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Stephens C. A remarkable life. Br Dent J 2024; 236:668-669. [PMID: 38730141 DOI: 10.1038/s41415-024-7409-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024]
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Stephens C. Editorial: Muscles at the expense of liver injury. Is it worth it? Aliment Pharmacol Ther 2024; 59:1003-1004. [PMID: 38523081 DOI: 10.1111/apt.17929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
LINKED CONTENTThis article is linked to Nash et al paper. To view this article, visit https://doi.org/10.1111/apt.17906
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Affiliation(s)
- C Stephens
- Servicio de Gastroenterología, Instituto de Investigación Biomédica de Málaga-IBIMA Plataforma BIONAND, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red en el Área Temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Bloom JR, Hsieh K, Lehrer EJ, Stephens C, Dickstein DR, Sheu R, Rosenzweig K, Samstein R. Frequent Friers: Outcomes in Patients Who Receive Multiple Courses of Lung SBRT. Int J Radiat Oncol Biol Phys 2023; 117:e7. [PMID: 37786051 DOI: 10.1016/j.ijrobp.2023.06.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic body radiation therapy (SBRT) is a definitive therapy for early-stage non-small cell lung cancer and solitary pulmonary metastases with high tolerability and excellent survival rates. With longer survival and patients developing subsequent primaries or oligometastatic disease, patients are receiving multiple repeat lung SBRT courses. This study aims to assess safety and efficacy of high-frequency SBRT (HF-SBRT) to the lung, defined as >3 courses. MATERIALS/METHODS A retrospective review was performed of patients who received >3 courses of lung SBRT. Logistic regression was performed to identify predictors of radiation pneumonitis (RP) and worsening pulmonary function (WPF). Local control (LC) and overall survival (OS) were evaluated using the Kaplan-Meier method. RESULTS Ninety-four courses of HF-SBRT to the lung were identified among 28 patients. 78% of patients received 3 SBRT courses, 12% received 4 courses, and 7.1% received >5 courses. Median follow-up was 4.4 years. Median age at time of treatment was 73 years-old; 58% males; 42% had an underlying pulmonary comorbidity; 39% prior lung surgery; 52% history of cardiac disease; 52% prior tobacco use; median ECOG 0. Median SBRT dose was 48 Gy. Median interval between courses was 5.6 months. Zero patients experienced greater than grade 2 acute CTCAE v5 toxicity. 7.2% (7) of patients developed RP at median time of 2.6 months [IQR: 1.4,7.4]; grade 1: 3 patients, grade 2: 1 patient, grade 3: 2 patients. Of patients who developed RP, 42% (3) went on to receive further SBRT without experiencing significant adverse events (AEs). History of pulmonary disease, prior lung surgery, and history of tobacco use strongly correlated with WPF but not RP (WPF p-values: <0.001, 0.003, <0.001, respectively). History of cardiac disease did not correlate with WPF or RP. Receiving bilateral lung SBRT treatment (vs unilateral) trended towards correlation with WPF (p = 0.06) and RP (p = 0.08). Time between SBRT courses did not significantly differ for those who developed RP (p = 0.62) or WPF (p = 0.42). No individual or plan sum dosimetric constraint (GTV, PTV, unilateral lung V5, lung V10, lung V20, unilateral mean lung dose, or total lung V20) significantly differed in those who experienced RP. WPF correlated with the plan sum unilateral lung V10 (p = 0.05). LC at 1-year was 100%, 1 local failure occurred at 13 months; 2-year OS was 91.7%, median OS 5.4 years. CONCLUSION Overall, HF-SBRT was well tolerated. Development of RP did not correlate with a specific individual or plan sum dosimetric parameter, with patients receiving subsequent courses of SBRT without increased AEs. WPF increasingly occurred with subsequent SBRT courses and correlated with unilateral plan sum V10. This study suggests that in appropriately selected patients, SBRT after RP can still be provided as definitive care, while further studies should validate this and focus attention on mitigating long-term WPF in patients who receive HF-SBRT.
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Affiliation(s)
- J R Bloom
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
| | - K Hsieh
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
| | - E J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - C Stephens
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - D R Dickstein
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
| | - R Sheu
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
| | - K Rosenzweig
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
| | - R Samstein
- Icahn School of Medicine at Mount Sinai, Department of Radiation Oncology, New York, NY
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Leiter A, Stephens C, Mhango G, Kong CY, Sigel K, Lin JJ, Gallagher EJ, LeRoith D, Wisnivesky JP. Impact of diabetes on stage I lung cancer treatment patterns and prognosis in older adults: A population-based cohort study. Heliyon 2023; 9:e17969. [PMID: 37455987 PMCID: PMC10344809 DOI: 10.1016/j.heliyon.2023.e17969] [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: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
Background Diabetes is a common comorbidity in patients with early-stage non-small cell lung cancer (NSCLC), a growing population due to increased LC screening. However, it is unknown if diabetes is associated with less aggressive NSCLC treatment and worse NSCLC outcomes. This study aimed to investigate treatment patterns and outcomes of older patients with Stage I NSCLC and diabetes. Methods Using national cancer registry data linked to Medicare, we identified patients ≥65 years old with Stage I NSCLC. Patients were categorized as having no diabetes, diabetes without severe complications (DM-c), or diabetes with ≥1 severe complication (DM + c). We used multinomial logistic regression to assess the association of diabetes and NSCLC treatment. The association of diabetes category with NSCLC and non-NSCLC survival was analyzed with Fine-Grey competing-risks regression. Results In 25,358 patients (75% no diabetes, 12% DM-c and 13% had DM + c), adjusted analyses showed that DM-c and DM + c were associated with increased odds of receiving limited resection rather than lobectomy (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.07-1.37 and OR 1.42, 95% CI 1.26-1.59, respectively). Competing risk regression showed diabetes was associated with increased risk of non-NSCLC death (DM-c hazard ratio [HR] 1.16, 95% CI: 1.08-1.25, DM + c HR 1.49, 95% CI: 1.40-1.59), but not NSCLC-specific death. Conclusion This study uncovers critical information on how diabetes is associated with less aggressive early-stage NSCLC care in older patients. This study also confirms that diabetes increases death from non-lung cancer causes and managing comorbidities is crucial to improving outcomes in older early-stage NSCLC survivors.
