gilts exposed to low doses (LOAEL, NOAEL, and MABEL) of zearalenone. The experiment was performed on 60 clinically healthy gilts with average BW of 14.5 ± 2 kg, divided into three experimental groups and a control group. Group ZEN5 were orally administered ZEN at 5 μg/kg BW, group ZEN10-10 μg ZEN/kg BW and group ZEN15-15 µg ZEN/kg BW. Five gilts from every group were euthanized on analytical dates 1, 2, and 3. Caecal water samples for in vitro analysis were collected from the ileocaecal region. The genotoxicity of caecal water was noted, particularly after date 1 in groups ZEN10 and ZEN15 with a decreasing trend. Electrophoresis revealed the presence of numerous comets without tails in groups C and ZEN5 and fewer comets with clearly expressed tails in groups ZEN10 and ZEN15. The distribution of LLC-PK1 cells ranged from 15% to 20% in groups C and ZEN5, and from 30% to 60% in groups ZEN10 and ZEN15. The analysis of caecal water genotoxicity during exposure to very low doses of ZEN revealed the presence of a counter response and a compensatory effect in gilts.
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Affiliation(s)
- Katarzyna Cieplińska
- Microbiology Laboratory, Non-Public Health Care Centre, ul. Limanowskiego 31A, 10-342 Olsztyn, Poland.
| | - Magdalena Gajęcka
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Adriana Nowak
- Institute of Fermentation Technology and Microbiology, Lodz University of Technology, 90-924 Lodz, Poland.
| | - Michał Dąbrowski
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Łukasz Zielonka
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
| | - Maciej T Gajęcki
- Department of Veterinary Prevention and Feed Hygiene, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego 13, 10-718 Olsztyn, Poland.
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Pasieka E. [Letter to the Editor (June 27, 2017) concerning the paper "Factors affecting exposure level for medical staff during orthopedic procedures under fluoroscopic control"]. Med Pr 2018; 69:109-111. [PMID: 29063913 DOI: 10.13075/mp.5893.00660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Ewa Pasieka
- Uniwersytecki Szpital Kliniczny w Białymstoku / University Clinical Hospital in Bialystok, Białystok, Poland (Pełnomocnik do spraw Systemu Zarządzania Jakością w obszarze radiologii i medycyny nuklearnej / Management representative for quality in radiology and nuclear medicine).
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18
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Staniszewska MA, Kopeć R, Budzanowski M, Owsiak E. [Authors response (October 15, 2017) to the letter to the Editor concerning the paper "Factors affecting exposure level for medical staff during orthopedic procedures under fluoroscopic control"]. Med Pr 2018; 69:113-114. [PMID: 29148547 DOI: 10.13075/mp.5893.00704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Maria A Staniszewska
- Uniwersytet Medyczny w Łodzi / Medical University of Lodz, Łódź, Poland (Wydział Nauk Biomedycznych i Kształcenia Podyplomowego, Zakład Medycznych Technik Obrazowania / Faculty of Biomedical Sciences and Postgraduate Education, Department of Medical Imaging Techniques).
| | - Renata Kopeć
- Instytut Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry)
| | - Maciej Budzanowski
- Instytut Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry)
| | - Edyta Owsiak
- Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy - Central Veterans' Hospital, Łódź, Poland (Klinika Ortopedii, Traumatologii i Rehabilitacji Pourazowej / Clinic of Orthopedy, Traumatology and Traumatic Rehabilitation)
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19
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Abstract
BACKGROUND One of the numerous sub-areas of interventional radiology is the use of X-rays in gastroenterology. X-ray fluoroscopy is applied in therapeutic procedures, including endoscopic retrograde cholangiopancreatography (ERCP) that is frequently performed. The ERCP procedure is aimed at imaging the pancreatic duct and biliary tracts. MATERIAL AND METHODS In this paper radiation risk to the gastrenterologist performing ERCP procedures was investigated. The procedures were performed by a single gastroenterologist in the ERCP Laboratory, University Clinical Hospital Military Memorial Medical Academy - Central Veterans' Hospital in Łódź, Poland. The study comprised 2 series of measurements, one taken during the procedures with continuous fluoroscopy mode, the other during procedures with fluoroscopy in pulsed mode at a frequency of 3 pulses/s. Exposure parameters, anatomical data of patient and dose equivalents for the eyes, skin of the hand and the effective dose for whole body of the gastroenterologist were recorded during each procedure. RESULTS The collected data cover 70 ERCP procedures - 40 procedures were controlled by continuous fluoroscopy and 30 by pulsed fluoroscopy. The results reveal that pulsed fluoroscopy makes it possible to reduce doses received by the gastroeneterologist from 45% to 60% compared to continuous fluoroscopy. CONCLUSIONS Endoscopic retrograde cholangiopancreatography procedures can cause radiation risk to the gastroenterologist performing them. The use of continuous fluoroscopy can result in achieving an equivalent dose to eye lens nearly 20 mSv per year, i.e., the decreased annual limit recommended by the International Commission on Radiological Protection (ICRP). Med Pr 2017;68(6):735-741.
