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Randomized Trial of Five or Two MRI-guided Adaptive Radiotherapy Treatments for Prostate Cancer (FORT). Int J Radiat Oncol Biol Phys 2023; 117:e378. [PMID: 37785281 DOI: 10.1016/j.ijrobp.2023.06.2486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The objective of this randomized clinical trial is to demonstrate that 2 treatments of real-time MRI-guided radiotherapy (RT) does not significantly increase patient-reported GI and GU symptoms compared to 5 treatments of RT 2 years after treatment completion (24 months). MATERIALS/METHODS Key Eligibility Criteria: Inclusion Criteria 1. Men aged > 18 with histologically confirmed low or intermediate risk prostate cancer per NCCN guidelines. 2. ECOG 0 - 1 3. IPSS < 18 4. Ability to receive MRI-guided radiotherapy. 5. Ability to complete the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Exclusion Criteria 1. Prior history of receiving pelvic RT. 2. Patient with history of IBD. 3. Hip replacements. 4. History of bladder neck or urethral stricture. 5. TURP < 8 weeks prior to RT 6. Metastatic (pelvic nodal or distant) disease on CT, Bone, and/or PSMA PET scan. Study Design/Endpoints: This is a randomized phase II non-inferiority trial comparing 2 fractions of ultrahypofractionated RT (25 Gy total with optional PSMA/MRI boost to 28 Gy) versus 5 fractions of ultra-hypofractionated RT (37.5 Gy total with optional PSMA/MRI boost to 45 Gy) in the definitive setting for prostate cancer. Subjects will be stratified based on pre-specified stratification factors and randomized 1:1 to receive 2 or 5 fractions using permuted block randomization. The primary endpoint is the change in patient-reported GI and GU symptoms as measured by EPIC at 2 years from end of treatment. Secondary endpoints will include both the safety endpoints including change in GI and GU symptoms at 3, 6, 12 and 60 months from end of treatment, and multiple efficacy endpoints including time to progression, prostate cancer specific survival and overall survival. SAMPLE SIZE The sample size is calculated based on a non-inferiority design. The non-inferiority margins are set to be a change score of 6 points for the GI symptoms and 5 points for the GU symptoms. The standard deviations of the change scores are assumed to be 13.2 for the GI symptoms and 10.5 for the GU symptoms based on estimates generated in RTOG 0415 trial. This level of change in scores are deemed as clinically meaningful. For example, 6 points of change score for GI symptoms corresponds to two symptoms worsening by 1 level (i.e., loose stools and frequency of bowel movements change from "no problem" to "very small problem") or one of the symptoms worsening by 2 levels (i.e., loose stool change from "no problem" to "small problem"). A sample size of 122 with 61 in each arm will ensure 80% power for GI endpoint and 83% power for GU endpoint to detect non-inferiority using a one-sided two-sample t-test at the significance level of 0.05. Adjusting for a projected 10% EPIC/non-compliance rate, 136 patients (68 per arm) will be randomized. Stratification Factors: Patients will be stratified according to baseline EPIC bowel and urinary domain scores and country of treatment. Enrollment: Twenty patients. RESULTS To be determined. CONCLUSION To be determined.
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Highlights from the Tenth International Workshop on HIV Persistence during Therapy, December 13-16, 2022, Miami, Florida-USA. J Virus Erad 2023; 9:100315. [PMID: 36911658 PMCID: PMC9996320 DOI: 10.1016/j.jve.2023.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The International Workshop on HIV Persistence during Therapy provides a forum in which HIV/AIDS researchers gather to share the latest research findings related to viral reservoirs and cure. The Tenth Workshop, which was attended by over 400 delegates, extended over 4 days and comprised eight sessions covering topics from the basic science of viral persistence to therapeutic approaches to HIV cure. Furthermore, satellite sessions on the first day of the Conference featuring cure research endeavours being pursued by the Bill and Melinda Gates Foundation as well as those being coordinated under the National Institutes of Health Martin Delaney Collaboratory program, provided important updates on research advances being made in these initiatives. As with previous conferences, the International Workshop on HIV Persistence during Therapy is primarily abstract-driven with only one invited talk for each of the sessions. This format, therefore, increases the number of presentations from early-stage investigators. Furthermore, presentations by Community representatives illustrated approaches to creating cure research literacy with effective messaging for the Community. The following article offers a synopsis of the meeting sessions. Due to space constraints, some presentations may have only been briefly discussed. Nevertheless, the Workshop abstracts can be found online (https://www/sciencedirect.com/journal/journal-of-virus-eradication/vol/8/suppl/S).