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Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1055, New York, NY, 10029, USA
| | - Christian Stephens
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Grace Mhango
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Chung Yin Kong
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Keith Sigel
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Jenny J. Lin
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
| | - Emily J. Gallagher
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1055, New York, NY, 10029, USA
| | - Derek LeRoith
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1055, New York, NY, 10029, USA
| | - Juan P. Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1087, New York, NY, 10029, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1232, New York, NY, 10029, USA
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Stephens C, Leiter A, Sigel KM, Kong CY, Wisnivesky J. Lung cancer treatment patterns in patients with diabetes. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18723 Background: Lung cancer is the leading cause of cancer death in the United States, with > 85% classified as non-small cell lung cancer (NSCLC). Diabetes mellitus (DM) is a common comorbidity in patients with NSCLC. While surgery is the standard of care for early-stage NSCLC, patients who have DM with end organ damage are considered medically inoperable according to treatment guidelines and whether this influences NSCLC treatment and outcomes is unclear. This study aimed to investigate treatment patterns and outcomes among patients with early-stage NSCLC and DM. Methods: Using the Surveillance, Epidemiology, and End Results database linked to Medicare (2000-2016), we identified patients ≥65 years old with Stage I-IIIA NSCLC treated with lobectomy, limited resection (wedge resection and segmentectomy), or no surgery. DM and complications at the time of NSCLC diagnosis were ascertained through published claims-based algorithms. Patients were categorized as having no DM, DM without severe complications (DM-c), or DM with ≥1 severe complication (i.e., end-organ damage, DM+c). We used multinomial logistic regression to assess if DM was associated with treatment. Association of DM with overall survival (OS) and lung cancer-specific survival (LCSS) was analyzed with Cox regression stratified by treatment type. These analyses controlled for demographics, comorbidities, and NSCLC histology and stage. Results: Of 60,300 patients analyzed, 45,270 (75%) had no DM, 6,873 (12%) had DM-c and 7,887 (13%) had DM+c. More patients with DM+c (N = 4,508[57%]), did not receive surgery vs. patients with DM-c (N = 3,771[55%]) and without DM (N = 23,289[51%]). DM was associated with lower odds of receiving lobectomy vs. no surgery in adjusted analysis (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.83-0.93 for DM-c, and OR: 0.91; 95% CI: 0.86-0.97 for DM+c vs. no DM), but not for limited resection vs. no surgery (OR: 0.92; 95% CI: 0.83-1.02 for DM-c and OR: 0.91; 95% CI: 0.92-1.11 for DM+c vs. no DM). Cox regression showed that in patients with lobectomy and limited resection, compared to no DM, DM+c was associated with worse OS (hazard ratio [HR]: 1.21; 95% CI: 1.15 to 1.27 [lobectomy]; HR: 1.17; 95% CI: 1.07-1.28 [limited resection]), but not LCSS (HR: 1.06; 95% CI: 0.99-1.14 [lobectomy]; HR: 1.02; 95% CI: 0.90-1.17 [limited resection]). Among patients who received no surgery, DM+c patients had both worse LCSS (HR: 1.05; 95% CI: 1.00-1.09 and OS (HR: 1.12; 95% CI: 1.08-1.16) vs. no DM. DM-c was not associated with worse LCSS or OS for all treatment categories. Conclusions: Patients with Stage I-IIIA NSCLC and DM+c were less likely to undergo surgery and had worse OS but not LCSS if they underwent full or limited resection, while they had worse OS and LCSS if they did not have surgery. These findings suggest that patients with DM with end-organ damage benefit from more aggressive NSCLC treatment, but research is needed to determine optimal treatments in these patients.
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Affiliation(s)
| | - Amanda Leiter
- Department of Endocrinology, Icahn School of Medicine at Mount Sinai, New York, NY
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Rapson R, King T, Morris C, Jeffery R, Mellhuish J, Stephens C, Marsden J. Effect of different durations of using a standing frame on the rate of hip migration in children with moderate to severe cerebral palsy: a feasibility study for a randomised controlled trial. Physiotherapy 2022; 116:42-49. [DOI: 10.1016/j.physio.2022.01.001] [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] [Received: 09/07/2020] [Revised: 07/23/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
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Stephens C, Dias A, Brennan C, Lazizi M, Skinner E, Angel C. SP9.1.10 Penthrox for management of fractures, dislocations and more: Orthopaedics in the Emergency Department during the COVID-19 pandemic. Br J Surg 2021. [PMCID: PMC8574434 DOI: 10.1093/bjs/znab361.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aim
Methoxyflurane has undergone a renaissance using a smaller dose in a handheld ‘Penthrox’ device. There is minimal literature regarding its use in common orthopaedic management. Our Minor Injury Unit (MIU) was created due to COVID19 pandemic. The aim of this study was to investigate whether a Penthrox device could improve fracture/joint dislocation management and decreased the need for theatre resources at our MIU.
Methods
We reviewed all cases where Penthrox was used to facilitate minor procedures within a two month period. We recorded patient demographics, injury, time of admission, discharge and management. Success was defined as fracture manipulation into an adequate position, joint congruence achieved or completion of a planned procedure.
Results
101 Penthrox doses were given to 89 patients over 97 episodes between 24/3/2020 and 26/5/2020. No complications were recorded. There was 100% success rate on fracture manipulation. For joint dislocation: 65% on native shoulder reduction; 30% on prosthetic total hip arthroplasty reduction; 100% on native elbow reduction. Penthrox was also used for other procedures such as wound reviews, removing external fixators, and applying braces with 100% success rate.
Conclusion
We have shown that Penthrox is safe and can be used for common emergency Orthopaedic procedures, particularly fracture manipulation. This helped keep operating theatres and other anaesthetic resources free which were especially vital and scarce during the COVID19 pandemic.
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Parry H, McIlroy G, Bruton R, Ali M, Stephens C, Damery S, Otter A, McSkeane T, Rolfe H, Faustini S, Wall N, Hillmen P, Pratt G, Paneesha S, Zuo J, Richter A, Moss P. Antibody responses after first and second Covid-19 vaccination in patients with chronic lymphocytic leukaemia. Blood Cancer J 2021; 11:136. [PMID: 34330895 PMCID: PMC8323747 DOI: 10.1038/s41408-021-00528-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [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: 05/21/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/15/2022] Open
Abstract
B-cell chronic lymphocytic leukaemia (CLL) is associated with immunosuppression and patients are at increased clinical risk following SARS-CoV-2 infection. Covid-19 vaccines offer the potential for protection against severe infection but relatively little is known regarding the profile of the antibody response following first or second vaccination. We studied spike-specific antibody responses following first and/or second Covid-19 vaccination in 299 patients with CLL compared with healthy donors. 286 patients underwent extended interval (10-12 week) vaccination. 154 patients received the BNT162b2 mRNA vaccine and 145 patients received ChAdOx1. Blood samples were taken either by venepuncture or as dried blood spots on filter paper. Spike-specific antibody responses were detectable in 34% of patients with CLL after one vaccine (n = 267) compared to 94% in healthy donors with antibody titres 104-fold lower in the patient group. Antibody responses increased to 75% after second vaccine (n = 55), compared to 100% in healthy donors, although titres remained lower. Multivariate analysis showed that current treatment with BTK inhibitors or IgA deficiency were independently associated with failure to generate an antibody response after the second vaccine. This work supports the need for optimisation of vaccination strategy in patients with CLL including the potential utility of booster vaccines.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Antibody Formation/drug effects
- BNT162 Vaccine
- COVID-19/blood
- COVID-19/immunology
- COVID-19/prevention & control
- COVID-19 Vaccines/administration & dosage
- COVID-19 Vaccines/immunology
- Female
- Humans
- Immunization, Secondary
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
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Affiliation(s)
- H Parry
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - G McIlroy
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - R Bruton
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - M Ali
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - C Stephens
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - S Damery
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - A Otter
- National infection Service, Public Health England, Porton Down, Salisbury, SP4 OJG, UK
| | - T McSkeane
- Cancer Research UK Clinical Trials Unit, University of Birmingham, B15 2TT, Birmingham, UK
| | - H Rolfe
- Cancer Research UK Clinical Trials Unit, University of Birmingham, B15 2TT, Birmingham, UK
| | - S Faustini
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - N Wall
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - P Hillmen
- St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK
| | - G Pratt
- Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, B15 2TH, UK
| | - S Paneesha
- Birmingham Heartlands Hospital, University Hospitals Birmingham, Bordesley Green East, B9 5SS, Birmingham, UK
| | - J Zuo
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - A Richter
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
| | - P Moss
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK.
- Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, B15 2TH, UK.
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Littlewood KE, Beausoleil NJ, Stafford KJ, Stephens C, Collins T, Quain A, Hazel S, Lloyd JF, Mallia C, Richards L, Wedler NK, Zito S. How decision-making about euthanasia for animals is taught to Australasian veterinary students. Aust Vet J 2021; 99:334-343. [PMID: 34002368 DOI: 10.1111/avj.13077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 11/27/2022]
Abstract
This study set out to explore how euthanasia decision-making for animals was taught to students in eight Australasian veterinary schools. A questionnaire-style interview guide was used by a representative at each university to interview educators. Educators were interviewed about their teaching of euthanasia decision-making for four categories of animals: livestock, equine, companion and avian/wildlife. Using thematic analysis, the terms provided by participants to describe how (mode of teaching) and what (specific content) they taught to students were categorised. Information about content was categorised into human-centred factors that influence decision-making, and animal-based indicators used to directly inform decision-making. All eight representatives reported some teaching relevant to euthanasia decision-making at their university for livestock, companion animal and avian/wildlife. One representative reported no such teaching for equid animals at their university. Observation of a euthanasia case was rarely reported as a teaching method. Five universities reported multiple modes of teaching relevant information, while two universities made use of modalities that could be described as opportunistic teaching (e.g., 'Discussion of clinical cases'). Factors taught at most universities included financial considerations, and that it is the owner's decision to make, while animal-based indicators taught included QoL/animal welfare, prognosis and behaviour change. Overall, most universities used a variety of methods to cover relevant material, usually including lectures and several other approaches for all animal types. However, because two universities relied on presentation of clinical cases, not all students at these veterinary schools will be exposed to make, or assist in making, euthanasia decisions.
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Affiliation(s)
- K E Littlewood
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - N J Beausoleil
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - K J Stafford
- School of Veterinary Science, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - C Stephens
- School of Psychology, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand
| | - T Collins
- College of Veterinary Medicine, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - A Quain
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales, 2006, Australia
| | - S Hazel
- School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, 5005, Australia
| | - Jk F Lloyd
- Discipline of Veterinary Sciences, College of Public Health, Medical & Veterinary Sciences, James Cook University, 1 Solander Drive, Townsville, Queensland, 4811, Australia
| | - C Mallia
- School of Environmental Sciences, Faculty of Science, Charles Sturt University, PO Box 789, Albury, New South Wales, 2640, Australia
| | - L Richards
- School of Veterinary Science, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - N K Wedler
- College of Veterinary Medicine, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - S Zito
- Animal Welfare Science and Education Department, Royal New Zealand SPCA National Office, 3047 Great North Road, Auckland, 0640, New Zealand
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Affiliation(s)
- C Stephens
- By email, President of the BOS 2001-2002, Bristol, UK
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Stephens C, Clutter J, Krok-Schoen J. Abstract PO-081: The relationship between socioeconomic status and nutritional intake in older female cancer survivors. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp20-po-081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background: As older adults (65+) are the age cohort most likely to be diagnosed with cancer and women tend to live longer than men, many cancer survivors are older females. However, older female survivors are an understudied group. Lifestyle behaviors such as maintaining a healthy diet have been shown to promote disease- free survivorship and improve health-related quality of life (HRQoL). Moreover, socioeconomic factors (e.g. income, education) have been shown to influence survivors’ lifestyle behaviors and long-term health outcome. However, socioeconomic factors that influence the diet quality of older female survivors have been greatly understudied in this population. This study sought to examine the influence of socioeconomic factors on the nutritional intake of older female survivors, while also investigating disparities in HRQoL and self-rated health.
Methods: Older women, with all cancer types and stages, who completed primary cancer treatment (i.e., chemotherapy, surgery, radiation) within the past five years, were eligible to participate. Older female survivors completed one-time surveys to assess HRQoL (RAND-36), body mass index (BMI), diet quality (Diet History Questionnaire II), and self-rated health. Demographic information and medical record data were also collected. Diet History Questionnaire II results were converted to 2015-2020 Healthy Eating Index (HEI) scores. Descriptive analyses, correlations, and stepwise linear regressions were utilized. Results: Participants (n=171) were, on average, 72.72 ±7.40 years old, and the majority were white (90.0%), had a household income between $20,000 and $100,000 (53.8%), completed at least a bachelor’s degree (54.7%), and were breast cancer survivors (68.0%). Mean BMI was 27.71±6.20 (overweight) with 63.7% of the participants being overweight or obese. Participant’s average physical and mental HRQoL composite scores were 41.94±10.50 and 48.47±7.18, respectively, out of 100. The mean HEI-2015 score of participants was 66.54±10.01, out of 100. Having higher educational attainment (β=0.417, p=0.032) and greater physical HRQoL (β=0.430, p=0.028) was associated with higher HEI scores. Having higher educational attainment (β=0.574, p=0.004) was also associated with higher mental HRQoL, and higher physical HRQoL (β=0.679, p<0.001) was associated with better self-rated health. Conclusions: Older female cancer survivors were found to have poor diet quality and high rates of being overweight or obese. Nutritional intake and HRQoL were found to be interrelated and associated with educational attainment. Results indicate the need for nutritional screening and consulting during cancer survivorship. Tailored lifestyle interventions, considering socioeconomic status, may improve the diet quality of older female survivors and help prevent chronic disease, mitigate treatment effects, and improve HRQoL in this underserved population.
Citation Format: Christian Stephens, Jill Clutter, Jessica Krok-Schoen. The relationship between socioeconomic status and nutritional intake in older female cancer survivors [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-081.