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Affiliation(s)
- Maria A Staniszewska
- Uniwersytet Medyczny w Łodzi / Medical University of Lodz, Łódź, Poland (Wydział Nauk Biomedycznych i Kształcenia Podyplomowego, Zakład Medycznych Technik Obrazowania / Faculty of Biomedical Sciences and Postgraduate Education, Department of Medical Imaging Techniques).
| | - Krzysztof Kujawski
- Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy - Central Veterans' Hospital, Łódź, Poland (Klinika Nefrologii, Nadciśnienia Tętniczego i Medycyny Rodzinnej / Clinic of Nephrology, Arterial Hypertension and Family Medicine).
| | - Renata Kopeć
- Instytut Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry).
| | - Krzysztof Sasak
- GE Medical Systems Polska Sp. z o.o. / GE Healthcare, Warszawa, Poland (Oddział Edukacji Klinicznej / Department of Clinical Education).
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20
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Ababu Y, Braka F, Teka A, Getachew K, Tadesse T, Michael Y, Birhanu Z, Nsubuga P, Assefa T, Gallagher K. Behavioral determinants of immunization service utilization in Ethiopia: a cross-sectional community-based survey. Pan Afr Med J 2017; 27:2. [PMID: 28983390 PMCID: PMC5619917 DOI: 10.11604/pamj.supp.2017.27.2.10635] [Citation(s) in RCA: 7] [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: 08/30/2016] [Accepted: 01/23/2017] [Indexed: 11/14/2022] Open
Abstract
Introduction According to the Ethiopian Health Sector Development Plan IV annual performance report (HSDP IV), Ethiopia targeted to reach 90% coverage with DPT-Hib-HepB 3 (Pentavalent3) vaccine and 86% coverage with measles vaccine in 2010- 2011. However, the actual performance fell-short of the intended targets due to several reasons. Therefore, a nationwide comprehensive study was conducted to examine the behavioral determinants of immunization practices in the Ethiopian context. The study employed the Modified Steps of Behavioral Change (SBC) Model as a theoretical lens. Methods A cross-sectional study was conducted in May 2012 in all the nine regions and the two city administrations of Ethiopia. The study used a community-based quantitative survey design comprising of multistage cluster sampling to draw relevant data from a sample of 2,328 caretakers whose children were 12-23 months of age at the time of data collection. Results Overall, the multivariate analysis findings revealed that caretakers, who had high knowledge were 2.24 times more likely to vaccinate their children than participants had low knowledge (OR= 2.24, 95%CI: 1.68-2.98). Participants who had high approval were 2.45 times more likely to vaccinate their children than participants who had unfavorable approval (OR= 2.45, 95%CI: 1.67-3.59); and participants who had high intention were 6.49 times more likely to vaccinate their children with pentavalent3 vaccines than participants who had low intention(OR= 6.49, 95%CI: 4.83-8). Also, it was clear from the regression analysis that aspects of caretakers' demographic characteristics were significant predictors of their immunization practice for the sample group. Conclusion We identified that caretakers' knowledge, approval, intention, parents' residence, and religious backgrounds were associated with immunization service utilization. To achieve sustainable behavioral change on immunization service utilization of the caretakers in Ethiopia, this study suggests investing in activities that enhance caretakers' knowledge, approval, intention, and practice components represented in the behavioral change model.