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PP 1.33 – 00167 Integrated single-cell multi-omic profiling of HIV latency reversal. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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PP 3.10 – 00168 Vpr synergizes with vorinostat to prevent HIV-1 latency establishment. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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466 KIR allelic variation is associated with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract No. 110 Intraductal carcinoma of the prostate in the era of mpMRI-targeted prostate biopsies: clinical, pathologic and radiologic characteristics. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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101 Uncommon alleles in FLG2 and TCHHL1 are associated with remission of atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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201 A basophil-neuronal axis promotes itch. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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In vitro demonstration of a potential role for STING agonist in HIV cure. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30194-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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The latency reversal activity of the SMAC mimetic AZD5582 in ART-suppressed SIV-infected rhesus macaques is potentiated by CD8a cell depletion. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30113-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Evaluation of IAP/SMAC mimetics as latency reversal agents in primary cells and cytokine induction in in vivo models predictive of cytokine release. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Epigenomic characterisation of a primary cell model of HIV latency. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30097-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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LB1067 Predictors of clearance without treatment versus with treatment in patients with atopic dermatitis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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The SMAC mimetic AZD5582 reverses HIV latency as a single agent in resting primary CD4+ T cells. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)31047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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281 Hidradenitis suppurativa encounters notable for infrequent biologic prescriptions and frequent opiate prescriptions. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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239 Age of atopic dermatitis onset influences longitudinal disease control and persistence in children. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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200 Risks and timing of future skin cancers in patients with actinic keratosis. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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253 Incidence of multiple primary keratinocyte carcinomas in organ transplant patients. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Comparison of Single Slice Versus Volume Based Evaluation of 3T MRI Apparent Diffusion Coefficient (ADC) Values in a Prospective Imaging Trial of Definitive Chemoradiation for Locally Advanced Cervical Cancer Patients. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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1017 Natural killer cell dysregulation underlies atopic dermatitis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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747 Intragenic copy number variation and filaggrin variation are associated with atopic dermatitis in African Americans. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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282 Moderate to severe atopic dermatitis is associated with allergic, autoimmune and cardiovascular comorbidities in US adults. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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306 Racial disparities in medical visits among children with atopic dermatitis in the Pediatric Eczema Elective Registry. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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275 Epidemiology of antibiotic prescribing in Dermatology: A retrospective analysis 2008-2016. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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259 Uncommon filaggrin variants are associated with persistent atopic dermatitis in African-Americans. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Adoptive T cell as a strategy for targeted delivery of immune checkpoint therapy. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Targeted screens identify new chromatin regulators of HIV latency. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30583-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Characterisation of immune exhaustion in natural killer cells and role in HIV infection. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30633-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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High-throughput single-cell transcriptome analysis of immune cells from HIV-1 infected individuals before and after therapy. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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CD8 T cells from HIV positive individuals on ART have a skewed differentiation phenotype and impaired proliferative responses. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30645-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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HIV specific T cells generated from HIV naive adult and cord blood donors target a range of novel viral epitopes—implications for a cure strategy after allogeneic HSCT and CBT. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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O060 Cross-sectional study of disease control among adults with atopic dermatitis and impact on patient-reported burden. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Establishing Predictors of Satellite Lesions in Men With Intermediate- and High-Risk Prostate Cancer for Improved Patient Selection for Focal and Focused Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hyperandrogenism is associated with preferential fat deposition of visceral versus subcutaneous (SC) abdominal fat in lean polycystic ovary syndrome (PCOS) women. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ex Vivo Expanded HIV-Specific T Cells From HIV+ Patients and Virus-Naïve Donors are Functionally Active: Implications for a Cure Strategy Post HSCT. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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169 Variation in the ‘atopic march’ by age of atopic dermatitis onset. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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380 Exome sequencing and rare variant analysis reveals multiple filaggrin mutations in Bangladeshi atopic eczema families and novel risk genes. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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197 Sociodemographic characteristics predict persistent atopic dermatitis disease activity into early adulthood: A longitudinal cohort study. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ultrastructural and Immunohistochemical Effects of Aqueous Leave Extract of Xylopia aethiopica on the Stomach in Streptozotocin-Induced Diabetic Rats. INT J MORPHOL 2016. [DOI: 10.4067/s0717-95022016000100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The utility of the Connectivity Map (CMAP) for HIV cure strategies. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)31404-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Dual-affinity re-targeting (DART) proteins overcome viral diversity to deplete the latent HIV-1 reservoir. J Virus Erad 2015. [DOI: 10.1016/s2055-6640(20)31288-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Comment évaluer le contrôle à long terme de la dermatite atopique dans les essais randomisés ? Une revue systématique. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Proposal for the generation of HIV-specific T cells from art patients. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Correlation of Quantitative Diffusion-Weighted and Dynamic Contrast-Enhanced MRI Parameters With NCCN Risk Group, Gleason Score, and Maximum Tumor Diameter in Prostate Cancer. Pract Radiat Oncol 2013; 3:S4. [PMID: 24674560 DOI: 10.1016/j.prro.2013.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chemotherapy-Only Preparative Regimen for Alternative Donor Hematopoietic Stem Cell Transplantation for Patients with Fanconi Anemia. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND Psoriasis is a common disease frequently studied in large databases. To date the validity of psoriasis information has not been established in The Health Improvement Network (THIN). OBJECTIVES To investigate the validity of THIN for identifying patients with psoriasis and to determine if the database can be used to determine the natural history of the disease. METHODS First, we conducted a cross-sectional study to determine if psoriasis prevalence in THIN is similar to expected. Second, we created a cohort of 4900 patients, aged 45-64 years, with a psoriasis diagnostic Read Code and surveyed their general practitioners (GPs) to confirm the diagnosis clinically. Third, we created models to determine if psoriasis descriptors (extent, severity, duration and dermatologist confirmation) could be accurately captured from database records. RESULTS Psoriasis prevalence was 1·9%, and showed the characteristic age distribution expected. GP questionnaires were received for 4634 of 4900 cohort patients (95% response rate), and psoriasis diagnoses were confirmed in 90% of patients. Duration of disease in the database showed substantial agreement with physician query (κ = 0·69). GPs confirmed that the psoriasis diagnosis was corroborated by a dermatologist in 91% of patients whose database records contained a dermatology referral code associated with a psoriasis code. We achieved good discrimination between patients with and without extensive disease based on the number of psoriasis codes received per year (area under curve = 0·8). CONCLUSIONS THIN is a valid data resource for studying psoriasis and can be used to identify characteristics of the disease such as duration and confirmation by a dermatologist.
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Focal nodular hyperplasia in pediatric allogeneic hematopoietic cell transplant: case series. Bone Marrow Transplant 2010; 45:1357-9. [PMID: 20140023 DOI: 10.1038/bmt.2009.336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
BACKGROUND The safety of topical therapies for atopic dermatitis (AD), a common and morbid disease, has recently been the focus of increased scrutiny, adding confusion as how best to manage these patients. OBJECTIVES The objective of these systematic reviews was to determine the safety of topical therapies for AD. METHODS Databases searched included: OVID Medline, Medline In-Process and Other Non-Indexed Citations, Embase, and the Cochrane Central Register of Controlled Trials. In addition to the articles identified by this search, investigators were also referred to a list of links (most recently updated 25 September 2005) to recent Food and Drug Administration (FDA) studies, reports and meetings regarding the topical calcineurin inhibitors for further potential references. Only fully published papers available in English and data obtained from FDA sites were included. Furthermore, the criteria for inclusion and exclusion for each systematic review were further evaluated at a meeting of all of the content and evidence-based medicine experts participating in this process and alteration of the inclusion criteria was done at that time when it was felt necessary to avoid inclusion of lower-quality data in the review. Qualitative review of the abstracted data was performed and reviewed at a meeting of all of the content and evidence-based medicine experts. RESULTS While systemic exposure to these topical agents does occur, physiological changes appear to be uncommon and systemic complications rare and have only been found with use of topical corticosteroids. CONCLUSIONS Based on the data that are available the overall safety of AD therapies appears to be good with the only documented systemic side-effects of therapy those occasionally seen with use of topical corticosteroids.
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