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Krok-Schoen JL, Pisegna J, Arthur E, Ridgway E, Stephens C, Rosko AE. Prevalence of lifestyle behaviors and associations with health-related quality of life among older female cancer survivors. Support Care Cancer 2020; 29:3049-3059. [PMID: 33040283 DOI: 10.1007/s00520-020-05812-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/02/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Healthy lifestyles including maintaining a normal weight, consuming a healthy diet, and being physically active can improve prognosis and health-related quality of life (HRQoL) among cancer survivors. The largest proportion of cancer survivors are older adults (≥ 65 years), yet their lifestyle behaviors are understudied. This study sought to examine the lifestyle behaviors (maintaining healthy weight, diet quality, physical activity) of older female cancer survivors and identify associations with HRQoL. METHODS Older female cancer survivors (n = 171) completed surveys to assess HRQoL (RAND-36), unintentional weight loss, body mass index (BMI), diet quality (HEI-2015), and physical activity. Demographic information and medical record data were also collected. Descriptive analyses, correlations, and stepwise linear regressions were utilized. RESULTS Physical and mental HRQoL of the sample (mean age = 74.50 years) were low: 41.94 ± 10.50 and 48.47 ± 7.18, respectively, out of 100. Physical activity was low: 75.3%, 54.2%, and 68.1% reported no strenuous, moderate, and mild physical activity, respectively. Mean BMI was 27.71 ± 6.24 (overweight) with 64% of the participants being overweight or obese. Mean HEI-2015 scores were 66.54 ± 10.0. Engagement in moderate physical activity was associated with higher physical HRQoL (β = 0.42, p = 0.004). Being white (β = 0.53, p < 0.001), older (β = 0.27, p = 0.025), and having higher HEI scores (β = 0.30, p = 0.011) were associated with higher mental HRQoL. CONCLUSIONS Older cancer survivors report poor diet quality, high rates of being overweight or obese, and low levels of physical activity that impact their HRQoL. Results indicate the need for tailored health coaching for older cancer survivors regarding their lifestyle behaviors to improve prognosis and HRQoL.
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Affiliation(s)
- Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 306N Atwell Hall, Columbus, OH, 43210, USA. .,Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH, USA.
| | - Janell Pisegna
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 306N Atwell Hall, Columbus, OH, 43210, USA
| | - Elizabeth Arthur
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH, USA.,College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, USA
| | - Emily Ridgway
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH, USA
| | - Christian Stephens
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 306N Atwell Hall, Columbus, OH, 43210, USA
| | - Ashley E Rosko
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, USA.,Division of Hematology, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, USA
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13
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Krok-Schoen JL, Pisegna J, Arthur E, Ridgway E, Stephens C, Rosko AE. Healthy lifestyle challenges among older female cancer survivors. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
156 Background: Healthy lifestyles including consuming a healthy diet, being physically active, and maintaining a normal weight can improve prognosis and health-related quality of life (HRQoL) among cancer survivors. The largest proportion of cancer survivors are older adults (≥65 years), yet their lifestyle behaviors are understudied. This study examined the lifestyle behaviors (diet quality, physical activity, maintaining healthy weight) of older female cancer survivors and associations with HRQoL. Methods: Women aged 65 years or older, with all cancer subtypes and stages, who had completed primary cancer treatment (i.e., chemotherapy, surgery, radiation) within the past five years, were eligible to participate. Older female cancer survivors (n = 171) completed one-time surveys to assess HRQoL (RAND-36), unintentional weight loss, body mass index (BMI), diet quality (Diet History Questionnaire II), and physical activity. Demographic information and medical record data were also collected. Diet History Questionnaire II results were converted to Healthy Eating Index (HEI)-2015 scores. Descriptive analyses, correlations, and stepwise linear regressions were utilized. Results: The majority of the sample (median age = 74.50±8.43 years) were white (90%), married (54.7%), breast cancer survivors (67.7%), and completed at least a bachelor’s degree (54.7%). Physical and mental HRQoL of the sample were low; 41.94±10.50 and 48.47±7.18, respectively, out of 100. Physical activity was low; 75.3%, 54.2%, and 68.1% reported no strenuous, moderate, and mild physical activity, respectively. Mean BMI was 27.71±6.24 (overweight), with 64% of the participants being overweight or obese. Mean HEI-2015 scores were 66.54+10.0 out of 100 and below the cutoff score of 80, which represents a “good diet”. Participating in moderate physical activity was associated with higher physical HRQoL (β = 0.42, p = 0.004). Being older (β = 0.27, p = 0.025), white (β = 0.53, p < 0.001), and having higher HEI scores (β = 0.30, p = 0.011) was associated with higher mental HRQoL. Conclusions: Older female cancer survivors reported lifestyle challenges including poor diet quality, low levels of physical activity, and high rates of being overweight or obese, which were associated with HRQoL. Results indicate the need for tailored health interventions for older female cancer survivors regarding their lifestyle behaviors to improve prognosis and HRQoL.
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Affiliation(s)
- Jessica L. Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
| | - Janell Pisegna
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH
| | | | - Emily Ridgway
- College of Nursing, The Ohio State University, Columbus, OH
| | - Christian Stephens
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH
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Littlewood KE, Beausoleil NJ, Stafford KJ, Stephens C, Collins T, Fawcett A, Hazel S, Lloyd J, Mallia C, Richards L, Wedler NK, Zito S. How management of grief associated with ending the life of an animal is taught to Australasian veterinary students. Aust Vet J 2020; 98:356-363. [PMID: 32458445 DOI: 10.1111/avj.12960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/08/2019] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Veterinarians have an important role in supporting and understanding their clients' grief. Veterinary schools have a duty to teach students how best to manage grief - both that of the students/future veterinarians and the clients. This study explores how grief management, associated with ending the life of an animal, was taught to students in eight Australasian veterinary schools. METHODS A questionnaire-style interview guide was used by a representative at each university to conduct structured interviews with educators in a snowball sampling approach. Educators were interviewed about the teaching of grief management for four categories of animals: livestock, equine, companion and avian/wildlife. The terms used by participants to describe what they taught were grouped into common themes. Teaching was defined by individual participants and included structured and unstructured approaches. The stage in the degree (preclinical or clinical years) that grief management was taught in the veterinary curriculum and by whom (e.g. clinicians or psychologists) is also described. RESULTS Grief management was taught more in preclinical than clinical years. However, due to how grief was characterised, much of this teaching was general 'nonspecific' teaching that included all categories of animals. Client grief was taught more generically, whereas, grief of veterinarians was taught using specific examples given by clinicians. CONCLUSION A more robust end-of-life (EoL) management curriculum that includes all aspects of grief management is likely to increase job satisfaction, client happiness and professional satisfaction.