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Affiliation(s)
- Yohannes Ababu
- Immunization program, World Health Organization, Addis Ababa, Ethiopia
| | - Fiona Braka
- Immunization program, World Health Organization, Addis Ababa, Ethiopia
| | - Aschalew Teka
- Immunization program, World Health Organization, Addis Ababa, Ethiopia
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Owsiak E, Kopeć R, Budzanowski M, Staniszewska MA. [Occupational exposure in orthopedic procedures under fluoroscopic control]. Med Pr 2017; 68:221-227. [PMID: 28345682 DOI: 10.13075/mp.5893.00396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND In interventional radiology the highest radiation doses are usually recorded for both the medical staff and the patients. Interventional procedures with X-rays are implemented in a number of medical specializations. This paper concerns the exposure of interventional teams performing orthopedic procedures under X-rays control. MATERIAL AND METHODS Doses for interventional teams were measured in the 3 Łódź hospitals. Thermoluminescent dosemeters were applied to measure the following dose equivalents: Hp(3) for eye lens, Hp(0.07) for palm skin, Hp(10) at the level of the neck without a protective shield (i.e., collar) and Hp(10) for the whole body on the front surface of the trunk (measured under the protective apron at the level of the chest). RESULTS Doses for the operator who performs surgery, assisting physicians and scrub nurse were measured during 95 procedures. The highest doses were received by the operator the dose for eyes per 1 procedure did not exceed 0.1 mSv, the highest dose for hands was 1.6 mSv and the highest recorded effective dose was 0.02 mSv. CONCLUSIONS On the basis of the results of measurements and their comparison with the values reported in the literature it may be concluded that the obtained results fall within the published reference range (for non-vascular procedures). This proves the compatibility of practice in the monitored Łódź hospitals with routine methodology applied in other interventional departments. The measurement results confirm that the usage of thermoluminescent dosimetry is fully adequate for the evaluation of exposure in interventional radiology and that the usage of at least 2 dosemeters for that staff is necessary. Med Pr 2017;68(2):221-227.
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Affiliation(s)
- Edyta Owsiak
- Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy - Central Veterans' Hospital, Łódź, Poland (Klinika Ortopedii, Traumatologii i Rehabilitacji Pourazowej / Clinic of Orthopedy, Traumatology and Traumatic Rehabilitation)
| | - Renata Kopeć
- Instytutu Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry)
| | - Maciej Budzanowski
- Instytutu Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry)
| | - Maria A Staniszewska
- Uniwersytet Medyczny w Łodzi / Medical University of Lodz, Łódź, Poland (Wydział Nauk Biomedycznych i Kształcenia Podyplomowego, Zakład Medycznych Technik Obrazowania / Faculty of Biomedical Sciences and Postgraduate Education, Department of Medical Imaging Techniques).
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Staniszewska MA, Kopeć R, Budzanowski M, Owsiak E. [Factors affecting exposure level for medical staff during orthopedic procedures under fluoroscopic control]. Med Pr 2017; 68:75-83. [PMID: 28245005 DOI: 10.13075/mp.5893.00395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Extended control of staff exposure in interventional radiology has been legally required over the last few years. This is determined by a number of factors, including the type of procedure, technical conditions and methodology. In orthopedic procedures fluoroscopy is used to control surgical reconstructions. An influence of particular factors on the registered values of doses received by the members of medical team performing osteosynthesis for limb fractures is presented in this paper. MATERIAL AND METHODS Doses received by individual interventional team members performing specific functions, operator, assisting physicians and scrub nurse, during a series of the procedures were measured. Each person was equipped with 4 dosimetric tools, containing thermoluminescent dosimeters, to measure the equivalent doses for the eyes, hand skin and the neck (outside the shield) and to evaluate effective doses. The investigations were performed in operational theatres of 3 hospitals in Łódź. RESULTS The equivalent doses per one procedure for the eyes and hand skin of the operator were 0.029-0.073 mSv and 0.366-1.604 mSv, respectively. Significantly higher doses were noted during the procedures of intramedullary osteosynthesis, especially for the operator. An average age and body mass index (BMI) of patients treated in the monitored hospitals did not differ statistically. CONCLUSIONS Based on the dosimetric measurements the following conclusions can be drawn: in orthopedic procedures of interventional radiology (IR) the exposure of the staff is mostly determined by the type of procedure and more precisely by its complexity and by the optimized use of X-ray unit, including pulsed fluoroscopy. It is also revealed that the operator is the most exposed person in the interventional team. Med Pr 2017;68(1):75-83.