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Affiliation(s)
- K E Littlewood
- Animal Welfare Science and Bioethics Centre, School of Veterinary Science, Massey University, Palmerston North, 4442, New Zealand
| | - N J Beausoleil
- Animal Welfare Science and Bioethics Centre, School of Veterinary Science, Massey University, Palmerston North, 4442, New Zealand
| | - K J Stafford
- Animal Welfare Science and Bioethics Centre, School of Veterinary Science, Massey University, Palmerston North, 4442, New Zealand
| | - C Stephens
- School of Psychology, College of Humanities and Social Sciences, Massey University, Palmerston North, 4442, New Zealand
| | - T Collins
- School of Veterinary Medicine, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - A Fawcett
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, New South Wales, 2006, Australia
| | - S Hazel
- School of Animal and Veterinary Sciences, The University of Adelaide, Adelaide, 5005, Australia
| | - Jkf Lloyd
- Discipline of Veterinary Sciences, College of Public Health, Medical & Veterinary Sciences, James Cook University, 1 Solander Drive, Townsville, Queensland, 4811, Australia
| | - C Mallia
- School of Environmental Sciences, Faculty of Science, Charles Sturt University, PO Box 789, Albury, New South Wales, 2640, Australia
| | - L Richards
- School of Veterinary Science, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - N K Wedler
- School of Veterinary Medicine, Murdoch University, South Street, Murdoch, Western Australia, 6150, Australia
| | - S Zito
- Animal Welfare Science and Education Department, Royal New Zealand SPCA National Office, 3047 Great North Road, Auckland, 0640, New Zealand
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Stephens C, Klemanski D, Lustberg MB, Noonan AM, Brill S, Krok-Schoen JL. Primary care physician's confidence and coordination regarding the survivorship care for older breast cancer survivors. Support Care Cancer 2020; 29:223-230. [PMID: 32338315 DOI: 10.1007/s00520-020-05448-3] [Citation(s) in RCA: 4] [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] [Received: 01/14/2020] [Accepted: 03/30/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE To examine primary care physician's (PCPs) internal (confidence, training) and external (communication, receipt of survivorship care plans (SCPs)) regarding their provision of survivorship care to older breast cancer survivors METHOD: A web-based questionnaire was completed individually by PCPs about their training and areas of survivorship they address under their care. A subset of survey participants was interviewed about survivorship care for older breast cancer survivors, care coordination, and areas of improvement regarding SCPs. RESULTS PCPs (n = 29) had an average 13.5 years in family practice. Forty-five percent surveyed as "somewhat confident" or "not confident" evaluating and managing the late effects of cancer treatment, and 25% surveyed as "somewhat confident" or "not confident" addressing the chronic comorbidities of older breast cancer survivors. More than half of PCPs surveyed that they reach out to their patients' oncologist "a little" or "none of the time" and that they receive SCPs "a little" or "none of the time." Semi-structured interviews also indicated that many PCPs did not receive a SCP from their patients' oncologists and that communication between the two providers regarding survivorship care was poor. CONCLUSION Participants indicated that PCP confidence in providing survivorship care is lacking and that lack of training, infrequent communication with oncologists, and underutilization of SCPs may contribute to this lack of confidence. These findings provide insight into the possible need for a well-defined shared care model, which has been encouraged but not always a routine part of survivorship care in various practice settings.
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Affiliation(s)
- Christian Stephens
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave., Columbus, OH, 43210, USA
| | - Dori Klemanski
- Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W. 10th Ave., Columbus, OH, 43210, USA
| | - Maryam B Lustberg
- Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W. 10th Ave., Columbus, OH, 43210, USA.,Department of Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, 43210, USA
| | - Anne M Noonan
- Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W. 10th Ave., Columbus, OH, 43210, USA.,Department of Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, 43210, USA
| | - Seuli Brill
- Department of Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, 43210, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave., Columbus, OH, 43210, USA. .,Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute, The Ohio State University, 460 W. 10th Ave., Columbus, OH, 43210, USA.
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16
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Green C, Stephens C, Acuff S, Minwell G, Pollard B, Walker D, Osborne D. Abstract No. 557 Overestimation of Y-90 lung shunt fraction by Tc99m-MAA scans: preliminary results. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.618] [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] Open
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17
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Ringdahl E, Seegmiller R, Aden J, Stephens C. A-75 Predicting neurocognitive impairment using the Green’s Medical Symptom Validity Test dementia profile formula. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
The Green’s Medical Symptom Validity Test (MSVT) is a measure of performance validity and has a formula to help distinguish genuine cognitive impairment from suboptimal engagement. The current study used the MSVT “dementia profile” formula to discriminate patients with no neurocognitive disorder (no NCD), mild neurocognitive disorder (mild NCD), and major neurocognitive disorder (major NCD).
Method
198 patients who were seen for comprehensive outpatient neuropsychological testing and passed all MSVT validity measures were included in the study. Specifically, participants included 103 persons with no NCD, 62 diagnosed with a mild NCD, and 33 with major NCD, who were collectively 58% male, with a mean age of 52-years-old (SD = 16.1) and mean education of 14.5 years (SD = 2.5).
Results
The difference score between easy and hard MSVT subtests predicted group assignment (r = .57, p < .001) and effectively differentiated the three groups (p < .001). Mean difference scores of both groups with diagnosed NCD exceeded recommended criteria suggestive of genuine cognitive impairment, with the differences score of major NCD being greater (p < .01) than the mild NCD. Group differences remained significant (p < .001) after adjusting for the effects of age and education. When the NCD groups were compared to the no diagnosis group, ROC curve analysis produced an AUC of .84, with a sensitivity of .72 and specificity of .83.
Conclusions
Findings from this study validate the established difference score between easy and hard subtests of the MSVT, and suggest that the difference score on a valid MSVT profile yields diagnostically relevant information pertaining to the level of an individual’s neurocognitive impairment.