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Affiliation(s)
- Maria A Staniszewska
- Uniwersytet Medyczny w Łodzi / Medical University of Lodz, Łódź, Poland (Wydział Nauk Biomedycznych i Kształcenia Podyplomowego, Zakład Medycznych Technik Obrazowania / Faculty of Biomedical Sciences and Postgraduate Education, Department of Medical Imaging Techniques).
| | - Renata Kopeć
- Instytut Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry)
| | - Maciej Budzanowski
- Instytut Fizyki Jądrowej im. Henryka Niewodniczańskiego Polskiej Akademii Nauk / The Henryk Niewodniczański Institute of Nuclear Physics, Polish Academy of Sciences, Kraków, Poland (Laboratorium Dozymetrii Indywidualnej i Środowiskowej / Laboratory of Individual and Environmental Dosimetry)
| | - Edyta Owsiak
- Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej - Centralny Szpital Weteranów / University Clinical Hospital Military Memorial Medical Academy - Central Veterans' Hospital, Łódź, Poland (Klinika Ortopedii, Traumatologii i Rehabilitacji Pourazowej / Clinic of Orthopaedy, Traumatology and Traumatic Rehabilitation)
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Deng X, Xu W, Yan R, Chen H, Shen W, Zhang M, Wu T, Xu B, He H, Ma Y. Immunogenicity and safety of different schedules of 2-dose varicella vaccination in China. Hum Vaccin Immunother 2016; 12:3113-3117. [PMID: 27455445 DOI: 10.1080/21645515.2016.1212795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We evaluated the safety and immunogenicity of different time intervals for a second dose of varicella vaccine in children in Zhejiang Province, China. Participants had all received a first dose of varicella vaccine and were assigned to 4 groups according to age (2-7 years). A second dose of live attenuated varicella vaccine was administered 1 month, 1 year, 3 years, or 5 years after the first. A serology assay was conducted and fluorescent-antibody-to-membrane-antigen test performed to measure the antibody titers against varicella before and approximately 30 days after the second dose. Of 1,078 participants, most tolerated the second dose well. Age at first dose did not affect the response to vaccination. Geometric mean titers (GMTs) significantly differed between group 1 and all other groups, both before and after the second vaccination. The GMT for group 1 was higher than those for the other 3 groups prior to the second vaccination (GMT = 20.52, 14.68, 12.49, 12.29, respectively, p < 0.001 for all), while the opposite was true after the second vaccination (GMT = 51.14, 83.37, 85.01, 81.83, respectively, p < 0.001 for all). There was no significant difference in seropositive rate among the 4 groups prior to the second vaccination (p = 0.093), and these rates were all 100% after the second vaccination. The vaccine was well tolerated in healthy children, regardless of the timing of the second dose. GMTs showed a particularly high boost after the second dose when the interval between doses was more than 1 year.