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Stephens C, Kashentseva E, Lu Z, Curiel D. Achievement of long term gene expression via adenoviral vector-mediated delivery of CRISPR/Cas9 for in vivo editing and gene knock-in. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.579] [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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Hunt L, Ritchie C, Patel K, Stephens C, Cataldo J, Smith A. PAIN AND EMERGENCY DEPARTMENT USE IN THE LAST MONTH OF LIFE BY OLDER ADULTS WITH DEMENTIA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2370] [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: 11/14/2022] Open
Affiliation(s)
- L Hunt
- San Francisco VA Health Care Center
| | - C Ritchie
- Division of Geriatrics, University of California, San Francisco
| | - K Patel
- Division of Geriatrics, University of California, San Francisco
| | - C Stephens
- Department of Community Health Systems, School of Nursing, University of California, San Francisco
| | - J Cataldo
- Department of Physiological Nursing, University of California, San Francisco
| | - A Smith
- Division of Geriatrics, University of California, San Francisco
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20
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Stephens C, Szabo A, Allen J, Alpass F. LIVEABLE ENVIRONMENTS AND THE QUALITY OF LIFE OF OLDER PEOPLE: AN ECOLOGICAL PERSPECTIVE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.443] [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
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21
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Meystre C, Koren C, Stephens C. INTEREST GROUP SESSION - QUALITATIVE RESEARCH: QUALITATIVE APPROACHES IN INVESTIGATING INTERGENERATIONAL FAMILY RELATIONSHIPS IN ADVANCED AGE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.019] [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: 11/13/2022] Open
Affiliation(s)
- C Meystre
- Institute of Psychology, University of Lausanne, Lausanne, Vaud
| | - C Koren
- University of Haifa, Hod Hasharon, HaMerkaz
| | - C Stephens
- Massey University, Palmerston North, Manawatu-Wanganui
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David D, Wertz V, Barrientos P, Allison T, Flint LA, Lee SJ, Ritchie C, Stephens C. USING THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR) TO GUIDE THE IMPLEMENTATION OF IMPACTT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2873] [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: 11/13/2022] Open
Affiliation(s)
- D David
- San Francisco VA Medical Center, San Francisco, California, United States
| | - V Wertz
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - P Barrientos
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - T Allison
- UCSF School of Medicine, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | - L A Flint
- UCSF School of Medicine Division of Geriatrics, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | - S J Lee
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Ritchie
- UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Stephens
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
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Stephens C, David D, Wertz V, Allison T, Flint LA, Barrientos P, Lee SJ, Ritchie C. IMPROVING PALLIATIVE CARE ACCESS THROUGH TECHNOLOGY (IMPACTT): PRELIMINARY FINDINGS FROM A PILOT STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2872] [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: 11/13/2022] Open
Affiliation(s)
- C Stephens
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California, United States
| | - D David
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - V Wertz
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - T Allison
- UCSF School of Medicine, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | - L A Flint
- UCSF School of Medicine Division of Geriatrics, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | - P Barrientos
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - S J Lee
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Ritchie
- UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
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Wertz V, Bui N, Uy E, Barrientos P, David D, Lee SJ, Ritchie C, Stephens C. ASSESSING TECHNICAL FEASIBILITY AND ACCEPTABILITY OF PROVIDING TELEHEALTH PALLIATIVE CARE IN NURSING HOMES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2875] [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: 11/13/2022] Open
Affiliation(s)
- V Wertz
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, California, United States
| | - N Bui
- Asian Health Services, Oakland, CA, USA; UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - E Uy
- UCSF School of Nursing, San Francisco, CA, USA
| | - P Barrientos
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - D David
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - S J Lee
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Ritchie
- UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Stephens
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
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Bui N, Halifax E, Uy E, Hunt L, David D, Lee SJ, Ritchie C, Stephens C. UNDERSTANDING NURSING HOME STAFF ATTITUDES TOWARDS DEATH AND DYING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2874] [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: 11/14/2022] Open
Affiliation(s)
- N Bui
- Asian Health Services, Oakland, California, United States
| | - E Halifax
- UCSF School of Nursing, San Francisco, CA, USA
| | - E Uy
- UCSF School of Nursing San Francisco, CA, USA
| | - L Hunt
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Nursing, San Francisco, CA, USA
| | - D David
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
| | - S J Lee
- San Francisco VA Medical Center, San Francisco, CA, USA; UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Ritchie
- UCSF School of Medicine, Division of Geriatrics, San Francisco, CA, USA
| | - C Stephens
- UCSF School of Nursing, Dept. of Community Health Systems, San Francisco, CA, USA
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Krebs M, Lopez J, El-Khoueiry A, Bang YJ, Postel-Vinay S, Abidah W, Im SA, Khoja L, Standifer N, Jones G, Marco-Casanova P, Frewer P, Berges A, Cheung A, Stephens C, Felicetti B, Dean E, Pierce A, Hollingsworth S. Phase I clinical and translational evaluation of AZD6738 in combination with durvalumab in patients (pts) with lung or head and neck carcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy279.401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Sunakawa Y, Stintzing S, Cao S, Luecke J, Thompson D, Moran M, Astrow S, Hsiang J, Stephens C, Zhang W, Tsuji A, Takahashi T, Denda T, Shimada K, Kochi M, Takeuchi M, Fujii M, Ichikawa W, Heinemann V, Lenz HJ. A biomarker study to validate predictors for clinical outcome of cetuximab based chemotherapy in first-line metastatic colorectal cancer (mCRC) patients: JACCRO CC-05/06AR and FIRE-3. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.031] [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: 11/12/2022] Open
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Osborne D, Acuff S, Whittle B, Taylor R, Green C, Findeiss L, Leschak S, Stephens C. 3:54 PM Abstract No. 127 Preliminary assessment of hospital staff body and hand radiation exposure during Y90 radioembiolization dose preparation and administration. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.144] [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: 11/17/2022] Open
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Affiliation(s)
- C Irvine
- Department of Dermatology, William Harvey Hospital, Ashford, South East Kent
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Sanabria-Cabrera J, Sanjuan-Jiménez R, Stephens C, Robles-Díaz M, Ortega-Alonso A, Jiménez-Pérez M, Medina-Cáliz I, Slim M, Andrade R, Lucena M. Hepatitis E Virus, A Diagnosis to Consider in Drug Induced Liver Injury Assessment. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.175] [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: 10/19/2022]
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Szabo A, Allen J, Stephens C, Alpass F. DOES PHYSICAL FUNCTIONING DECLINE AFTER RETIREMENT? A LONGITUDINAL INVESTIGATION FROM 2006 TO 2016. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2035] [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)
- A. Szabo