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Affiliation(s)
- Xuan Deng
- a Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , PR China
| | - Wenqing Xu
- b Shanghai Institute of Biological Products Company , Shanghai , PR China
| | - Rui Yan
- a Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , PR China
| | - Haiping Chen
- c China National Pharmaceutical Group Corporation , Beijing , PR China
| | - Wei Shen
- b Shanghai Institute of Biological Products Company , Shanghai , PR China
| | - Min Zhang
- c China National Pharmaceutical Group Corporation , Beijing , PR China
| | - Tengjie Wu
- b Shanghai Institute of Biological Products Company , Shanghai , PR China
| | - Bin Xu
- c China National Pharmaceutical Group Corporation , Beijing , PR China
| | - Hanqing He
- a Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou , PR China
| | - Yanli Ma
- c China National Pharmaceutical Group Corporation , Beijing , PR China
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Zagouri F, Roussou M, Kastritis E, Gavriatopoulou M, Eleutherakis-Papaiakovou E, Kanellias N, Kalapanida D, Christoulas D, Migkou M, Terpos E, Dimopoulos MA. Lenalidomide with low- or intermediate-dose dexamethasone in patients with relapsed or refractory myeloma. Leuk Lymphoma 2016; 57:1776-80. [PMID: 26916452 DOI: 10.3109/10428194.2016.1151513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To compare the outcomes of patients with relapsed or refractory multiple myeloma (RRMM) who were treated with lenalidomide combined with high versus low dose of dexamethasone. One hundred forty consecutive relapsed or refractory multiple myeloma (RRMM) patients who received lenalidomide with dexamethasone, in two consecutive time periods, were divided into two groups: group RD (70 consecutive patients in the first period) who received lenalidomide with intermediate doses of dexamethasone and group Rd (70 consecutive patients in the more recent period) who received lenalidomide with low-dose dexamethasone. 62% and 73% of patients who received RD and Rd (p = 0.148) achieved at least a partial response, accordingly. The median OS was 20 and 41 months for the RD and the Rd group, accordingly. In the multivariate analysis, Rd was associated with improved PFS. More patients treated with RD developed grade 3&4 neutropenia and fatigue. It seems that Rd is at least as effective as RD.
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Affiliation(s)
- Flora Zagouri
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Maria Roussou
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Efstathios Kastritis
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Maria Gavriatopoulou
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | | | - Nikolaos Kanellias
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Despoina Kalapanida
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Dimitrios Christoulas
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Magdalini Migkou
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Evangelos Terpos
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
| | - Meletios A Dimopoulos
- a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece
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Mege JP, Wenzhao S, Veres A, Auzac G, Diallo I, Lefkopoulos D. Evaluation of MVCT imaging dose levels during helical IGRT: comparison between ion chamber, TLD, and EBT3 films. J Appl Clin Med Phys 2016; 17:143-157. [PMID: 26894346 PMCID: PMC5690206 DOI: 10.1120/jacmp.v17i1.5774] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 08/19/2015] [Accepted: 07/02/2015] [Indexed: 11/23/2022] Open
Abstract
The purpose of this investigation was to evaluate the dose on megavoltage CT (MVCT) images required for tomotherapy. As imaging possibilities are often used before each treatment and usually used several times before the session, we tried to evaluate the dose delivered during the procedure. For each scanning mode (fine, normal, and coarse), we first established the relative variation of these doses according to different technical parameters (explored length, patient setup). These dose variations measured with the TomoPhant, also known as Cheese phantom, showed the expected variations (due to the variation of scattered radiation) of 15% according to the explored length and ± 5% according to the phantom setup (due to the variation of the point of measurement in the bore). In order to estimate patient doses, an anthropomorphic phantom was used for thermoluminescent and film dosimetry. The degree of agreement between the two methods was very satisfactory (the differences correspond to 5 mGy per imaging session) for the three sites studied (head & neck, thorax, and abdomen). These measurements allowed us to estimate the delivered dose of between 1 cGy and 4 cGy according to the site and imaging mode. Finally, we attempted to investigate a way to calculate this delivered dose in our patients from the study conducted on a cylindrical phantom and by taking into account data from the initial kV-CT scan. The results we obtained were close to our measurements, with discrepancies below 5 mGy per MVCT.