- School of Psychology, Massey University, Wellington, New Zealand
| | - J. Allen
- School of Psychology, Massey University, Wellington, New Zealand
| | - C. Stephens
- School of Psychology, Massey University, Wellington, New Zealand
| | - F. Alpass
- School of Psychology, Massey University, Wellington, New Zealand
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Alpass F, Szabo A, Allen J, Stephens C. INFORMAL CAREGIVING AND HEALTH: LONGITUDINAL FINDINGS FROM THE HEALTH, WORK, AND RETIREMENT STUDY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.563] [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: 11/14/2022] Open
Affiliation(s)
- F. Alpass
- Massey University, Palmerston North, New Zealand
| | - A. Szabo
- Massey University, Palmerston North, New Zealand
| | - J. Allen
- Massey University, Palmerston North, New Zealand
| | - C. Stephens
- Massey University, Palmerston North, New Zealand
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Walsh J, Hosseini C, Allen J, Alpass F, Stephens C, Brown L. THE IMPACT OF RELIGIOSITY ON MEANING-MAKING AMONG OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2864] [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: 11/13/2022] Open
Affiliation(s)
- J. Walsh
- Palo Alto University, Los Gatos, California,
| | - C. Hosseini
- Palo Alto University, Los Gatos, California,
| | - J. Allen
- Massey University, Palmerston, New Zealand
| | - F. Alpass
- Massey University, Palmerston, New Zealand
| | | | - L.M. Brown
- Palo Alto University, Los Gatos, California,
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Yap T, Krebs M, Postel-Vinay S, Bang Y, El-Khoueiry A, Abida W, Harrington K, Sundar R, Carter L, Castanon-Alvarez E, Im S, Berges A, Khan M, Stephens C, Ross G, Soria J. Phase I modular study of AZD6738, a novel oral, potent and selective ataxia telangiectasia Rad3-related (ATR) inhibitor in combination (combo) with carboplatin, olaparib or durvalumab in patients (pts) with advanced cancers. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32607-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Cole P, Gornall BT, Wood MD, Whitcher R, Bannon A, Bloomer S, Fear J, Hale H, Humphries J, Hunak S, Jones C, Matthewman C, Matthews A, Slater S, Stephens C, Stewart J. Strategies for engaging with future radiation protection professionals: a public outreach case study. J Radiol Prot 2015; 35:N25-N32. [PMID: 26444019 DOI: 10.1088/0952-4746/35/4/n25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
It is evident that there is a nuclear skills shortage within the UK, and logically it can be assumed that the shortfall extends to the radiation protection arena. Plans for nuclear new-build and the decommissioning of existing nuclear sites will require many more people with radiological knowledge and practical competencies. This converts to a nuclear industry requirement in the order of 1000 new recruits per year over at least the next ten years, mainly as new apprentices and graduates. At the same time, the strong demand for persons with radiation protection know-how in the non-nuclear and health care sectors is unlikely to diminish. The task of filling this skills gap is a significant one and it will require a determined effort from many UK stakeholders. The Society for Radiological Protection (SRP) has adopted a strategy in recent years to help address this skills gap. The aim is to engage the interest of secondary school students in the science of radiation and inspire them to follow a career in radiation protection. This paper presents the reasoning behind this strategy and, in an 'outreach case study', describes the establishment of the annual SRP Schools Event. This event is becoming an important addition to the national efforts aimed at increasing the numbers of skilled UK radiation protection professionals over the forthcoming decades.
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Affiliation(s)
- P Cole
- Radiation Protection Office, University of Liverpool, Liverpool, L69 3BX, UK
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Abdul-Wahab A, Takeichi T, Liu L, Stephens C, Akiyama M, McGrath JA. Intrafamilial phenotypic heterogeneity of epidermolytic ichthyosis associated with a new missense mutation in keratin 10. Clin Exp Dermatol 2015; 41:290-3. [DOI: 10.1111/ced.12751] [Citation(s) in RCA: 3] [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] [Accepted: 03/29/2015] [Indexed: 11/28/2022]
Affiliation(s)
- A. Abdul-Wahab
- St John's Institute of Dermatology; King's College London (Guy's Campus); London UK
| | - T. Takeichi
- St John's Institute of Dermatology; King's College London (Guy's Campus); London UK
- Department of Dermatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - L. Liu
- Viapath; St Thomas’ Hospital; London UK
| | - C. Stephens
- Department of Dermatology; Poole Hospital NHS Foundation Trust; Poole UK
| | - M. Akiyama
- Department of Dermatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - J. A. McGrath
- St John's Institute of Dermatology; King's College London (Guy's Campus); London UK
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Stephens C, Ortega-Alonso A, Medina-Cáliz I, Robles-Díaz M, Castiella A, Otazua P, Zapata E, Gomez-Moreno E, López-Nevot M, Ruiz-Cabello F, Soriano G, Roman E, Hallal H, Andrade R, Lucena M. Autoantibody presentation in Drug-Induced Liver Injury (DILI) and idiopathic Autoimmune Hepatitis (AIH): The influence of HLA alleles. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.342] [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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Medina-Cáliz I, Robles-Díaz M, Stephens C, González-Jiménez A, Sanabria-Cabrera J, Ortega-Alonso A, García-Cortés M, Mirwani S, Thorpe B, Jiménez-Pérez M, Fernández M, Navarro J, Montané E, Barriocanal A, Prieto M, García-Eliz M, Bessone F, Hernández N, Carrera E, Mengual E, Blanco E, Montes M, Bellido I, García-Muñoz B, Andrade R, Lucena M. Hepatotoxicity related to Herbals and Dietary Supplements (HDS): a cause for concern. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.351] [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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Robles-Diaz M, Gonzalez-Jimenez A, Medina-Caliz I, Stephens C, García-Cortes M, García-Muñoz B, Ortega-Alonso A, Blanco-Reina E, Gonzalez-Grande R, Jimenez-Perez M, Rendón P, Navarro JM, Gines P, Prieto M, Garcia-Eliz M, Bessone F, Brahm JR, Paraná R, Lucena MI, Andrade RJ. Distinct phenotype of hepatotoxicity associated with illicit use of anabolic androgenic steroids. Aliment Pharmacol Ther 2015; 41:116-25. [PMID: 25394890 DOI: 10.1111/apt.13023] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 09/15/2014] [Accepted: 10/21/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND We have observed an increase in hepatotoxicity (DILI) reporting related to the use of anabolic androgenic steroids (AAS) for bodybuilding. AIM To characterise phenotype presentation, outcome and severity of AAS DILI. METHODS Data on 25 cases of AAS DILI reported to the Spanish (20) and Latin-American (5) DILI Registries were collated and compared with previously published cases. RESULTS AAS DILI increased from representing less than 1% of the total cases in the Spanish DILI Registry in the period 2001-2009 to 8% in 2010-2013. Young men (mean age 32 years), requiring hospitalisation, hepatocellular injury and jaundice were predominating features among the AAS cases. AAS DILI caused significantly higher bilirubin values independent of type of damage when compared to other drug classes (P = 0.001). Furthermore, the cholestatic AAS cases presented significantly higher mean peak bilirubin (P = 0.029) and serum creatinine values (P = 0.0002), compared to the hepatocellular cases. In a logistic regression model, the interaction between peak bilirubin values and cholestatic damage was associated with the development of AAS-induced acute kidney impairment (AKI) [OR 1.26 (95% CI: 1.035-1.526); P = 0.021], with 21.5 ×ULN being the best bilirubin cut-off point for predicting AKI risk (AUCROC 0.92). No fatalities occurred. CONCLUSIONS Illicit recreational AAS use is a growing cause of reported DILI that can lead to severe hepatic and renal injury. AAS DILI is associated with a distinct phenotype, characterised by considerable bilirubin elevations independent of type of damage. Although hepatocellular injury predominates, acute kidney injury develops in cholestatic cases with pronounced jaundice.
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Affiliation(s)
- M Robles-Diaz
- Servicio de Farmacología Clínica and Unidad de Gestión Clínica (UGC) de Gastroenterología y Hepatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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Lisle J, Mertens-Walker I, Stephens C, Stansfield S, Herington A, Clements J, Stephenson S. 142: Proteolytic regulation of the EphB4 receptor in prostate cancer. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50120-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Maus MKH, Grimminger PP, Mack PC, Astrow SH, Stephens C, Zeger G, Hsiang J, Brabender J, Friedrich M, Alakus H, Hölscher AH, Lara P, Danenberg KD, Lenz HJ, Gandara DR. KRAS mutations in non-small-cell lung cancer and colorectal cancer: implications for EGFR-targeted therapies. Lung Cancer 2013; 83:163-7. [PMID: 24331409 DOI: 10.1016/j.lungcan.2013.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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: 07/27/2013] [Accepted: 11/11/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND KRAS mutations are associated with diverse biologic functions as well as prognostic and predictive impact in non-small cell-lung cancer (NSCLC) and colorectal cancer (CRC). In CRC, benefit from monoclonal antibody therapies targeting EGFR is generally limited to patients whose tumors have wild-type (WT) KRAS, whereas data suggest that this association is not present for NSCLC. We hypothesized that the unique tobacco-related carcinogenesis of NSCLC results in a divergence of KRAS MT genotype compared with CRC, contributing to differences in outcomes from EGFR-targeted therapies. MATERIAL AND METHODS Tumor from 2603 patients (838 CRC and 1765 NSCLC) was analyzed for KRAS mutations. DNA was extracted from microdissected formalin-fixed-paraffin-embedded specimens (FFPE) and 7 different base substitutions in codons 12 and 13 of KRAS were determined. RESULTS KRAS mutation genotype differed significantly between NSCLC and CRC in frequency (25% vs. 39%; p<0.001), smoking-associated G>T transversions (73% versus 27%; p<0.001), and ratio of transversions to transitions (3.5 vs. 0.79; p<0.001). In NSCLC GLY12Cys mutations, resulting from a codon 12 GGT>TGT substitution, were observed in 44% compared to 10% for CRC. In contrast, codon 12 or 13 GLY>ASP substitutions (resulting in a G>A transition) were more frequent in CRC (42%) compared with NSCLC (21%). CONCLUSION In this large dataset, KRAS mutation patterns are quantitatively and qualitatively distinct between NSCLC and CRC, reflecting in part differences in tobacco-related carcinogenesis. In light of differences in predictive value for EGFR-directed monoclonal antibody therapy and prognosis for specific KRAS mutations between NSCLC and CRC, these data provide an underlying biologic rationale.
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Affiliation(s)
- M K H Maus
- Department of General, Visceral and Tumor Surgery, University of Cologne, Germany; Response Genetics, Inc., Los Angeles, CA, USA.
| | | | - P C Mack
- Department of Molecular Biology and Biochemistry, University of California, Davis, Sacramento, USA
| | - S H Astrow
- Department of General, Visceral and Tumor Surgery, University of Cologne, Germany
| | - C Stephens
- Department of General, Visceral and Tumor Surgery, University of Cologne, Germany
| | - G Zeger
- Department of General, Visceral and Tumor Surgery, University of Cologne, Germany; Department of Pathology, Keck School of Medicine, University of Southern California, USA
| | - J Hsiang
- Department of General, Visceral and Tumor Surgery, University of Cologne, Germany
| | - J Brabender
- Response Genetics, Inc., Los Angeles, CA, USA
| | - M Friedrich
- Department of Thoracic, Vascular and Heart Surgery, University of Göttingen, Germany
| | - H Alakus
- Department of General, Visceral and Tumor Surgery, University of Cologne, Germany
| | | | - P Lara
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - K D Danenberg
- Formerly Response Genetics, Inc., Los Angeles, CA, USA
| | - H J Lenz
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - D R Gandara
- Department of Molecular Biology and Biochemistry, University of California, Davis, Sacramento, USA
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Robles-Díaz M, Stephens C, Medina-Cáliz I, González A, González-Jiménez A, Ulzurrun E, Kaplowitz N, Andrade R, Lucena M. PP025—Improving hy’s law definition to better predict the risk of developing acute liver failure in drug-induced liver injury (DILI). Clin Ther 2013. [DOI: 10.1016/j.clinthera.2013.07.060] [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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Medina-Cáliz I, González-Jiménez A, Bessone F, Hernández N, Sánchez A, Di Pace M, Arrese M, Brahm J, Ruíz A, Arancibia J, Kershenobich D, Loaeza A, Girala M, Mendez-Sanchez N, Dávalos M, Lizarzabal M, Mengual E, Stephens C, Robles-Díaz M, Andrade R, Lucena M. PP022—Variations in drug-induced liver injury (DILI) between different prospective dili registries. Clin Ther 2013. [DOI: 10.1016/j.clinthera.2013.07.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alpass F, Pond R, Stephens C, Stevenson B, Keeling S, Towers A. The Influence of Ethnicity and Gender on Caregiver Health in Older New Zealanders. J Gerontol B Psychol Sci Soc Sci 2013; 68:783-93. [DOI: 10.1093/geronb/gbt060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
In understanding health and illness, it has long been apparent that psychological and social aspects are as important as the biological explanations of the biomedical model. Recent studies of women's experience of menopause have demonstrated the psychological and social constructions of women's bodies, but have neglected to include individual embodiment and the notion of a social world that is inescapably embodied. This paper presents arguments for the consideration of an integrated approach to embodiment and, drawing upon recent theorizing, a conceptual framework that is able to take into account the integration of psyche, biology, and culture. The accounts of 80 New Zealand women, aged between 45 and 60, are analysed, using categories labelled, 'visceral', 'experiential', 'normative' and 'pragmatic', to provide a description of women's embodied and culturally embedded experience of menopause. The incorporation of these analytic categories, and the usefulness of the application of the model in contemporary applied work, is discussed.
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Fuhrman-Luck R, Stansfield S, Stephens C, Loessner D, Clements J. 251 Kallikrein-related Peptidase 4 and Prostate Cancer – an Extended Role in Tumour Progression. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70946-2] [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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Tan DS, Aamdal S, Freyer G, Jones RJ, Kaye SB, Pujade-Lauraine E, Fog J, Wrang Teilum M, Glue C, Baker A, Emeribe UA, Elvin P, Stephens C, Stuart M, Walker J, Boven E. The potential of circulating microRNA (miRNA) levels as a biomarker in drug development: An analysis of tumor-serum samples from patients on a phase I trial of saracatinib-paclitaxel (P)-carboplatin (C). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10548] [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: 11/20/2022] Open
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Danenberg PV, Stephens C, Cooc J, Gandara DR, Mack PC, Grimminger PP, Danenberg KD. A novel RT-PCR approach to detecting EML4-ALK fusion genes in archival NSCLC tissue. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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