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Saracco A, Szabó BK, Aspelin P, Leifland K, Tánczos E, Wilczek B, Axelsson R. Contrast-enhanced ultrasound using real-time contrast harmonic imaging in invasive breast cancer: comparison of enhancement dynamics with three different doses of contrast agent. Acta Radiol 2015; 56:34-41. [PMID: 24445092 DOI: 10.1177/0284185114520860] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In the last few years new potential applications have been developed for contrast-enhanced ultrasound (CEUS) and the management of breast diseases, but there is still some debate concerning the optimal dose to evaluate breast lesions, especially as a diagnostic tool. PURPOSE To compare different CEUS doses of injected contrast agent in order to establish an optimal dose for the diagnosis of invasive breast cancer. MATERIAL AND METHODS In Group A we compared the bolus dose of 1.2 mL vs. 2.4 mL and in Group B we compared the bolus dose of 2.4 mL vs. 4.8 mL (26 and 25 invasive carcinomas, respectively). CEUS was performed in real-time contrast harmonic imaging (CHI) using a L9-3 MHz probe. All examinations were recorded in a contrast side/side imaging mode loop for 120 s. Wash-in and wash-out patterns of the contrast agent were analyzed with advanced US quantification software and kinetic curves were used for statistical analysis. RESULTS In Group B (2.4 mL vs. 4.8 mL), more and stronger correlation was found among kinetic parameters (area under the curve, P < 0.00001; lognormal model parameters, μ, P = 0.0007 and σ, P < 0.0001; mean transit time, P < 0.0001; model-based wash-out ratios, W21m, P = 0.0002; W50m, P = 0.0001; time-to-peak, P = 0.005) as compared to Group A (1.2 mL vs. 2.4 mL). CONCLUSION The optimal way to evaluate kinetic features of invasive breast tumors using real-time CEUS is with an injection of contrast agent of either 2.4 mL or 4.8 mL.
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Affiliation(s)
- Ariel Saracco
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Botond K Szabó
- Department of Radiology, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Peter Aspelin
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karin Leifland
- Division of Radiology, Department of Breast Imaging, Unilabs Capio S:T Göran Hospital, Stockholm, Sweden
| | - Ervin Tánczos
- Bolyai Institute, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
- Department of Medical Physics and Informatics, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Brigitte Wilczek
- Division of Radiology, Department of Breast Imaging, Unilabs Capio S:T Göran Hospital, Stockholm, Sweden
| | - Rimma Axelsson
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Rajkovic A, Grootaert C, Butorac A, Cucu T, Meulenaer BD, van Camp J, Bracke M, Uyttendaele M, Bačun-Družina V, Cindrić M. Sub-emetic toxicity of Bacillus cereus toxin cereulide on cultured human enterocyte-like Caco-2 cells. Toxins (Basel) 2014; 6:2270-90. [PMID: 25093386 PMCID: PMC4147582 DOI: 10.3390/toxins6082270] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 07/18/2014] [Accepted: 07/22/2014] [Indexed: 12/16/2022] Open
Abstract
Cereulide (CER) intoxication occurs at relatively high doses of 8 µg/kg body weight. Recent research demonstrated a wide prevalence of low concentrations of CER in rice and pasta dishes. However, the impact of exposure to low doses of CER has not been studied before. In this research, we investigated the effect of low concentrations of CER on the behavior of intestinal cells using the Caco-2 cell line. The MTT (mitochondrial 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and the SRB (sulforhodamine B) reactions were used to measure the mitochondrial activity and cellular protein content, respectively. Both assays showed that differentiated Caco-2 cells were sensitive to low concentrations of CER (in a MTT reaction of 1 ng/mL after three days of treatment; in an SRB reaction of 0.125 ng/mL after three days of treatment). Cell counts revealed that cells were released from the differentiated monolayer at 0.5 ng/mL of CER. Additionally, 0.5 and 2 ng/mL of CER increased the lactate presence in the cell culture medium. Proteomic data showed that CER at a concentration of 1 ng/mL led to a significant decrease in energy managing and H2O2 detoxification proteins and to an increase in cell death markers. This is amongst the first reports to describe the influence of sub-emetic concentrations of CER on a differentiated intestinal monolayer model showing that low doses may induce an altered enterocyte metabolism and membrane integrity.
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Affiliation(s)
- Andreja Rajkovic
- Laboratory of Food Microbiology and Food Preservation, Ghent University, Ghent B-9000, Belgium; E-Mail:
| | - Charlotte Grootaert
- Laboratory of Food Chemistry and Human Nutrition, Ghent University, Ghent B-9000, Belgium; E-Mails: (C.G.); (T.C.); (B.D.M.); (J.C.)
| | - Ana Butorac
- Laboratory for Biology and Microbial Genetics, Faculty of Food Technology and Biotechnology, Zagreb University, Zagreb HR-10000, Croatia; E-Mails: (A.B.); (V.B.-D.)
| | - Tatiana Cucu
- Laboratory of Food Chemistry and Human Nutrition, Ghent University, Ghent B-9000, Belgium; E-Mails: (C.G.); (T.C.); (B.D.M.); (J.C.)
| | - Bruno De Meulenaer
- Laboratory of Food Chemistry and Human Nutrition, Ghent University, Ghent B-9000, Belgium; E-Mails: (C.G.); (T.C.); (B.D.M.); (J.C.)
| | - John van Camp
- Laboratory of Food Chemistry and Human Nutrition, Ghent University, Ghent B-9000, Belgium; E-Mails: (C.G.); (T.C.); (B.D.M.); (J.C.)
| | - Marc Bracke
- Laboratory of Experimental Cancer Research, University Hospital Ghent, Ghent B-9000, Belgium; E-Mail:
| | - Mieke Uyttendaele
- Laboratory of Food Microbiology and Food Preservation, Ghent University, Ghent B-9000, Belgium; E-Mail:
| | - Višnja Bačun-Družina
- Laboratory for Biology and Microbial Genetics, Faculty of Food Technology and Biotechnology, Zagreb University, Zagreb HR-10000, Croatia; E-Mails: (A.B.); (V.B.-D.)
| | - Mario Cindrić
- Laboratory for System Biomedicine and Centre for Proteomics and Mass Spectrometry, “Ruđer Bošković” Institute, Zagreb HR-10000, Croatia; E-Mail:
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Dougherty DM, Marsh-Richard DM, Hatzis ES, Nouvion SO, Mathias CW. A test of alcohol dose effects on multiple behavioral measures of impulsivity. Drug Alcohol Depend 2008; 96:111-20. [PMID: 18378098 PMCID: PMC2566966 DOI: 10.1016/j.drugalcdep.2008.02.002] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 02/12/2008] [Accepted: 02/13/2008] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acute alcohol administration affects impulsive behavior, although these effects vary as a function of alcohol dose, assessment instrument, and time of measurement following administration. METHODS We concurrently examined the dose-dependent effects of alcohol on three distinct types of impulsivity tasks (continuous performance [IMT], stop-signal [GoStop], and delay-discounting [SKIP] tasks). Ninety healthy alcohol drinkers were assigned to one of the three task groups (n=30 each), each group experienced placebo, 0.2, 0.4, 0.6, and 0.8 g/kg alcohol doses across 5 experimental days, and task performance was assessed at 0.5h before and 0.25, 1.0, and 2.0 h after alcohol administration. We hypothesized that impulsive responding on all tasks would be increased by acute alcohol administration both across time and during the peak BrAC, but the magnitude would depend on the task being tested. Analyses included the time course and the peak BrAC effects. Task comparisons of peak behavioral changes following each dose are illustrated using standardized scores. RESULTS While alcohol consumption increased impulsive responding during all three tasks to some extent, our hypothesis was only partially supported. During the IMT, the 0.6 and 0.8 g/kg doses produced increased impulsive responding across time and at the peak BrAC. However, during the GoStop and SKIP, impulsivity increased across time regardless of the alcohol dose size, with no differences in impulsive responding among dose conditions at peak BrAC. CONCLUSIONS This study demonstrated alcohol-induced changes in impulsivity are not uniformly affected by alcohol. These data, in conjunction with previous studies, further support that impulsivity is not a unitary construct.
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Affiliation(s)
- Donald M. Dougherty
- Neurobehavioral Research Laboratory and Clinic, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Dawn M. Marsh-Richard
- Neurobehavioral Research Laboratory and Clinic, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Erin S. Hatzis
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157 USA*
| | - Sylvain O. Nouvion
- Neurobehavioral Research Laboratory and Clinic, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Charles W. Mathias
- Neurobehavioral Research Laboratory and Clinic, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
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